The Impact of Engagement Processes on the First-appointment Attendance Rate at a Regional Outpatient Psychological Trauma Service

The inconsistent and contradictory nature of the results of studies that focus on client characteristics as possible explanations for first-appointment non-attendance is referenced and contrasted with the effectiveness of simple agency interventions to increase first-appointment attendance. The Family Trauma Centre's remit and pre-study engagement process are described. The perceived idiosyncratic aspects of inviting people suffering from psychological trauma to attend a clinical service are noted as contributory factors in initially tolerating a high first-appointment did-not-attend rate. Three new initial engagement processes are then described and results of their application to 30 referrals in total (10 for each process) are presented. The overwhelming finding is that paying close attention to any of the three initial engagement processes increases first-appointment attendance. Based on these findings, the Family Trauma Centre developed a new initial engagement protocol. The principle that services should pay more attention to their engagement processes than on the characteristics of their client groups when seeking to reduce first-appointment did-not-attend rates is supported.