The determinants of participation in individual psychotherapy in an acute patients9therapeutic community

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Abstract
In an acute patients' therapeutic community 1173 patients were treated in 1977-90. During their 2090 treatment episodes 94% participated moderately or very actively in individual psychotherapy. The associations of participation were analyzed, on the basis of polytomous logistic regression analysis. Non-participation (2% of all episodes) was associated with the first treatment episode, a stable therapeutic community policy, and a short treatment time of less than 18 days. The determinants of passive participation (4%) were young age of less than 23 years, rural dwelling place, involuntary admission, treatment time of less than 81 days, and a diagnosis of personality disorder, typical schizophrenia, or other psychosis. A moderately active participation (35% of all; very active, 59% as a referent) was associated with male sex and young age of less than 23 years, low professional and social background, involuntary admission, unstable treatment policy, short treatment time of less than 40 days, and a diagnosis of borderline psychosis or typical schizophrenia. In summary, modifications in inpatient psychotherapy and an integration into the whole treatment entity are necessary when encountering young, minimally educated, nonmotivated, often male patients prone to nonparticipation.