[What happens with an advice to begin psychotherapy after psychotherapeutic councelling in a psychosomatic CL-Unit?]

In 1995, 285 patients had been advised by our institute to begin psychotherapy. After a period of one year they were contacted and asked if they had started or refused psychotherapy. Those who refused psychotherapy were asked about their reasons for doing so. 67,3% responded and 49,2% of the patients commencced psychotherapy. Signifiantly more younger patients as well as patients with a higher educational qualification took the advice of the institute to start psychotherapy. Gender did not influence the patient's decision to accept or refuse psychotherapy. The participants suffered more profound depression and anxiety than their counterparts. Lack of seeing a need for psychotherapy was the most common reason for refusals, accounting for 26,7% of the cases. The second miost common reason was reported to be practical and organisational in nature as well as mistakes done by the therapists. Comparing the group in view of the reasons for refusing psychotherapy no difference in age and gender was evident. However, patients with a lower educational qualification were less judicious as far as the need for psychotherapy was concerned. Less frequently they believed in a psychogenic cause for their complaints. The results of this study can help the therapist identifying patients who need to be admitted more intensely during the first diagnostic session in order to achieve a higher motivation for psychotherapy.