Improving Attendance and Retention Rates in Group Therapy

Each year, students in the social work interns at the West Los Angeles VA Medical Center develop a cognitive behavioral therapy group with veterans. The group focused on educating veterans about ways in which they could actively participate in reducing their own symptoms of depression. Cognitive-Behavioral Therapy focuses on the effects that our thoughts have on our feelings and behaviors (NACBT, 2000).

Each group was provided with a binder of assessment tools, educational materials, and group exercises. We began recruiting group members by following the basic referral system already in place at the clinic. The referral system worked as follows: when a veteran is requesting mental health services for the first time at our clinic, or after a significant period of absence, they meet with a clinician for an intake interview. It is during this intake interview that a clinician makes the decision with the veteran as to whether or not to refer him/her to a group. In the three weeks that we had to prepare for the group, we received 13 referrals from case managers and clinicians. We contacted the veterans by phone to explain the group and invite them to join. Out of 13 referrals, we reached 4 veterans who expressed interest in attending the group-approximately 30%. Three of these veterans attended the first group session, and only one of them returned to complete the second week of the group-a 7% retention rate.

Marketing Techniques

The clinic provided services for hundreds of veterans with diagnoses of chronic and persistent mental illness. Our team of social work interns sought to devise a variety of new tactics to both lure veterans to join the group as well as encourage them to return to the group in subsequent weeks.

We began by addressing the way that the group was marketed to veterans and their case managers. Initially, we presented the group to case managers as a Cognitive Behavioral therapy group for clients experiencing depression. Our presentation was clinical and deficit-focused.