As already written in other articles all over the world, walk-in services are becoming more and more popular .
The logic that characterizes walk-in services, as anticipated in a previous article, can be summarized in 3 points:
- receive a visit without an appointment , simply by entering the Center, clinical study or web page;
- receive the service usually in a short time (not waiting hours);
- cheapness , and in some cases free of charge, of the services
In an article, Direct access psychotherapy: the logic and advantages of walk-in services , we explained some advantages of services set up according to this logic, outlining the future trends of walk-in services, convinced that the spread they have in the rest of the world will soon it will also concern Italy.
Do the Walk-in Services meet the needs?
Canadian Institutes of Health Research research on care services in Canada highlights the benefits of walk-in services.
As experienced by everyone, it will surely have happened to you too, the problem of traditional services lies in the long waiting lists and very often long treatment times.
The “walk-in” logic could easily overcome the problems associated with the long waiting lists present in all public health services, including those aimed at mental health.
In order to improve the accessibility of mental health services, in Canada (and in other parts of the world) more and more mental health counseling services are born with a view to direct access without an appointment .
The Canadian Institutes of Health Research asked itself the question, to evaluate the effectiveness and efficiency of Single Session Therapy within the walk-in services starting from 3 questions:
1) Is the single-session walk-in model of service delivery clinically effective in terms of reducing psychological distress?
2) Who benefits most from the single-session walk-in approach?
3) How does the single-session walk-in model compare to the traditional model of waiting lists?
To give an answer, the two models (walk-in services vs traditional model) of intervention provided by two mental health services were compared.
On the one hand, the single-session counseling provided at a Kitchener counseling facility and on the other the traditional model of a counseling service provided by a London facility where a waiting list is used to manage the demand were examined. of services.
Some features:
- Clients aged 16 and over who agreed to attend were first interviewed while waiting for the one-time session in Kitchener, or during the phone call they received to seek advice from the London service and were placed on a waiting list .
- 359 people agreed to participate in the first interview with Kitchener and 165 in London, and the vast majority were successfully re-interviewed 4 and 10 weeks later.
- 48 participants agreed in-depth interviews after the 10-week follow-up to discuss the services received. The two samples were similar in terms of country of birth, language and employment status. A majority of respondents surveyed reported low income: 59% of the Kitchener group and 65% of the London group reported annual household income of less than $ 20,000.
Those who attended the walk-in were slightly younger and with a good chance of being male (40.5% of those seeking walk-in services, compared to 26.1% seeking traditional counseling).
The results
Returning to the first question the researchers asked, “Is the Walk-in Consulting Model more effective than the traditional Consulting Services Model?”
Compared to the general improvement, the data showed that both groups of participants (entrusted to the two types of service) improved regardless of the service model.
Participants who benefited from counseling at walk-in services demonstrated faster improvements than those who sought counseling under the traditional model .
The improvement was measured using the “Health Questionnaire-12 (GHQ-12) (range 0 -36)” tool where higher scores mean greater psychological stress.
The results demonstrate that participants who were answered according to the walk-in model transition from a clinical severity level to a normal level (i.e., a GHQ score of 13 or less) after five weeks while the comparison group , on average, it does not reach this threshold until the tenth week .
Participants of both models reported greater use of other community services, participants who used walk-in services were more active in finding services that were useful to their condition , this is attributable to greater participation of the consultant in favoring activation and an action plan.
Who benefits most from the walk-in consulting model?
The improvement was greatest (in the walk-in model) for people with complex needs , such as coping with abuse, trauma, severe mental problems, health or well-being problems of children.
Participants of both models improved ; however, those with complex needs seeking help from the traditional model showed a small change over a longer time, while those with complex needs, who benefited from the single session service at the walk-in services, experienced improvements in less time.
The walk-in model has been very useful for:
- participants who said they were seriously thinking about change;
- participants who had previously made a change and wanted to keep it;
- the in-depth interviews confirmed that people who were thinking they needed changes in their lives found the experience most productive.
Does the Walk-in model save money?
The data collected for this study did not demonstrate that the walk-in model saves the company money in the short term (within 10 weeks of using the walk-in clinic).
However, the faster improvement associated with the walk-in counseling model clearly benefits help seekers and their families, employers and communities .
This study provides further evidence that walk-in counseling services can:
- Offer relief from serious problems
- Prevent both escalation of problems and deterioration of health
- Ensure faster access to services.
Conclusions
Therefore, if mental health services, provided both according to the traditional model and according to the logic of the single session in walk-in services, both turn out to be positive for the experience of the people and the possibility of facing a discomfort, a temporary crisis or a complex need, it seems appropriate to underline, as done in other blog articles, that single-session walk-in services can guarantee some advantages :
- Economic savings for public services, with repercussions on the entire community of reference
- Shorter times in resolving the needs expressed
- Reduction of the waiting list, with timely responses to requests for psychological support, responding to the need in a timely manner
- Eliminate the idea that a psychological path is necessarily long, shortening the distance between services aimed at psychological well-being and people who, due to mistrust and preconceived ideas, do not apply even if they feel the need (in Italy the percentage of these people oscillates between 77 and 92%).
Federico Piccirilli
Psychologist, Psychotherapist
Co-Founder of the Italian Center
for Single Session Therapy
Bibliography
Cannistrà, F., Piccirilli, F. (2018). Single session therapy. Principles and practices. Giunti Editore, Florence.
Hoyt, MF & Talmon, M. (eds.) (2014). Capturing the Moment. Single Session Therapy and Walk-In Services. Bancyfelin, UK: Crown House.
Hoyt, MF, Bobele M. Slive A., Young J. & Talmon, M. (eds.) (2018). Single-Session Therapy by walk-in or appointment. Routledge, New York.