“Do you still want to be seen?”: The pros and cons of active waiting list management

Abstract

OBJECTIVE: This study examined the impact on a clinic waiting list of introducing an "opt-in" system for patients awaiting individual outpatient cognitive behavioral therapy. The proportion of patients opting in was identified, along with demographic, eating, and psychopathological factors that might make some more likely to opt out. METHOD: The sample consisted of 116 patients with eating disorder. Each completed measures of eating and axis 1 and 2 characteristics at assessment. They received one opt-in letter and a reminder. Those who opted in immediately or after a reminder were compared with those who did not. RESULTS: Just over two-thirds of the patients opted to remain on the waiting list. No demographic or eating characteristics differentiated those individuals. Those who did not opt in immediately had higher levels of depression, psychoticism, and borderline personality disorder cognitions. However, that difference disappeared when the reminder letter was sent. DISCUSSION: Waiting list reductions can be achieved through an active "opt-in" mechanism, and this approach does not disadvantage specific individuals but speeds access to treatment for the majority of patients. However, further research is needed to track pathways of care to determine whether such initiatives have longer term positive or negative impacts.