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Predicting First-Session Attendance: The Influence of Referral Source and Client Income

Predicting which clients will keep their therapy appointments is an important task given the costs associated with therapy nonattendance. In particular, past research suggests that some prospective clients are at high risk of not attending their first sessions. The authors examined whether basic information provided by 397 prospective outpatient clients at the time of scheduling their initial appointments could predict which clients would attend their first sessions. Consistent with past studies, 37% of prospective clients did not attend their first sessions. A logistical regression revealed that referral source was a significant predictor of which clients would be first-session attendees, explaining 22% of the variance associated with first-session attendance. Client annual income accounted for an additional 2% of the explained variance. The combination of these predictors accurately predicted first-session attendance for 73% of prospective clients. Possible explanations for these findings as well as their usefulness for mental health clinicians are discussed.