Related Experiment Video
Updated: May 18, 2026

Investigating Pain-Related Avoidance Behavior using a Robotic Arm-Reaching Paradigm
Published on: October 3, 2020
To attend or not attend? A critical review of the factors impacting on initial appointment attendance from an
1School of Psychological Sciences, University of Manchester, Manchester, UK.
Background:
A large proportion of initial therapy appointments are not attended. Whether this reflects service-user choice or an unmet need for therapy, non-attendance can impact on patients, therapists, services and research evaluation.
Aims:
To understand the complexities of this phenomenon, this paper reviews the mental health literature to gain further insight into how predictor variables can influence professional help-seeking decisions.
Methods:
This review reveals a modest success at identifying specific demographic and psychological factors, yet methodological issues surrounding data collection techniques have often led to contradictory and inconclusive findings.
Conclusions:
This paper examines the possibility that approach-avoidance conflict [Kushner, M.G. & Sher, K.J. (1989, 1991). Fear of psychological treatment and its relation to mental health service avoidance. Professional Psychology: Research and Practice, 20, 251-257; The relation of treatment fearfulness and psychological service utilization: An overview. Professional Psychology: Research and practice, 22, 196-203] could explain the contradictions in the literature because, in this model, different factors involved in driving engagement versus avoidance become more salient depending on a dynamic interplay of timing, the individual and their service context. The core principles behind this approach-avoidance conceptualisation are explained and further avenues for research are identified.
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