In a sample of 89 patients referred from a psychiatric service emergency
room, the author investigated variables related to completion and
noncompletion of the physician's recommendation. The completers (58%)
tended to be older and more educated, to be diagnosed as depressed, and to
demonstrate congruence in terms of their request and their perception of
the physician's goal. Implications for referral include ensuring that the
interview with the patient includes a communication, empathy, and mutual
influence. Using the negotiated approach and criteria derived during the
clinical interview, certain patients can be identified as being "at risk"
for noncompletion and as requiring special efforts.