An investigation of treatment return after psychological therapy for depression and anxiety.

Background: Some patients return for further psychological treatment in routine services, although it is unclear how common this is, as scarce research is available on this topic.

Aims: To estimate the treatment return rate and describe the clinical characteristics of patients who return for anxiety and depression treatment.

Method: A large dataset (N=21,029) of routinely collected clinical data (2010-2015) from an English psychological therapy service was analysed using descriptive statistics.

Results: The return rate for at least one additional treatment episode within 1-5 years was 13.7%. Furthermore, 14.5% of the total sessions provided by the service were delivered to treatment-returning patients. Of those who returned, 58.0% continued to show clinically significant depression and/or anxiety symptoms at the end of their first treatment, while 32.0% had experienced a demonstrable relapse before their second treatment.

Conclusions: This study estimates that approximately one in seven patients return to the same service for additional psychological treatment within 1-5 years. Multiple factors may influence the need for additional treatment, and this may have a major impact on service activity. Future research needs to further explore and better determine the characteristics of treatment returners, prioritise enhancement of first treatment recovery, and evaluate relapse prevention interventions.