Background
Current quantitative methods for personalising psychotherapies for
depression are unlikely to be able to inform clinical decision-making for hundreds of
years. Novel alternative methods to generate hypotheses for prospective testing
are therefore required, and we showcase mixed methods as one such approach.
By exploring ...
Background
Current quantitative methods for personalising psychotherapies for
depression are unlikely to be able to inform clinical decision-making for hundreds of
years. Novel alternative methods to generate hypotheses for prospective testing
are therefore required, and we showcase mixed methods as one such approach.
By exploring patients’ perspectives in-depth, and integrating qualitative and
quantitative data at the level of the individual, we may identify new potential
psychosocial predictors of psychotherapy outcomes, potentially informing the
personalisation of depression treatment in a shorter timeframe. Using Morita
Therapy (a Japanese psychotherapy) as an exemplar, we thus explored how
Morita Therapy recipients’ views on treatment acceptability explain their adherence
and response to treatment.
Methods
The Morita Trial incorporated a pilot randomised controlled trial of Morita
Therapy versus treatment as usual for depression, and post-treatment qualitative
interviews. We recruited trial participants from General Practice record searches in
Devon, UK, and purposively sampled data from 16 participants for our mixed
methods analysis. We developed typologies of participants’ views from our
qualitative themes, and integrated these with quantitative data on number of
sessions attended and whether participants responded to treatment in a joint
typologies and statistics display. We enriched our analysis using participant
vignettes to demonstrate each typology.
Results
We demonstrate that (1) participants who could identify with the principles of
Morita Therapy typically responded to treatment, regardless of how many sessions
they attended, whilst those whose orientation towards treatment was incompatible
with Morita Therapy did not respond to treatment, again regardless of treatment
adherence; (2) participants whose personal circumstances impeded their
opportunity to engage in Morita Therapy attended the fewest sessions, though still
benefitted from treatment if the principles resonated with them.
Conclusions
We identified new potential relationships between ‘orientation’ and
outcomes, and ‘opportunity’ and adherence, which could not have been identified
using existing non-integrative methods. This mixed methods approach warrants
replication in future trials and with other psychotherapies to generate hypotheses,
based on typologies (or profiles) of patients for whom a treatment is more or less
likely to be suitable, to be tested in prospective trials.