Lay People’s Views on the Appropriateness of Psychotherapies

Abstract

Rationale, aims and objectives When choosing a particular psychotherapy, psychotherapists are expected to take into account their clients’ preferences, needs, and values, their own professional experience, and what is currently known regarding the real impact of these therapies. Psychotherapists widely vary the one from the other in the weight they attribute to each of these factors. We examined the way lay people judge of the appropriateness of therapeutic decisions taken by clinical psychologists.Methods 206 participants were presented with 24 vignettes depicting the way a psychotherapist has selected therapy. They were composed according to a three within-subject factor design: (a) the frequency with which the therapy was used in clinical practice in the area, (b) the patients’ usual level of appreciation of this therapy, and (c) the level of scientific evidence supporting the use of this therapy (strong evidence, weak evidence, unknown evidence and no evidence). The participants rated appropriateness of the decision in each case.Results For half the participants, the most important factor was the patients’ appreciation of the therapy in general. Even scientifically supported therapies were considered as only mildly appropriate if patients in general didn’t like them much. For the remaining half of participants, scientific evidence was the most important factor: Therapies that were well appreciated by patients were not viewed as appropriate if they were not scientifically grounded.Conclusions Creating authoritative multilingual web sites synthesizing the main findings regarding the impact of diverse therapies would be a way through which at least some patients could judge of the appropriateness of the technique they have been offered by their psychotherapists. Their (informed) reactions could ease changes in direction of more weight attributed to existing scientific evidence from the part of therapists.