Abstract
BackgroundProviders of psychological therapies are encouraged to offer patients choice about their treatment, but there is very little information about what preferences people have or the impact that meeting these has on treatment outcomes.MethodCross-sectional survey of people receiving psychological treatment from 184 NHS services in England and Wales. 14,587 respondents were asked about treatment preferences and the extent to which these were met by their service. They were also asked to rate the extent to which therapy helped them cope with their difficulties.ResultsMost patients (12,549–86.0 %, 95 % CI: 85.5–86.6) expressed a preference for at least one aspect of their treatment. Of these, 4,600 (36.7 %, 95 % CI: 35.8–37.5) had at least one preference that was not met. While most patients reported that their preference for appointment times, venue and type of treatment were met, only 1,769 (40.5 %) of the 4,253 that had a preference for gender had it met. People who expressed a preference that was not met reported poorer outcomes than those with a preference that was met (Odds Ratios: appointment times = 0.29, venue = 0.32, treatment type = 0.16, therapist gender = 0.32, language in which treatment was delivered = 0.40).ConclusionsMost patients who took part in this survey had preferences about their treatment. People who reported preferences that were not met were less likely to state that treatment had helped them with their problems. Routinely assessing and meeting patient preferences may improve the outcomes of psychological treatment.
Highlights
Providers of psychological therapies are encouraged to offer patients choice about their treatment, but there is very little information about what preferences people have or the impact that meeting these has on treatment outcomes
Much of the literature examining the effect of patient choice on clinical outcomes in mental health focuses on selection between psychological and pharmacological treatment, and yields varied results
Patients who reported that they were not given adequate choice were less likely to agree that their treatment helped them cope with their difficulties. Differences between those who had preferences that were met and those with no preferences were less marked aside from for type of therapy and time of day: those reporting that these preferences were met, were more likely to report that therapy had helped them with their problems. Data from this survey suggest that three quarters of people who are referred to psychological therapy services for common mental health problems have a preference for when therapy is delivered, and around half have a preference for where and what type of therapy
Summary
Providers of psychological therapies are encouraged to offer patients choice about their treatment, but there is very little information about what preferences people have or the impact that meeting these has on treatment outcomes. It has been argued that increasing the amount of choice that patients have can encourage them to take greater interest in their health, increase their adherence to treatment and ensure more cost effective use of available resources [1]. Some studies indicate that receiving preferred treatment conveys an additional benefit in terms of clinical measures and treatment retention [13, 14] as well as cost-effectiveness [15], while others find no effect [16, 17]. These contrasting findings may be due to the reluctance of patients with strong preferences to enter controlled trials where they could be randomised to treatment, even those with partial-preference designs [18, 19]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
