Patient perspectives on working with preferences in psychotherapy: A consensual qualitative research study

TY - JOUR

T1 - Patient perspectives on working with preferences in psychotherapy

T2 - A consensual qualitative research study

AU - Cooper, Mick

AU - Malta, Gina Di

AU - Knox, Sarah

AU - Oddli, Hanne Weie

AU - Swift, Joshua K.

PY - 2023/1/20

Y1 - 2023/1/20

N2 - ObjectiveAssessing and accommodating patient preferences is integral to evidence-based practice. This qualitative study sought to explore patient perspectives and experiences of preference work in psychotherapy.MethodsParticipants were 13 UK-based patients who had completed up to 24 sessions of a collaborative–integrative psychotherapy. Ten participants identified as female and three as male. Interviews were conducted at endpoint and analyzed using a team-based, consensual qualitative research approach.ResultsThree superordinate domains were developed: Preferences Themselves, Process of Working with Preferences in Psychotherapy, and Effect of Preference Work (or its Absence). Patients typically wanted leadership, challenge, and input from their psychotherapist, and an affirming style. Patients attributed the origin of their preferences to personal history, characteristics, or circumstances; the present psychotherapy; or past episodes of psychotherapy. Some preferences changed over time. Preference work was described as having positive effects on the therapeutic relationship and patients’ intrapersonal worlds; however, variantly, non-accommodation of preferences was also experienced as beneficial.ConclusionOur findings provide in-depth answers to a range of novel questions on preference work—potential mechanisms by which preference work impacts outcomes, factors that may facilitate preference work, and origins of preferences—as well as nuancing previously-established quantitative findings. Implications for clinical training and practice are discussed.

AB - ObjectiveAssessing and accommodating patient preferences is integral to evidence-based practice. This qualitative study sought to explore patient perspectives and experiences of preference work in psychotherapy.MethodsParticipants were 13 UK-based patients who had completed up to 24 sessions of a collaborative–integrative psychotherapy. Ten participants identified as female and three as male. Interviews were conducted at endpoint and analyzed using a team-based, consensual qualitative research approach.ResultsThree superordinate domains were developed: Preferences Themselves, Process of Working with Preferences in Psychotherapy, and Effect of Preference Work (or its Absence). Patients typically wanted leadership, challenge, and input from their psychotherapist, and an affirming style. Patients attributed the origin of their preferences to personal history, characteristics, or circumstances; the present psychotherapy; or past episodes of psychotherapy. Some preferences changed over time. Preference work was described as having positive effects on the therapeutic relationship and patients’ intrapersonal worlds; however, variantly, non-accommodation of preferences was also experienced as beneficial.ConclusionOur findings provide in-depth answers to a range of novel questions on preference work—potential mechanisms by which preference work impacts outcomes, factors that may facilitate preference work, and origins of preferences—as well as nuancing previously-established quantitative findings. Implications for clinical training and practice are discussed.

KW - Patient preferences

KW - aptitude-treatment interaction research

KW - alliance

KW - process research

KW - consensual qualitative research

U2 - 10.1080/10503307.2022.2161967

DO - 10.1080/10503307.2022.2161967

M3 - Article

SN - 1050-3307

JO - Psychotherapy Research

JF - Psychotherapy Research

ER -