Preferences for cognitive behavioural therapy and psychodynamic psychotherapy for panic disorder - Who chooses which and why?

Objective: Few studies have examined factors associated with patient’s choice of particular psychological treatments. The present study explores possible associations to, and the reasons given for, patient’s choice of Panic Control Treatment (PCT) or Panic-Focused Psychodynamic Psychotherapy (PFPP) for Panic Disorder with or without Agoraphobia (PD/A). Method: Both quantitative and qualitative analyses were applied to data obtained from 109 adults with PD/A who were randomized to the Choice condition in the doubly randomized controlled preference trial from which this data are drawn. Results: The strongest associations were between treatment credibility ratings and the treatment choice (d = -1.00 and 1.31, p < .01, for PCT and PFPP respectively). Treatment choice was also moderately associated with patient characteristics, treatment helpfulness beliefs, and learning style. Qualitative analysis revealed that patients gave contrasting reasons for their treatment choice; either a focus on the present, symptom reduction and problem-solving for those who chose PCT or a focus on the past, symptom understanding and reflection for those who chose PFPP. Conclusions: When offered a choice between two evidence-based psychotherapies for PD/A, the resulting choice was primarily a function of the patient’s beliefs about the chosen therapy, its potential for success, and their preferred learning style.