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 demonstrated 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 and (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. TRIAL REGISTRATION Current Controlled Trials, ISRCTN17544090. Registered on 23 July 2015.

中文翻译：

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使用新型混合方法对抑郁症进行心理治疗的个性化：森田疗法的一个例子。

背景技术当前用于个性化抑郁症心理治疗的定量方法不太可能能够为数百年的临床决策提供依据。因此，需要新颖的替代方法来生成用于预期检验的假设，并且我们将混合方法展示为一种这样的方法。通过深入研究患者的观点，并在个体水平上整合定性和定量数据，我们可以确定心理治疗结果的新的潜在社会心理预测因素，从而有可能在更短的时间内告知抑郁症治疗的个性化。因此，我们以森田疗法（日本的心理疗法）为例，探讨了森田疗法接受者对治疗可接受性的看法如何解释他们的依从性和对治疗的反应。方法森田试验纳入了森田疗法与通常的抑郁症治疗及治疗后定性访谈的随机对照试验。我们从英国德文郡的全科医学记录搜索中招募了试验参与者，并有针对性地从16名参与者中抽取了数据进行混合方法分析。我们从质性主题中发展了参与者观点的类型，并将这些与关于参加会议的次数以及参与者是否对治疗进行了反应的定量数据进行了整合，以联合类型和统计显示方式进行。我们使用参与者短片丰富了我们的分析，以演示每种类型。结果我们证明了（1）能够识别Morita治疗原则的参与者通常对治疗有反应，不论他们参加了多少次会议，而那些与森田疗法相违背的人都对治疗没有反应，再次是无论治疗依从性如何；（2）因个人情况而无法参加森田疗法的参与者参加了最少的会议，但如果这些原则引起共鸣，仍然可以从治疗中受益。结论我们确定了“方向”与结果，“机会”与依从性之间的新的潜在关系，而使用现有的非综合性方法则无法确定这些关系。这种混合方法可确保在以后的试验中以及与其他心理治疗方法进行重复以产生假设，根据前瞻性试验中测试的或多或少适合治疗的患者的类型（或特征）。试用注册电流控制试验，ISRCTN17544090。2015年7月23日注册。