ABSTRACT

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.

摘要

目的：很少有研究检查与患者选择特定心理治疗方法相关的因素。本研究探讨了患者选择恐慌症（PD / A）或没有恐慌症时的恐慌控制治疗（PCT）或以恐慌为重点的心理动力心理治疗（PFPP）的可能关联和原因。

方法：定量和定性分析均应用于从109名PD / A成年人中获得的数据，他们在双随机对照偏爱试验中随机选择了选择条件，并从中抽取了该数据。

结果：治疗可信度等级与治疗选择之间最强的关联（d  = -1.00和1.31，p  <.01，分别针对PCT和PFPP）。治疗选择还与患者特征，治疗帮助信念和学习方式有中等相关性。定性分析表明，患者选择治疗的原因相反。对于选择PCT的人员来说，要么关注当前，减少症状和解决问题，要么对于那些选择PFPP的人而言关注过去，对症状的理解和反思。

结论：当在PD / A的两种循证心理疗法之间进行选择时，最终的选择主要取决于患者对所选疗法的信念，成功的潜力以及他们偏爱的学习方式。