Will patients accept randomization to psychoanalysis? A feasibility study.

Area of Science:

• Psychiatry and Psychology
• Clinical Trial Design

Background:

• Psychoanalytic outcome studies often face challenges with randomized designs.
• Comparing long-term psychoanalysis with other therapies requires robust methodologies.

Purpose of the Study:

• To evaluate the feasibility of a randomized design for comparing psychoanalysis with supportive expressive therapy and cognitive behavior therapy.
• To determine if patient recruitment and randomization rates support a larger randomized controlled trial (RCT).

Main Methods:

• A randomized design was proposed to compare psychoanalysis (3-4 sessions/week for 5 years) with supportive expressive therapy and cognitive behavior therapy (1-2 sessions/week for up to 40 sessions).
• Feasibility was assessed by a target recruitment rate of 30% among eligible patients.
• Patient eligibility and willingness to be randomized were tracked through screening and interviews.

Main Results:

• Out of 132 initial respondents, 11 patients (8.3% of respondents, 44% of those interviewed) met eligibility criteria.
• Eight of the 11 eligible patients accepted randomization, achieving a participation rate of 39%-92% within a 95% confidence interval.
• This rate supports the feasibility of recruiting for such a comparative psychotherapy trial.

Conclusions:

• The study supports the feasibility of implementing a randomized controlled trial (RCT) to compare intensive psychoanalysis with shorter-term psychotherapies.
• The findings provide a basis for future research into the comparative effectiveness of different psychotherapy modalities.
• Pre-treatment characteristics and initial reliability data for adherence scales were collected for the randomized participants.