Treatment Preferences and Outcome in a Randomized Controlled Trial for Depression Comparing Supportive-Expressive Therapy to Medication and Pill Placebo

Previous research regarding the relationship between patient treatment preferences on outcome has been equivocal, with some studies finding a significant relationship between preference match and outcome, and others finding no such evidence. This study examines the effect of patient treatment preference match on outcome using data from a previously published randomized controlled trial comparing supportive-expressive therapy (SET), to antidepressant medication plus clinical management, and to pill-placebo plus clinical management. The original study included 156 participants receiving treatment at the Center for Psychotherapy research at the University of Pennsylvania in Philadelphia, PA. This study is the first to examine the relationship between preferences and outcome in a randomized controlled trial of brief psychodynamic therapy for depression. It was found that treatment preference match or mismatch was not significantly associated with outcome, nor was there a significant interaction with the therapeutic alliance. Treatment preference match or mismatch was also not associated with likelihood of study dropout. Implications are discussed.