How do therapists assess suitability? A qualitative study exploring therapists' judgements of treatment suitability for depressed adolescents

BACKGROUND: Despite the need for a better understanding of treatment suitability, how it is determined by therapists in real-life practice is still unknown. The study aimed to explore how therapists working with depressed teenagers make judgements about treatment suitability across three treatment modalities: (a) Short-term Psychoanalytic Psychotherapy, (b) Cognitive Behaviour Therapy, and (c) Brief Psychosocial Intervention. METHODS: The study used a qualitative analysis within a randomised controlled trial. Therapists' judgements of treatment suitability were studied via an exploratory content analysis. This trial is registered with current controlled trials, number ISRCTN83033550. RESULTS AND DISCUSSION: A wide range of factors were considered in therapists' judgements of suitability, with significant variation in themes across treatment modalities. Although a much higher number of therapists judged the allocated treatment modality to be suitable to the client than not, many also indicated ambivalence and uncertainty towards their decision-making. This demonstrates a possibility that treatment suitability may be more accurately assessed as a continuum over multiple time points throughout treatment