Clients' Perceptions of Treatment for Depression: II. Problematic or Hindering Aspects

Clients' perceptions of the problematic or hindering aspects of treatment in the NIMH Treatment of Depression Collaborative Research Program were investigated, from the perspective of factors hypothesized to be common across treatments and those hypothesized to be specific to one type of treatment. Overall, 36% of the 154 treatment completers indicated that something was problematic for them about their treatment or about their participation in the research. It was primarily clients in the imipramine plus clinical management and placebo plus clinical management conditions who gave responses categorized as specific to the treatment they had received, which for imipramine clients consisted primarily of complaints related to medication side effects. In addition, a small subset of pharmacotherapy clients indicated that they wanted psychotherapy. There were no significant differences among treatment conditions in the report of problems categorized as aspects common across all the treatments, such as therapist techniques and personal qualities. However, the report of a problem coded as a common aspect identified a small group of clients (n = 15) whose treatment outcome was comparatively less favorable.