Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jun 18;20(1):313.
doi: 10.1186/s12888-020-02682-1.

Patient experiences of psychological therapy for depression: a qualitative metasynthesis

Susan McPherson  1 , Claire Wicks  2 , Ilaria Tercelli  2
Affiliations
Review

Patient experiences of psychological therapy for depression: a qualitative metasynthesis

Susan McPherson et al. BMC Psychiatry. .

Abstract

Background: Globally, national guidelines for depression have prioritised evidence from randomised controlled trials and quantitative meta-analyses, omitting qualitative research concerning patient experience of treatments. A review of patient experience research can provide a comprehensive overview of this important form of evidence and thus enable the voices and subjectivities of those affected by depression to have an impact on the treatments and services they are offered. This review aims to seek a comprehensive understanding of patient experiences of psychological therapies for depression using a systematic and rigorous approach to review and synthesis of qualitative research.

Method: PsychINFO, PsychARTICLES, MEDLINE, and CINAHL were searched for published articles using a qualitative approach to examine experiences of psychological therapies for depression. All types of psychological therapy were included irrespective of model or modes of delivery (e.g. remote or in person; group or individual). Each article was assessed following guidance provided by the Critical Appraisal Skill Programme tool. Articles were entered in full into NVIVO and themes were extracted and synthesized following inductive thematic analysis.

Results: Thirty-seven studies, representing 671 patients were included. Three main themes are described; the role of therapy features and setting; therapy processes and how they impact on outcomes; and therapy outcomes (benefits and limitations). Subthemes are described within these themes and include discussion of what works and what's unhelpful; issues integrating therapy with real life; patient preferences and individual difference; challenges of undertaking therapy; influence of the therapist; benefits of therapy; limits of therapy and what happens when therapy ends.

Conclusions: Findings point to the importance of common factors in psychotherapies; highlight the need to assess negative outcomes; and indicate the need for patients to be more involved in discussions and decisions about therapy, including tailoring therapy to individual needs and taking social and cultural contexts into account.

Keywords: Depression; Guidelines; Patient choice; Patient experience; Psychological therapies.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Prisma Flowchart
See this image and copyright information in PMC

References

    1. National Institute for Health and Care Excellence . Depression in adults: recognition and Depression in adults: recognition and management management Clinical guideline. 2009. - PubMed
    1. Gelenberg A, Freeman M, Markowitz J, Rosenbaum J, Thase M, Trivedi M, et al. Practice guideline for treatment of patients with major depressive disorder. 2010.
    1. Jobst A, Brakemeier E-L, Buchheim A, Caspar F, Cuijpers P, Ebmeier KP, et al. European psychiatric association guidance on psychotherapy in chronic depression across Europe. Eur Psychiatry. 2016;33:18–36. doi: 10.1016/j.eurpsy.2015.12.003. - DOI - PubMed
    1. McQuaid JR, Lin EH, Permanente Washington K, Jones VY, of Columbia D. York N, et al. Clinical Practice Guideline for the Treatment of Depression Across Three Age Cohorts. 2019.
    1. NHS England. Five year Foward view for mental health. London: NHS England; 2016. https://www.england.nhs.uk/wpcontent/%0Auploads/2016/02/Mental-Health-Ta....