A Qualitative Analysis of Stakeholder Attitudes Regarding Personalized Provider Selection and Patient-Therapist Matching

Abstract

This study explored mental health care patients and therapists' perspectives on using therapists' measurement-based and problem-specific effectiveness data to inform case assignments - a type of treatment personalization that has been shown to outperform non-measurement-based case assignment as usual (Constantino et al., 2021). We conducted semi-structured qualitative interviews with 8 patients (75% women; M age = 33.75 years) and 8 therapists (75% women; M age = 47.50 years). The interview protocols were unique to stakeholder group. Recorded responses were transcribed and qualitatively analyzed by four judges using a blend of consensual qualitative research and grounded theory methods. Derived patient domains included preferred characteristics of a provider, and experiences and suggestions regarding provider selection. Within the domains, most patients expressed an interest in accessing more specific provider information online. Additionally, most patients indicated that both provider outcome track records and personal preference information (e.g., therapist characteristics) should be considered in the therapist selection process. All patients endorsed being comfortable with having the ability to select a provider based on a list of empirically well-matched recommendations. Derived therapist domains included using routine outcomes monitoring for patient-provider matching, referral source and direct patient use of preferred provider lists, and improvements to the provider selection process. Within the domains, all therapists remarked that outcome data would be useful for matching patients to providers; however, most also indicated that outcome data should not be the only factor used in provider selection. All therapists expressed a willingness to be included in preferred provider lists that incorporate track record data. Overall, both patients and therapists held generally positive views toward using therapist effectiveness data to help personalize mental health care. Yet, both stakeholder groups acknowledged that other personalization factors should be considered alongside these data. Based on these results, our team is in the process of implementing patient-therapist match strategies in larger and more diverse mental health care contexts.

Keywords: Measurement-based care; Patient-therapist matching; Personalization; Stakeholder attitudes.