Credibility clusters, preferences, and helpfulness beliefs for specific forms of psychotherapy.

BACKGROUND There is some evidence that the perceived credibility of specific forms of psychotherapy, beliefs about helpful and not-so-helpful interventions, and differential treatment preferences may influence both therapeutic alliance and outcome, at least in the short term. The present study explored whether distinct clusters exist, based on credibility ratings, and how these may be related to treatment preferences and beliefs about the helpfulness of specific interventions. METHOD Written descriptions of psychodynamic, cognitive, and cognitive-behavioural psychotherapy were rated by a random community sample with the 'normal' level of psychiatric treatment (n= 121), psychiatric outpatients with limited previous experience of psychiatric care (n= 118), and a group of psychiatric 'veterans' with long experience of psychiatric care (n= 48). Participants completed a questionnaire focusing on beliefs about the helpfulness of specific therapy components, rated the credibility of each form of psychotherapy, and ranked the alternatives in terms of preferences. RESULTS Using cluster analysis, six distinct groups of participants were delineated. Some approached psychotherapy in an undifferentiated manner, tending to either embrace all or reject all of the methods examined. Others had differentiated ideas about the credibility of specific therapeutic approaches. These clusters were strongly associated with differential treatment preferences. They were also associated with helpfulness beliefs, type of psychological problems, previous experiences with psychotherapy, and gender. Analysis of the interactions among these factors revealed that the distribution across clusters was almost entirely accounted for by the helpfulness beliefs. CONCLUSIONS For clinicians, it may be important to investigate the differential appeal of specific components of psychotherapy as well as entire therapy packages in individual cases prior to commencing therapy. For researchers, it may be important to consider whether outcome studies would become more informative by taking patients' beliefs and preferences into account.