Informed consent for psychotherapy: the moderating role of therapeutic alliance, prior knowledge and autonomous motivation on decision‐making and treatment expectation

Abstract

Background Informed consent is an ethical prerequisite for psychotherapy. There are no routinely used standardized strategies for obtaining informed consent. A new optimized informed consent consultation (OIC) strengthened treatment‐relevant aspects. It remains unclear which factors influence the OIC efficacy regarding clinical and decision‐related outcomes. Methods N = 122 adults were included in a randomized controlled online trial. Participants received an information brochure on psychotherapy (TAU; n = 61) or OIC + TAU (n = 61). The main and interaction effects of group allocation, therapeutic alliance, prior knowledge about psychotherapy and treatment motivation on treatment expectations, decisional conflict and capacity to consent were tested. Floodlight analyses were conducted for significant interactions. Results Large interaction effects were shown between treatment motivation and group allocation on treatment expectations (β = −0.53) and between prior knowledge and group assignment on capacity to consent (β = 0.68). The interaction between treatment motivation and group allocation was significant up to a motivation score of 5.54 (range: 1–7). The interaction between prior knowledge and group assignment was significant up to a knowledge score of 14.38 (range: 5–20). Conclusion Moderator analyses indicated varying efficacy degrees for the OIC regarding decisional outcomes and expectation. Especially patients with little treatment motivation or low prior knowledge benefited from optimized information about the efficacy and possible side effects of psychotherapy. Trial Registration: PsychArchives (https://doi.org/10.23668/psycharchives.4929): 17.06.2021