Skip to main content
Top
Published in: Trials 1/2016

Open Access 01-12-2016 | Research

The experience of adolescents participating in a randomised clinical trial in the field of mental health: a qualitative study

Authors: Nick Midgley, Danny Isaacs, Katharina Weitkamp, Mary Target

Published in: Trials | Issue 1/2016

Login to get access

Abstract

Background

This descriptive study aimed to investigate adolescents’ motivations for participating in a randomised controlled trial (RCT), to explore the understanding that the young people had regarding a number of aspects of the trial design, to examine whether or not they found participation in the trial to be acceptable and what affected this, and to identify whether and how the young people felt that their participation in the RCT impacted on their experience of therapy and on therapeutic change.

Methods

Seventy-six adolescents who were taking part in a large-scale RCT to evaluate the clinical and cost effectiveness of psychological therapies for depression were interviewed at two time-points after completing therapy. The semi-structured interviews, which included a focus on the young people’s experience of the research study, were analysed using framework analysis.

Results

The vast majority of adolescents found it acceptable to participate in the clinical trial, and many agreed to participate for reasons of ‘conditional altruism’. However consent was often given without great understanding of the key elements of the trial, including the difference between treatment arms and the randomisation process. Although the adolescents were largely positive about their experiences from taking part, the study raises questions about whether clinical outcomes may be influenced by participation in the research elements of the trial.

Conclusions

Although adolescents are under-represented in clinical trials, those who do participate are generally positive about the experience; however, careful thought needs to be given to key elements of the trial design and the potential impact of the research participation on clinical outcomes.

Trial registration

ISRCTN registry, ISRCTN83033550. Registered on 15 October 2009.
Literature
1.
go back to reference Fonagy P, Cottrell D, Phillips J, Bevington D, Glaser D, Allison E. What works for whom? A critical review of treatments for children and adolescents. 2nd ed. New York: Guilford Press; 2014. Fonagy P, Cottrell D, Phillips J, Bevington D, Glaser D, Allison E. What works for whom? A critical review of treatments for children and adolescents. 2nd ed. New York: Guilford Press; 2014.
2.
go back to reference O’Cathain A, Thomas KJ, Drabble SJ, Rudolph A, Hewison J. What can qualitative research do for randomised controlled trials? A systematic mapping review. BMJ Open. 2013;3:e002889.CrossRefPubMedPubMedCentral O’Cathain A, Thomas KJ, Drabble SJ, Rudolph A, Hewison J. What can qualitative research do for randomised controlled trials? A systematic mapping review. BMJ Open. 2013;3:e002889.CrossRefPubMedPubMedCentral
3.
go back to reference Brown DL, Cowdery JE, Jones TS, Langford A, Gammage C, Jacobs TL. Adolescent knowledge and attitudes related to clinical trials. Clin Trials. 2015;12:212–4.CrossRefPubMed Brown DL, Cowdery JE, Jones TS, Langford A, Gammage C, Jacobs TL. Adolescent knowledge and attitudes related to clinical trials. Clin Trials. 2015;12:212–4.CrossRefPubMed
4.
go back to reference Notley C, Christopher R, Hodgekins J, Byrne R, French P, Fowler D. Participant views on involvement in a trial of social recovery cognitive-behavioural therapy. Br J Psychiatry. 2015;206:122–7.CrossRefPubMed Notley C, Christopher R, Hodgekins J, Byrne R, French P, Fowler D. Participant views on involvement in a trial of social recovery cognitive-behavioural therapy. Br J Psychiatry. 2015;206:122–7.CrossRefPubMed
5.
go back to reference Read K, Fernandez CV, Gao J, Strahlendorf C, Moghrabi A, Pentz RD, et al. Decision-making by adolescents and parents of children with cancer regarding health research participation. Pediatrics. 2009;124:959–65.CrossRefPubMed Read K, Fernandez CV, Gao J, Strahlendorf C, Moghrabi A, Pentz RD, et al. Decision-making by adolescents and parents of children with cancer regarding health research participation. Pediatrics. 2009;124:959–65.CrossRefPubMed
7.
go back to reference Barakat LP, Patterson CA, Mondestin V, Chavez V, Austin T, Robinson MR, et al. Initial development of a questionnaire evaluating perceived benefits and barriers to pediatric clinical trials participation. Contemp Clin Trials. 2013;34:218–26.CrossRefPubMed Barakat LP, Patterson CA, Mondestin V, Chavez V, Austin T, Robinson MR, et al. Initial development of a questionnaire evaluating perceived benefits and barriers to pediatric clinical trials participation. Contemp Clin Trials. 2013;34:218–26.CrossRefPubMed
8.
go back to reference Barakat LP, Schwartz LA, Reilly A, Deatrick JA, Balis F. A qualitative study of phase III cancer clinical trial enrollment decision-making: perspectives from adolescents, young adults, caregivers, and providers. J Adolesc Young Adult Oncol. 2014;3:3–11.CrossRefPubMedPubMedCentral Barakat LP, Schwartz LA, Reilly A, Deatrick JA, Balis F. A qualitative study of phase III cancer clinical trial enrollment decision-making: perspectives from adolescents, young adults, caregivers, and providers. J Adolesc Young Adult Oncol. 2014;3:3–11.CrossRefPubMedPubMedCentral
9.
go back to reference Rothwell PM. External validity of randomised controlled trials: ‘To whom do the results of this trial apply?’. Lancet. 2005;365:82–93.CrossRefPubMed Rothwell PM. External validity of randomised controlled trials: ‘To whom do the results of this trial apply?’. Lancet. 2005;365:82–93.CrossRefPubMed
10.
go back to reference Goodyer IM, Tsancheva S, Byford S, Dubicka B, Hill J, Kelvin R, et al. Improving mood with psychoanalytic and cognitive therapies (IMPACT): a pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depres. Trials. 2011;12:175.CrossRefPubMedPubMedCentral Goodyer IM, Tsancheva S, Byford S, Dubicka B, Hill J, Kelvin R, et al. Improving mood with psychoanalytic and cognitive therapies (IMPACT): a pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depres. Trials. 2011;12:175.CrossRefPubMedPubMedCentral
11.
go back to reference Chambers WJ, Puig-Antich J, Hirsch M, Paez P, Ambrosini PJ, Tabrizi MA, et al. The assessment of affective-disorders in children and adolescents by semistructured interview - test-retest reliability of the Schedule for Affective-Disorders and Schizophrenia for school-age children, present episode version. Arch Gen Psychiatry. 1985;42:696–702.CrossRefPubMed Chambers WJ, Puig-Antich J, Hirsch M, Paez P, Ambrosini PJ, Tabrizi MA, et al. The assessment of affective-disorders in children and adolescents by semistructured interview - test-retest reliability of the Schedule for Affective-Disorders and Schizophrenia for school-age children, present episode version. Arch Gen Psychiatry. 1985;42:696–702.CrossRefPubMed
12.
go back to reference Midgley N, Ansaldo F, Target M. The meaningful assessment of therapy outcomes: incorporating a qualitative study into a randomized controlled trial evaluating the treatment of adolescent depression. Psychotherapy. 2014;51:128–37.CrossRefPubMed Midgley N, Ansaldo F, Target M. The meaningful assessment of therapy outcomes: incorporating a qualitative study into a randomized controlled trial evaluating the treatment of adolescent depression. Psychotherapy. 2014;51:128–37.CrossRefPubMed
14.
go back to reference Midgley N, Holmes J, Parkinson S, Stapley E, Eatough V, Target M. ‘Just like talking to someone about like shit in your life and stuff, and they help you’: hopes and expectations for therapy among depressed adolescents. Psychother Res. 2014. doi:10.1080/10503307.2014.973922. Midgley N, Holmes J, Parkinson S, Stapley E, Eatough V, Target M. ‘Just like talking to someone about like shit in your life and stuff, and they help you’: hopes and expectations for therapy among depressed adolescents. Psychother Res. 2014. doi:10.​1080/​10503307.​2014.​973922.
16.
go back to reference Quinn PM. Qualitative research & evaluation methods. 4th ed. London: Sage; 2015. Quinn PM. Qualitative research & evaluation methods. 4th ed. London: Sage; 2015.
17.
go back to reference Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess RG, editors. Analyzing qualitative data. New York: Routledge; 1994. p. 173–94.CrossRef Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess RG, editors. Analyzing qualitative data. New York: Routledge; 1994. p. 173–94.CrossRef
18.
go back to reference Srivastava A, Thomson SB. Framework analysis: A qualitative methodology for applied policy research. J Admin Gov. 2009;4:72–9. Srivastava A, Thomson SB. Framework analysis: A qualitative methodology for applied policy research. J Admin Gov. 2009;4:72–9.
19.
go back to reference Bazeley P, Jackson K. Qualitative data analysis with NVivo. London: Sage; 2013. Bazeley P, Jackson K. Qualitative data analysis with NVivo. London: Sage; 2013.
21.
go back to reference Ferguson PR. Patients’ experiences and views of clinical trials. Med Law. 2001;20:143–52.PubMed Ferguson PR. Patients’ experiences and views of clinical trials. Med Law. 2001;20:143–52.PubMed
23.
go back to reference Appelbaum PS, Roth LH, Lidz CW, Benson P, Winslade W. False hopes and best data: consent to research and the therapeutic misconception. Hastings Cent Rep. 1987;17(2):20–4.CrossRefPubMed Appelbaum PS, Roth LH, Lidz CW, Benson P, Winslade W. False hopes and best data: consent to research and the therapeutic misconception. Hastings Cent Rep. 1987;17(2):20–4.CrossRefPubMed
24.
go back to reference Featherstone K, Donovan JL. Why don’t they just tell me straight, why allocate it?’ The struggle to make sense of participating in a randomised controlled trial. Soc Sci Med. 2002;55:709–19.CrossRefPubMed Featherstone K, Donovan JL. Why don’t they just tell me straight, why allocate it?’ The struggle to make sense of participating in a randomised controlled trial. Soc Sci Med. 2002;55:709–19.CrossRefPubMed
25.
go back to reference Rogers A, Day J, Randall F, Bentall RP. Patients’ understanding and participation in a trial designed to improve the management of anti-psychotic medication: a qualitative study. Soc Psychiatry Psychiatr Epidemiol. 2003;38:720–7.CrossRefPubMed Rogers A, Day J, Randall F, Bentall RP. Patients’ understanding and participation in a trial designed to improve the management of anti-psychotic medication: a qualitative study. Soc Psychiatry Psychiatr Epidemiol. 2003;38:720–7.CrossRefPubMed
26.
go back to reference Biddle L, Cooper J, Owen-Smith A, Klineberg E, Bennewith O, Hawton K, et al. Qualitative interviewing with vulnerable populations: individuals’ experiences of participating in suicide and self-harm based research. J Affect Disord. 2013;145:356–62.CrossRefPubMed Biddle L, Cooper J, Owen-Smith A, Klineberg E, Bennewith O, Hawton K, et al. Qualitative interviewing with vulnerable populations: individuals’ experiences of participating in suicide and self-harm based research. J Affect Disord. 2013;145:356–62.CrossRefPubMed
27.
go back to reference Kneipp SM, Lutz BJ, Levonian C, Cook C, Hamilton JB, Roberson D. Women’s experiences in a community-based participatory research randomized controlled trial. Qual Health Res. 2013;23:847–60.CrossRefPubMed Kneipp SM, Lutz BJ, Levonian C, Cook C, Hamilton JB, Roberson D. Women’s experiences in a community-based participatory research randomized controlled trial. Qual Health Res. 2013;23:847–60.CrossRefPubMed
28.
go back to reference Le H-N, Perry DF, Genovez M, Cardeli E. In their own voices: Latinas’ experiences with a randomized controlled trial. Qual Health Res. 2013;23:834–46.CrossRefPubMed Le H-N, Perry DF, Genovez M, Cardeli E. In their own voices: Latinas’ experiences with a randomized controlled trial. Qual Health Res. 2013;23:834–46.CrossRefPubMed
29.
go back to reference Wootten AC, Abbott JM, Siddons HM, Rosenthal MA, Costello AJ. A qualitative assessment of the experience of participating in a cancer-related clinical trial. Support Care Cancer. 2011;19:49–55.CrossRefPubMed Wootten AC, Abbott JM, Siddons HM, Rosenthal MA, Costello AJ. A qualitative assessment of the experience of participating in a cancer-related clinical trial. Support Care Cancer. 2011;19:49–55.CrossRefPubMed
Metadata
Title
The experience of adolescents participating in a randomised clinical trial in the field of mental health: a qualitative study
Authors
Nick Midgley
Danny Isaacs
Katharina Weitkamp
Mary Target
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Trials / Issue 1/2016
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-016-1474-2

Other articles of this Issue 1/2016

Trials 1/2016 Go to the issue