In this blog, Alison Jenaway reflects on running a randomised controlled trial earlier in her career.
When I was a trainee psychiatrist I ran a randomised controlled trial (RCT) of cognitive therapy for depression. I was full of admiration for the people who agreed to take part. Some of them were really struggling and yet they agreed to be part of a trial which meant they might, or might not, get cognitive therapy. There was a 50/50 chance for each person. If you didn’t get the therapy, you still had to turn up to repeated appointments with me. You’d fill in a whole load of forms about your mood and how you were managing. It was also important that the “control group” did not get any other kind of therapy instead. That would have messed up the results.
Of course, if someone’s mood got a lot worse and they really needed more treatment, then we would withdraw them from the trial. This kind of relapse was one of the outcomes we were studying. We were interested in how many people in the control group relapsed, compared to those in the therapy group.
To make sure people taking part in studies like this are properly protected, every research trial has safeguards built in. An Ethics Panel has to approve every study. They can insist on changes to ensure that taking part doesn’t cause harm.
When I asked people why they agreed to take part, knowing that they might not get the treatment, some said they were doing it in the hope of getting the therapy. However most said that they wanted to help others. They understood that being part of a research project was one way that they could do that. Perhaps that was one way of giving meaning to their suffering?
Dr Alison Jenaway is a Consultant Psychiatrist in Psychotherapy in the Liaison Psychiatry Service in Cambridge. She is a CAT therapist and supervisor and has been using CAT for around 20 years, and is currently Chair of the national Association for Cognitive Analytic Therapy.