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Table 6 Participant-identified factors related to negative affective attitude about trials

From: Advancing cluster randomised trials in children’s therapy: a survey of the acceptability of trial behaviours to therapists and parents

Factors related to negative affective attitude

Sample verbatim text responses from therapist participants

i) Time, therapist capacity, and resources

• Concerned about time commitments on top of day job

• Would this be in addition to my normal caseload or just replace some treatments for the eligible children?

• Additional time required in order to provide additional intervention

• Potential time implications

• Potentially more work

• Unclear how much extra time this will take – where time coming from – impact on other children on caseload

ii) Confidence in and with the new intervention

• Providing a ‘new treatment’ which the [therapist] does not have confidence in – or asking others to deliver – will impact on the effectiveness of the ‘treatment’.

• Being randomly allocated without confidence that the treatment could work would not sit comfortably.

• If the therapy was new and not already evidence based it might be difficult to agree to take part.

• May not feel skilled/confident in the treatment

• Not knowing the treatment/client group – I am more confident with some client groups than others.

• My concern would be if the type of treatment being offered by the trial would not be what I would usually do and I would have concerns regarding the quality of care and outcomes.

iii) (Dis)agreement with the benefit of intervention allocation

• I might not agree with the treatment I am implementing, and I might feel bad that the child is not getting the usual interventions.

• May be a treatment approach that I don’t agree with or feel may not be the most beneficial to the child

• May still clash with professional judgement on what intervention would be most effective

iv) Loss of autonomy

• Loss of individuality for selection of appropriate treatments

• Concerns about possible restrictions when creative problem-solving

• That won’t have choice of treatments for a child I see

• If after a while it became apparent that the therapy isn’t working/appropriate for the child I would be concerned about the lack of flexibility to change the approach.