Who Should Receive Subsidized Psychotherapy?: Analysis of Decision Makers’ Think-Aloud Protocols

Abstract

Three groups of judges representing clinical, political, and laypersons’ perspectives were given the task of prioritizing patients for subsidized psychotherapy within the Swedish health care system. The authors documented the judges’decision-making processes in think-aloud protocols and analyzed them qualitatively, focusing on the conflict between the urgency of a case and its suitability for treatment. In an earlier statistical analysis of the same material, clinicians had seemed to pay more attention to suitability criteria, whereas health care officials and laypersons prioritized based on urgency. The qualitative findings confirmed the centrality of this conflict and contributed to a deeper understanding of decision makers’ways of coping with it. Their conceptions of suitability and urgency were also elucidated by analysis of the think-aloud protocols.