Emily M. Johnson, Julie C. Gass, Jennifer S. Funderburk

As we work to ascertain "what works clinically?" in integrated care, qualitative data from patients can inform our understanding of which aspects of treatment are helpful to patients. Prior research suggests that process factors (e.g., therapeutic rapport), coping skills (e.g., those taught in CBT), and knowledge are valued by patients in Primary Care Behavioral Health (PCBH; Allen et al., 2025; Koehler et al., 2020). The goals of this secondary analysis were to describe which aspects of anxiety treatment patients found most helpful and examine whether responses differed by type of treatment (structured intervention vs. unstructured counseling). We hypothesized that patients in the structured intervention would be more likely to identify learning skills (vs. process factors) as most helpful and patients in the unstructured treatment would be more likely to identify process factors (vs. learning skills) as most helpful. Data are from 119 patients who attended ≥1 treatment session and completed the 16-week post-treatment assessment in a randomized clinical trial. 61 patients received Modular Anxiety Skills Training, a structured CBT intervention, and 58 received PCBH treatment as usual, which primarily comprised supportive counseling and psychoeducation. We inductively coded responses to an open-ended question: “Thinking back on the treatment sessions you completed with the behavioral health provider since you started this study, what was most helpful to you?” 44% of patients identified learning skills as the most helpful aspect of anxiety treatment compared to 39% for process factors, 9% knowledge, 6% nothing, and 3% other. Among those reporting learning skills as most helpful, relaxation techniques and general coping tools were frequently reported. For patients reporting process factors, having someone to talk to/listen was most common. As hypothesized, patients in the structured intervention were more likely to identify skills (67%) than process factors (33%) as most helpful, whereas those in PCBH treatment as usual were more likely to identify process factors (63%) vs. skills (37%), p=.003. Obtaining patient perspectives is integral to understand what patients find helpful in treatment. Consistent with prior research, we found that patients receiving anxiety treatment valued both process factors and learning skills. Results suggest that within more structured treatment, such as CBT skills training interventions, patients are more likely to perceive learning skills as the most helpful aspect of treatment. This presentation will be of interest to both clinicians and researchers in PCBH as we discuss the importance of blending common factors and skills training to optimize the impact of treatment.

Discuss how qualitative research helps us to better understand patient perspectives

Describe the difference between process factors, coping skills, and knowledge

List multiple aspects of PCBH treatment that are valued by patients with anxiety