TherapyMatch-D: A randomized controlled trial of psychological treatment selection for depression

This trial is open to adults aged 18 and older who are experiencing depression and are seeking help through an NHS Talking Therapies service. To be suitable, you must have a depression score that shows you could benefit from 'high-intensity' (Step 3) therapy, which is standard for moderate to more severe symptoms. You can still join if you have anxiety alongside depression or if you are currently taking antidepressant medication.

You will need to be comfortable completing your initial mental health assessment in English without needing an interpreter. People who have had therapy before are welcome to join, as long as their therapist confirms that high-intensity care is the right next step for them.

This study is tied to specific participating NHS clinics. You cannot join if you are not receiving care through one of the participating services or if your care is better suited to low-intensity support (such as guided self-help).

If your local Talking Therapies clinic is taking part, you will have your usual initial assessment with an NHS clinician. During this appointment, your therapist will enter your routine information into a computer system. Depending on which group your clinic has been assigned to, the system may provide a personalized therapy recommendation (either CBT or counselling), or your clinic will use its normal process to discuss your options.

In either case, you and your therapist will make the final decision together. You will then attend your chosen therapy sessions just as you normally would within the NHS. There are no extra hospital visits, experimental drugs, or medical procedures involved. The study simply follows your progress during your regular treatment to see how well you recover. A small number of patients may also be invited to complete a short, optional interview to share their thoughts on the decision-making process.