Discussion
OLP
RTA
This qualitative study–nested within a 3-week RCT in test anxious students–sought out to assess participants’ views and experiences towards a novel IP intervention and to compare them to those of participants receiving OLPs. Further, we aimed to corroborate these findings with data from open-ended questions of the RCT and to give insights into individual characteristics and appearances of imaginations from study participants.Four key themes were identified: (1) attitudes towards the intervention, (2) applicability of the intervention, (3) experience of effects, (4) characteristics of the imagination (see Regarding the experience of effects (theme 3) and characteristics (theme 4) of the IPs, a wide range of beneficial effects, as well as various individual pill properties were reported. Mostly, the IP intervention helped with stress relief and increased participants’ concentration and self-confidence. The experienced effects matched those, that participants recorded in the interactive document after the treatment session (see Overall, the qualitative findings derived from the RTA could be confirmed with the open-ended questions from the RCT and the results from the IP group can be applied to those participants receiving OLPs: The OLP intervention was equally well received, described as easy to apply, and initially met with ambivalence (openness and skepticism), although initial skepticism was countered by the treatment rationale provided. Similarly, the reported effects of both groups were comparable. However, some intervention-specific themes emerged in the qualitative interviews, particularly related to only one intervention: Imagining a pill was, for instance, considered more demanding and challenging by some participants compared to taking a physical pill, whereas imagination was also regarded as a central component of the intervention. Additionally, the IP intervention was described as a possible alternative for individuals who have an aversion to pills. In terms of effects, whereas both interventions were perceived as beneficial during the learning phase, solely OLP participants additionally reported having felt a supportive effect during the exam. This finding suggests that OLPs may be more helpful in acute situations, whereas IPs may be more protective, counteracting the onset of symptoms in a preventive manner.This is the first qualitative study on the use of IPs. However, qualitative research exists in the field of OLP: There, participants of OLP intervention arms rated OLPs to be acceptable and reported an overall positive experience [Whereas the treatment rationale seems to be decisive in order to produce placebo effects, the component of a physical pill might apparently not be. IP and OLP are, however, not only equally efficacious (difference n.s. 