The authors of this review demonstrate the correlation between the cultural features, social factors and the patients’ expectations from the psychotherapy. Russian psychologists have been paying very little attention to client expectations. It is very often that convergence between the patient´s expectations from psychotherapy and that the psychotherapist offers the patient - often depends on the success of the therapy. The results of many studies confirm that clients´ expectations are an important factor with regards to the efficiency of psy-chotherapy as well as to the rate of drop-outs. Reliable methods of assessment of clients´ expectations allow to create and to implement strategies of pre-therapy interventions. The theoretical structure of patients´ expectations is complex, as is the set of their determinants. Patients´ choices reflect their mentality, the social stratum and cultural tradition they belong to, their personal traits and value systems, inner dynamic factors including the type of attachment and particularities of the psychopathology, and so on. The paper covers multiple aspects of determination of the construct «patient´s expectations». Particular focus is on the cultural determinants of Russian patients´ expectations. In the analysis of cultural determinants of therapy expectations the authors used approaches of Ruth Benedict and Geert Hofstede. According to Benedict´s classification Russian culture might be considered more as so-called Dionysian culture. According to authors’ analysis more pertinent patients´ expectations formed by Russian culture might be such psychotherapies as psychodrama, NLP, Gestalt-therapy Holotropic Breathwork; and in a less degree – psychoanalysis.

After the analysis of the frequency of occurrence of various motives conception (the pregnancy), the authors concluded that only 20% of women are such motives as « pregnancy for a child» and «pregnancy from a loved one to» (positive in relation to the unborn child), which is significantly less (p<0.05) than the predominance of non-structural motifs. In the primaparous women with low anxiety level the most prevalent conception motive was "to comply with social expectations" (75%) and "to preserve own health" (25%). In the primaparous women with high anxiety level the most prevalent motive was "pregnancy for the sake of a child" (65%), and also "to preserve relationship" (25%) and "to preserve health" (10%). In the primaparous women with "nominally normal" anxiety level (for a pregnancy) the most prevalent motives were "pregnancy to preserve relationship" (55%) and "to comply with social expectations" (40%). In the multiparous women the main motives were "to comply with social expectations" (25%) "to preserve relationship with a man» (35%) and "to preserve health" (15%). In summary, according to the obtained data, in the primaparous women with low anxiety level the most prevalent motives were not positive with regard to the expected child (or associated with a beloved spouse), but driven by rational ideas of "compliance" and "health benefit". In contrast, the primaparous women with high anxiety level were frequently more positively motivated with regard to the expected child (i.e. high anxiety level was frequently caused by the worries about the expected child).

The authors present the data of comparative analysis of the prevalence and severity of depressive symptoms and anxiety in the primaparous and multiparous women in the third trimester of pregnancy. According to this study, the symptoms of depression were found in 45% of pregnant women; in the primaparous women - in 2 times more often than the multiparous women ( 51% and 30% respectively). Also, the authors concluded that high anxiety level is observed in almost 100% of the multiparous women, but this level corresponds to "nominally normal level" in the third trimester of pregnancy (less than 18 points on Hamilton scale). However, in the primaparous women the «nominally normal level» of anxiety is observed only in 55% of cases; in the rest of women the level of anxiety varies from low (in 20% of women) to very high (in 25% of pregnant women), which may indicate a disturbance in the formation of normal psychological component of gestational dominance in the primaparous women evaluated and justify the necessity of individual and group psychotherapy.

One of the most important factors, influencing the development on concept of confidence in psychotherapy is social environment. The analysis of expectations of Russian patients towards psychotherapy (this construct with a certain limitations can be assimilated to concept of confidence in psychotherapy) requires taking into account social environment factor, including social-demographic situation in the Russian Federation. According to the results of a survey of the Public Opinion Foundation (POF) including 1500 individuals aged 18+ years (dated November 2014), the use of psychotherapeutic and psychological services decreased since 2006 by 20% (!) and today constitutes less than 20%. According to participant’s opinion, the accessibility of psychotherapeutic service slightly increased (by 5%). During the same time period the number of respondents who are certain that reference to psychologists or psychotherapists is worthless increased by 8%. At the same time, according to national statistical investigations, more than 30% of population has psychiatric conditions requiring medical help or consultation of a psychiatrist, or, more often, a psychotherapist or clinical psychologist. Consequently, there is a decrease of confidence in psychotherapy among potential service consumers in our country, which is to no small degree associated with concern of disapproval of psychotherapeutic help by reference group (friends, colleagues, family members etc.). In other words, psychotherapeutic or psychological help will be associated with shame and insecurity. The reason for such an attitude of population to psychotherapeutic treatment are likely distorted perception, associated with lack of information, apprehensive attitude towards psychiatric treatment (which is closely related in the public consciousness to psychotherapy). The attitude of internists and health officials towards psychotherapy may play an important role in the discrediting psychotherapy. One gets the impression that nowadays at the present stage of development of psychotherapy in our country, educational function of psychotherapist becomes of paramount significance. It should be aimed both at the development of knowledge on the efficacy of psychotherapeutic methods and at the necessity of engagement of psychotherapists and psychologists in diagnostics and treatment alongside with internal medicine doctors, and also at the promotion of credibility of psychotherapy among the potential users of psychotherapeutic services.

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