Clinician interventions and participant characteristics that foster adaptive patient expectations for psychotherapy and psychotherapeutic change.

Abstract

Patients' expectations about the efficacy and nature of psychotherapy have long been considered important common treatment factors, and the empirical literature has largely supported this perspective. In this practice-oriented review, we examine the research on the association between patients' psychotherapy expectations and both adaptive treatment processes and outcomes. We also examine the research on specific psychotherapist interventions and patient and psychotherapist characteristics that influence the development of positive expectations for psychotherapy and psychotherapeutic change. The primary function of this review is to derive applied clinical strategies from the extant empirical literature in order to help clinicians in their attempts to address and influence their patients' psychotherapy-related expectations. Although the literature is not yet conclusive in supporting such strategies, we place the results in theoretical, clinical, and empirical contexts to suggest the most likely best practices at this time, and to stimulate further research on the expectation construct.

“Just like talking to someone about like shit in your life and stuff, and they help you”: Hopes and expectations for therapy among depressed adolescents

“…It is unlikely, for example, that most CBT or psychodynamic therapists working with young people would think of themselves as taking a doctor-like role in therapy, yet for many young people, this may be what they are expecting. Whether disconfirming pre-treatment expectations leads to better or worse engagement is a matter of debate in the adult therapy literature (see Constantino et al, 2012), but this study would seem to support the need to both explicitly explore young people's expectations of therapy, and to engage in honest negotiation early in treatment about what therapy may involve. Recent attempts to offer young people better information about CAMHS before beginning therapy are illustrated by My CAMHS Choices (www.mycahmschoices.org), in which therapists answer questions in online video clips about therapy, with the topics being identified by young service users.…”

Experiences of support in working toward personal recovery goals: a collaborative, qualitative study

“…Health professionals’ ability to inspire and maintain hope is viewed as playing a central role in the motivational resources necessary for recovery [40–42]. Having life goals increases service users’ motivation for treatment [43], and such goals contribute to health and well-being [43, 44].…”

The practical use of placebo effect in psychotherapeutic treatment of patients with substance use disorders: therapeutic and ethic consequences

“…При этом совпадение ожиданий пациента с объяснением бу-дущего процесса лечения, которое при первом кон-такте дает психотерапевт, в значительной мере вли-яет на дальнейшее участие пациента в лечении [31]. Кроме того, пациенты могут приходить к психоте-рапевту с уже готовыми ожиданиями в отношении того, как будет проводиться психотерапия и какими могут быть ее результаты: при этом чем выше ожи-дания, тем больше пациент вовлекается в процесс лечения, тем больший эффект можно видеть в ходе терапии и сильнее эффект «реморализации» [30][31][32][33]. Здесь может быть проведена аналогия с феноме-ном «чуда» в религии.…”