Examining patient characteristics as predictors of patient beliefs about treatment credibility and expectancies for treatment outcome.

Abstract

Although it is widely documented that a patient’s expectations for treatment outcome and credibility beliefs about treatment are consistent correlates of outcomes across settings and treatment modalities, few data exist regarding predictors of these expectations and beliefs. The current study aimed to test specific patient characteristics, such as demographic variables (e.g., age, sex, race) and clinical variables (e.g., diagnosis, level of depression, anxiety), as predictors of treatment expectancy, and credibility beliefs in a naturalistic treatment setting. Five hundred patients in a New England-based partial hospital program completed a battery of self-report measures and a structured diagnostic interview at admission following a program orientation, but prior to contact with their therapists. Multivariate regression models showed that only depression severity was a unique predictor of expectancy, β = −.312, p < .001. Male sex, β = −.155, p < .001, more severe depression, β = −.167, p = .003, and current social anxiety disorder (SAD), β = −.123, p = .006, predicted lower credibility beliefs. Patients with current posttraumatic stress disorder (PTSD) reported higher credibility beliefs, β = .122, p = .008. Neither treatment-outcome expectancy nor treatment-credibility belief differed significantly by race, level of education, or marital status. Patients with more severe symptoms and SAD may stand to benefit most from interventions aimed at enhancing expectations and credibility beliefs. Further research is needed to identify additional characteristics and treatment factors associated with treatment expectancy, as well as methods for enhancing expectancy.

Portuguese validation of the credibility/expectancy questionnaire in routine practice

“…Finally, regarding the predictive validity of CEQ and symptomatic decrease in session 3, our results suggest that outcome expectation, specifically, has an effect in decreasing symptoms. These results are consistent with those of other validations (Cohen et al, 2015;Devilly & Borkovec, 2000;Smeets et al, 2008), which evidence that outcome expectation predict the decrease of the depressive and anxiety symptoms, treatment satisfaction and the improvement of well-being.…”

“…The credibility/expectancy questionnaire (CEQ) (Devilly & Borkovec, 2000) is one of the mostly used measures to assess the client's credibility and expectancy, which has shown results not only in reducing depressive, anxiety and general symptoms, but also in the increase of the therapeutic alliance in the psychotherapy (cf. Cohen, Beard, & Björgvinsson, 2015;Greenberg, Constantino, & Bruce, 2006;Newman & Fisher, 2010;Sochting, Tsai, & Ogrodniczuk, 2016;Stinson, Perez, Ohrt, Von Schell, & Bruening, 2018;Thompson-Hollands, Bentley, Gallagher, Boswell, & Barlow, 2014;Tompkins, Swift, Rousmaniere, & Whipple, 2017). It is a self-report questionnaire composed by 6 items clustered in two subscales: i) credibility; and ii) outcome expectation (Devilly & Borkovec, 2000).…”

Moderators and predictors of response to behavior therapy for tics in Tourette syndrome

“…Positive expectations for treatment depend, at least in part, on agreement between the patient and the clinician on the goals of treatment as well as the specific components of the therapy. 30 Thus, open discussion about the goal (tic reduction) and techniques of CBIT (e.g., awareness training and competing response training) between the therapist and the patient is warranted.…”

Does Expectancy and Homework Compliance Predict Change in CBT?

“…This relationship appears to exist for various anxiety disorders (e.g. [8,10,16]). However the question arises as to which specific mechanisms cause the expectations of a patient to affect the change process [11].…”

“…Although CBT is recognized as an empirically welldocumented treatment, the exact mechanisms that cause a change have not been explored so far [7]. Studies investigating the effectiveness of CBT in psychotherapy have shown that the positive treatment expectations of a patient play a central role and are directly related to the therapy result [8][9][10]. However, again little is known about the specific mechanisms responsible…”