The relationship between trainee therapists’ and clients’ initial expectations and actual treatment duration and outcomes.

Swift, Joshua K.; Derthick, Annie O.; Tompkins, Kelley A.

doi:10.1037/pri0000065

Cited by 16 publications

(11 citation statements)

References 17 publications

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“…Thus, it is plausible that each dyad member's OE contributes in unique ways to their own and their partner's experience of the therapeutic relationship and, ultimately, to the patient's treatment outcome. Supporting this perspective, although the vast majority of OE studies have focused exclusively on patient OE, the few exceptions all found that more optimistic therapist OE (for a specific patient's outcome) was associated with greater patient improvement (Connor & Callahan, 2015;Joyce et al, 2003;Meyer et al, 2002;Swift, Derthick, & Tompkins, 2018). Moreover, there is some evidence that greater therapist OE is associated with more positive patient-perceived alliance quality (Meyer et al, 2002).…”

mentioning

confidence: 99%

Dyadic, longitudinal associations among outcome expectation and alliance, and their indirect effects on patient outcome.

Constantino¹,

Aviram²,

Coyne³

et al. 2020

Journal of Counseling Psychology

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Research indicates that patient outcome expectation (OE) correlates with improvement, and that this association may be mediated by better patient-therapist alliances. However, despite OE and alliance being dyadic and dynamic constructs, most research on these direct and indirect associations has assessed these variables from only one dyad member’s perspective and at single time points. Addressing these gaps, we used a longitudinal actor-partner interdependence model to first examine OE-alliance associations. Namely, we assessed “actor” effects (relation between each member’s OE at 1 session and his or her own next session alliance) and “partner” effects (relation between each member’s partner’s OE at 1 session and his or her own next session alliance). Second, we tested whether significant actor or partner effects of OE on alliance translated into better patient outcomes (indirect effects). Analyses were conducted at within- and between-dyad levels. Data derived from a generalized anxiety disorder trial in which 85 patients received 15 sessions of either cognitive-behavioral therapy (CBT) or CBT integrated with motivational interviewing. After every session, patients and therapists rated OE and alliance, and patients rated their worry. At the within-dyad level, there were OE-alliance actor effects for both patients and therapists. There was also a within-dyad partner effect; when patients had greater OE at one session their therapists reported better next-session alliances. Finally, all within-dyad effects in turn related to lower subsequent worry. Results reveal ways in which session-by-session fluctuations in both patient and therapist OE translate into better outcomes through their influence on alliance quality.

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mentioning

confidence: 99%

Dyadic, longitudinal associations among outcome expectation and alliance, and their indirect effects on patient outcome.

Constantino¹,

Aviram²,

Coyne³

et al. 2020

Journal of Counseling Psychology

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show abstract

“…There is increasing evidence that patients do have preferences for psychotherapy or pharmacotherapy (McHugh, Whitton, Peckham, Welge, & Otto, ), cognitive behavioral or interpersonal psychotherapy, individual or group therapy, brief or long‐term psychotherapy (Swift, Derthick, & Thompkins, ). As awareness of psychological treatments grows, prospective patients may want to compare different treatments before choosing a preferred psychotherapy approach.…”

Section: How Do Ests Mitigate Patient Anxieties?mentioning

confidence: 99%

Whose anxiety are we treating, anyway?

2019

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Objectives This paper explores the ways empirically supported treatments (ESTs) help patients, therapists, and institutional administrators contain anxiety regarding complex human problems. Method The authors synthesized relevant literature with their experience as clinicians and psychotherapy researchers. Results ESTs may manage patient anxieties by framing their symptoms in clearly stated mechanisms and relying on a therapist who is an “expert” capable of healing them quickly. ESTs allow therapists to streamline treatment decisions and minimize intersubjective aspects of treatment which reduces the complexity of therapy. ESTs assist institutional administrators in the top–down dissemination of treatments and limit concerns about malpractice and insurance reimbursement by providing assurance that interventions have been vetted. Conclusions While recognizing the benefits of ESTs, relying on ESTs to manage anxieties may diminish the importance of patient factors and clinical judgment, the other critical aspects of evidence‐based practice, and thus limit the potential of clinical practice to reduce human distress.

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“…In that study, trainees were found to be optimistic but inaccurate in their expectations pertaining to both attrition risk and likelihood of client improvement. A more recent study by Swift, Derthick, and Tompkins (2018) has provided greater understanding of that effect. Following intake, both practicum therapists and clients completed a measure of expectancies concerning their work together.…”

Section: Training To Thwart Attrition: the Role Of Intakementioning

confidence: 99%

The science of training II: Prepracticum and practicum training.

Callahan

Watkins²

2018

Training and Education in Professional Psychology

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Following a brief review of the evidence available at the time, Christensen and Jacobson (1994) concluded that professional training was unwarranted on the basis of client outcomes. As a result, they advocated for psychologists to focus on program development, training, and supervision while promoting an expansion of paraprofessional-, peer-, and self-administered mental health services. In this updated and expanded review, we focus more narrowly on prepracticum and practicum training in doctoral health services psychology and examine the evidence more closely. At the omnibus level, we conclude that evidence for training-as-usual remains lacking. However, closer inspection reveals effective training methods that significantly improve important psychotherapy elements (e.g., relational competencies;Hill et al., 2015) and client outcomes. After review of the empirical literature, we conclude that (1) training-as-usual is insufficient, (2) selection of individuals for training may be of critical importance, (3) training can produce measurable effects, and (4) those changes are both directly and indirectly associated with reduction of attrition and improved client outcomes. Rather than concluding that training is unwarranted, we conclude that training merits evidence-based augmentation.

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The relationship between trainee therapists’ and clients’ initial expectations and actual treatment duration and outcomes.

Cited by 16 publications

References 17 publications

Dyadic, longitudinal associations among outcome expectation and alliance, and their indirect effects on patient outcome.

Dyadic, longitudinal associations among outcome expectation and alliance, and their indirect effects on patient outcome.

Whose anxiety are we treating, anyway?

The science of training II: Prepracticum and practicum training.

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