Patients' expectations have long been considered a contributory factor to successful psychotherapy. Expectations come in different guises, with outcome expectations centered on prognostic beliefs about the consequences of engaging in treatment. In this article, we define outcome expectations and present assessment methods and clinical examples of outcome expectations. Our research review includes a comprehensive meta-analysis (N =8,016 patients across 46 independent samples) of the association between pretherapy or early-therapy outcome expectations and posttreatment outcomes. The overall weighted effect size was d=.24, p<.001, indicating a small but significant positive effect of outcome expectations on adaptive treatment outcomes. We also provide a narrative review of mediators of the expectation-outcome link and patient factors that relate to their outcome expectations. Finally, we discuss limitations of the research base and offer therapeutic practices based on our findings.

This is the first study to examine change in depression and anxiety across the first year of adoptive parenthood in same-sex couples (90 couples: 52 lesbian, 38 gay male). Given that sexual minorities uniquely contend with sexual orientation-related stigma, this study examined how both internalized and enacted forms of stigma affect the mental health of lesbians and gay men during the transition to parenthood. In addition, the role of contextual support was examined. Higher perceived workplace support, family support, and relationship quality were related to lower depressive and anxious symptoms at the time of the adoption, and higher perceived friend support was related to lower anxiety symptoms. Lower internalized homophobia and higher perceived neighborhood gay-friendliness were related to lower depressive symptoms. Finally, individuals with high internalized homophobia who lived in states with unfavorable legal climates regarding gay adoption experienced the steepest increases in depressive and anxious symptoms. Findings have important implications for counselors working with sexual minorities, especially those experiencing the transition to parenthood.

Little research has investigated the division of child care and housework in adoptive or lesbian/gay parent families, yet these contexts “control for” family characteristics such as biological relatedness and parental gender differences known to be linked to family work. This study examined predictors (measured preadoption) of the division of child care and housework (measured postadoption) in lesbian (n = 55), gay (n = 40), and heterosexual (n = 65) newly adoptive couples. Same‐sex couples shared child care and housework more equally than heterosexual couples. For the full sample, inequities in work hours between partners were associated with greater discrepancies in partners' contributions to child care and masculine tasks; inequities in income between partners were related to greater discrepancies in contributions to feminine tasks. Participants who contributed more to child care tended to contribute more to feminine tasks. These findings extend knowledge of how labor arrangements are enacted in diverse groups.

No abstract

This study examines the three facets of psychological resilience (i.e., perceived control, commitment to living, challenge versus stability) as predictors of depressive symptoms over time among spousal caregivers of persons with Alzheimer disease; these resilience factors were considered over and above dementia-related and socio-demographic control variables. A sample of 105 cohabiting spouses of persons diagnosed with probable or possible Alzheimer disease was recruited for this study. Multilevel modeling enabled us to examine baseline resilience, and the direction and magnitude of change in resilience over time, as distinct predictors of depressive symptoms one year later, and change in depressive symptoms between points of measurement. Both Time 1 control and challenge predicted lower levels of depressive symptoms one year later; furthermore, an increase in challenge over this interval predicted lower Time 2 depressive symptoms. In contrast, commitment did not emerge as a statistically significant predictor of caregiver depression. Findings of this study provide general support for the stress process model of caregiving; in particular, the central role of intra-psychic factors as significant predictors of depressive symptoms over time.