The hour of departure: Predicting attrition in the training clinic from role expectancies.

Abstract

In addition to having potentially deleterious effects on clients in distress, client attrition also thwarts efforts by trainee clinicians to develop psychotherapy competencies that are uniquely associated with providing middleor late-stage treatment. Within the established literature, one well-replicated correlate of attrition is client expectations. Thus, the following study investigated whether client attrition within a training clinic could be prospectively predicted from pretreatment expectancies. To that end, all adult clients presenting for an intake at a training clinic completed the Psychotherapy Expectancy Inventory-Revised (PEI-R). First, normative reference ranges for the PEI-R total and factor scores were developed. Next, analyses revealed that these reference ranges had good specificity in prospectively identifying clients that subsequently prematurely terminated treatment. Moreover, the computed positive likelihood ratios revealed that an individual who obtains a total score outside of the reference range is 7 times more likely to prematurely terminate therapy in comparison with individuals obtaining scores within the normative reference range. Training clinics are therefore encouraged to routinely administer the PEI-R as a means of identifying individuals at risk for attrition and defining which role expectations may need to be modified.

The three-legged stool of evidence-based practice in eating disorder treatment: research, clinical, and patient perspectives

“…Role expectancies consist of what patients anticipate will happen in treatment (e.g. the process); outcome expectancies include predictions about the effectiveness of treatment and the probability of improvement [ 53 , 54 ]. Outcome expectancies are a form of response expectancies, which underpin both the placebo and nocebo responses, and play a key role in the efficacy of many treatments [ 55 ].…”

Exploring young people's expectations of a youth mental health care service

“…Role expectations refer to a client's expectations of their role and also their expectations around their therapist's role.. 4,5,7,8 Research with adults shows that clients with considerably high or low pretreatment role expectations are significantly more likely to prematurely terminate therapy. 9 Pretreatment role expectations have also been found to be strong predictors of the client's perceived level of working alliance and bond with their therapist. 10 Expectations around the processes of therapy represent one of the least examined areas.…”

Exploring Pretreatment Expectancies in a Campus Mental Health Setting: The Validation of a Novel Expectancies Measure

“…In a previous investigation, role expectations at intake predicted premature termination (Aubuchon‐Endsley & Callahan, ). All clients presenting for intake completed the PEI‐R (Berzins, ; Rickers‐Ovsiankina, Geller, Berzins, & Rogers, ), and normative reference ranges for total and factor scores were computed for use in campus settings.…”