Treatment expectancies, patient alliance and outcome: Further analyses from the National Institute of Mental Health Treatment of Depression Collaborative Research Program.

Abstract

Prior analyses from the National Institute of Mental Health Treatment of Depression Collaborative Research Program indicated that patients' expectancies of treatment effectiveness (S. M. Sotsky et al., 1991) and the quality of the therapeutic alliance (J. L. Krupnick et al., 1996) predicted clinical improvement. These data were reanalyzed to examine the hypothesis that the link between treatment expectancies and outcome would be mediated by patients' contribution to the alliance. Among 151 patients who completed treatment, this hypothesis was supported, suggesting that patients who expect treatment to be effective tend to engage more constructively in session, which helps bring about symptom reduction. Therapists' expectancies for patient improvement also predicted outcome, although this association was not mediated by the alliance. None of the expectancy scales interacted with alliance ratings in the prediction of clinical improvement.

Effects of biological explanations for mental disorders on clinicians’ empathy

“…Given the ascendancy of biomedical conceptions of psychopathology, clinicians' pessimistic expectancies could actually decrease patients' chances of benefiting from psychotherapy (33). Furthermore, if biological conceptualizations lead clinicians to increasingly favor pharmacotherapy over psychotherapy, this could potentially exacerbate the kind of decreases in empathy found in the current study.…”

Mental Health Service Providers: College Student Perceptions of Helper Effectiveness

“…Client perceptions of an MHSP's competency in regard to treating specific needs have an effect on the therapeutic alliance as well as clients' ability to facilitate positive changes in their lives. According to Meyer et al (2002), client expectancy concerning the effectiveness of counseling is critical and often sufficient for inspiring positive change for the client. As far back as 1973, Frank asserted that counseling is most effective when both the client and counselor believe in the effectiveness of the intervention.…”

A Theoretical Model of Common Process Factors in Youth and Family Therapy

“…In addition, distracted novice therapists have been found to be the most likely to use self-disclosure . A number of studies have found therapist expectancies of treatment outcomes related to treatment outcomes but unfortunately nothing is known about whether or not therapist behaviors mediated this relationship (Joyce, Ogrodniczuk, Piper, & McCallum, 2003;Meyer et al, 2002). There do not appear to be studies in the youth mental health literature examining this link in our conceptual model.…”