Predictors of Change in Patient Treatment Outcome Expectation
Andreea Visla, PhD & 2 others
November 28, 2021
Abstract
This article examined patients’ change in outcome expectation across cognitive-behavior therapy for generalized anxiety disorder, as well as participant factors that are associated with both pretreatment outcome expectation and expectation change. Findings: On average, patients’ outcome expectation becomes more positive over time. Moreover, the degree of such change is influenced by several baseline and early treatment patient factors and by the therapist themselves. Meaning: Therapists should consider assessing outcome expectation throughout cognitive-behavior therapy for generalized anxiety disorder and pay attention to baseline patient characteristics (i.e., demographic and clinical variables) and their early change in general self-efficacy, as these might be important clinical indicators of both patients’ pretreatment outcome expectation level and expectation change. In addition, therapists should “know thyself,” as they may differ in their ability to foster positive expectancy change for their average patient (which could bear on clinical practices and training needs). Next Steps: Future research needs to replicate the current findings and extend them by investigating therapist-level characteristics and/or actions that might explain why some therapists do a significantly better job than others of facilitating positive patients’ outcome expectation. This latter focus would contribute to developing more effective evidence-based therapist trainings.
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About the Authors
Michael J. Constantino, Ph.D.
Dr. Michael J. Constantino received his BA in Psychology from the State University of New York (SUNY) at Buffalo, and his MS and PhD from the Pennsylvania State University. He completed a predoctoral clinical internship at SUNY Upstate Medical University, and a postdoctoral fellowship at the Stanford University Medical Center. He then joined the Clinical Psychology faculty at the University of Massachusetts Amherst (UMass), where is a Professor of Psychological and Brain Sciences (PBS). At UMass, he directs the Psychotherapy Research Lab, teaches graduate and undergraduate courses on psychotherapy, supervises clinicians-in-training, and is the PBS Graduate Program Director. Among other professional positions, Dr. Constantino is Past- President of the North American Society for Psychotherapy Research and APA Division 29 (Society for the Advancement of Psychotherapy). Dr. Constantino’s professional and research interests center on patient, therapist, and dyadic characteristics/processes influencing psychosocial treatments; pantheoretical principles of clinical change (i.e., common factors); and measurement-based care.President of the North American Society for Psychotherapy Research, and current President of APA Division 29 (Society for the Advancement of Psychotherapy). Dr. Constantino’s professional and research interests center on patient, therapist, and dyadic characteristics/processes influencing psychosocial treatments; pantheoretical principles of clinical change (i.e., common factors); and measurement-based care.http://www.umass.edu/pbs/people/michael-constantino https://sites.google.com/site/constantinotherapyresearchlab/home
Christoph Flückiger, Ph.D., SwissBPP
Dr. Christoph Flückiger received his Doctorate in Clinical Psychology, with an emphasis in Psychotherapy Research from the University of Bern, Switzerland. He was post-doctoral researcher at the Department of Counseling Psychology at the University of Wisconsin-Madison. Recently, he is professor and head of a psychotherapy research lab for generalized anxiety disorder at the University of Zürich, Switzerland. Christoph Flückiger is licensed psychotherapist and supervisor in Switzerland and Germany. He is Editor-Elect of the journal Psychotherapy Research.
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References
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