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Psychotherapy Relationships That WorkEvidence-Based Responsiveness$
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John C. Norcross

Print publication date: 2011

Print ISBN-13: 9780199737208

Published to Oxford Scholarship Online: May 2011

DOI: 10.1093/acprof:oso/9780199737208.001.0001

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(p.354) Chapter 18 Expectations
Psychotherapy Relationships That Work

Michael J. Constantino

Carol R. Glass

Diane B. Arnkoff

Rebecca M. Ametrano

JuliAnna Z. Smith

Oxford University Press

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. This chapter defines outcome expectations and present assessment methods and clinical examples of outcome expectations. The research review includes a comprehensive meta-analysis (N = 8,016 patients across forty-six independent samples) of the association between pre- 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. This chapter also provides a narrative review of mediators of the expectation–outcome link and patient factors that relate to their outcome expectations. Finally, this chapter discusses limitations of the research base and offer therapeutic practices based on the findings.

Keywords:   patient expectations, outcome expectations, treatment outcome, meta-analysis, therapy relationship

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