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.
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