Journal article
The Relationship Between Clients' Expectation of Therapist Support and Challenge and Treatment Outcome: A Response Surface Analysis
Psychotherapy (Chicago, Ill.), Vol.59(3), pp.481-486
09/01/2022
DOI: 10.1037/pst0000440
PMID: 35604718
Abstract
Clients' expectations of treatment have long been posited as an important therapeutic factor in treatment success. Decades of research and meta-analytic findings have supported the notion that client expectations about what will happen over the course of therapy and how beneficial therapy will be are directly related to treatment factors, such as the working alliance and treatment outcome. Client expectations can be categorized into two broad categories, outcome expectations (i.e., how beneficial treatment will be) and treatment expectations (i.e., what will happen in treatment). This study sought to examine clients' treatment expectations, specifically, their role expectations, which represent their beliefs of how their therapists will act in session. Data for this study included 1,233 clients participating in individual counseling with 49 therapists at a university counseling center. Multilevel polynomial regression and response surface analysis were used to test congruent and discrepant effects of clients' pretreatment support and challenge expectancy on reductions in their psychological distress over the course of treatment. Results indicated that reductions in clients' psychological distress were the greatest when their support and challenge expectancy scores were congruent and high. In other words, clients who expected both high challenge and high support from their therapist, prior to the start of counseling, reported the greatest improvement in counseling. Clients similarly reported reductions in their psychological distress when their support and challenge expectations were congruent and low, although this effect was smaller than when they expected high levels of both support and challenge. Together, these findings suggest that when clients' expectations of support and challenge are similar, they fare better in treatment, as opposed to when they expect a greater amount of support than challenge or vice versa.
Clinical Impact Statement Question: How do clients' expectations of therapist support and challenge impact their treatment outcome? Findings: This study found that reductions in clients' psychological distress were the greatest when they expected their therapists to provide both high challenge and high support prior to the onset of treatment. Meaning: Therapists should recognize the effect of client's role expectation and attend to these expectations at the beginning of therapy and, when appropriate, intervene to help develop more adaptive expectations. Next Steps: Future research can seek to investigate the relationship between clients' role expectations, therapists' in-session behaviors, and treatment outcomes.
Details
- Title: Subtitle
- The Relationship Between Clients' Expectation of Therapist Support and Challenge and Treatment Outcome: A Response Surface Analysis
- Creators
- Kun Wang - Univ Iowa, Dept Psychol & Quantitat Fdn, 361 Lindquist Ctr, Iowa City, IA 52242 USAHalin Chung - Univ Iowa, Dept Psychol & Quantitat Fdn, 361 Lindquist Ctr, Iowa City, IA 52242 USAShannon L. Stuart-Maver - Univ Iowa, Dept Psychol & Quantitat Fdn, 361 Lindquist Ctr, Iowa City, IA 52242 USABarry Schreier - University of IowaPatrick Galligan - Univ Iowa, Univ Counseling Serv, Iowa City, IA 52242 USAHolly Davis - Univ Iowa, Univ Counseling Serv, Iowa City, IA 52242 USAD. Martin Kivlighan - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Psychotherapy (Chicago, Ill.), Vol.59(3), pp.481-486
- DOI
- 10.1037/pst0000440
- PMID
- 35604718
- NLM abbreviation
- Psychotherapy (Chic)
- ISSN
- 0033-3204
- eISSN
- 1939-1536
- Publisher
- Educational Publishing Foundation-American Psychological Assoc
- Number of pages
- 6
- Language
- English
- Date published
- 09/01/2022
- Academic Unit
- Psychiatry; Psychological and Quantitative Foundations; Internal Medicine
- Record Identifier
- 9984359954902771
Metrics
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