Believing is seeing: An evolving research program on patients' psychotherapy expectations

Abstract

In this article I discuss one facet of my evolving research program focused on patients' psychotherapy-related expectations. Although generally considered a common psychotherapeutic factor, expectations have been historically undervalued conceptually, empirically, and clinically. Attempting to somewhat redress this slight, I will (a) define the various forms of patients' psychotherapy-related expectations, (b) present relevant findings from research that my colleagues, students, and I have conducted, (c) summarize an integrative psychotherapy approach that underscores expectations as an explanatory construct for patients' corrective experiences, and (d) highlight future research directions for increasing our understanding of the nature and functions of the expectancy construct.

Abstract

Dans cet article je discute une facette de mon programme de recherche en évolution focalisé sur les attentes des patients reliées à la psychothérapie. Bien que généralement considérées comme un facteur commun, les attentes ont été historiquement sous-évaluées conceptuellement, empiriquement et cliniquement. Dans l'idée d'essayer de réparer cette faiblesse, je vais (a) définir les différentes formes d'attentes du patient concernant la psychothérapie, (b) présenter des résultats pertinents de recherches que mes collègues, mes étudiants et moi-même avons réalisées, (c) résumer une approche psychothérapeutique intégrative qui souligne les attentes comme l'un des 15 facteurs explicatifs de l'expérience correctrice des patients, et (d) souligner les directions des recherches futures pour augmenter notre compréhension de la nature et des fonctions du concept d'attente.

Abstract

In diesem Artikel diskutiere ich eine Fassette meines sich in der Entwicklung befindenden Forschungsprogramms, welches sich mit den therapiebezogenen Erwartungen von Patienten befasst. Obwohl Patientenerwartungen als allgemeiner psychotherapeutischer Wirkfaktor aufgefasst werden, sind sie bisher konzeptionell, empirisch und klinisch unterbewertet worden. Mit dem Ziel diesem Umstand Abhilfe zu schaffen werde ich (a) die verschiedenen Formen von Psychotherapieerwartungen definieren, (b) relevante empirische Befunde von meinen Kollegen, Studenten und mir darlegen, (c) einen integrativen psychotherapeutischen Ansatz, welcher Therapieerwartungen im Sinne von korrektiven Erfahrungen unterschätzt, zusammenfassen und (d) zukünftige Forschungsrichtungen für ein zunehmendes Verständnis über die Natur und Funktionsweise von Erwartungen hervorheben.

Abstract

Nel presente articolo ho riportato un aspetto del mio programma di ricerca in progress che è focalizzato sulle aspettative dei pazienti legate alla psicoterapia. Sebbene venga spesso considerato come un fattore della psicoterapia le aspettative sono state storicamente sottovalutate concettualmente, empiricamente e clinicamente. Cercando in qualche modo di oltrepassare questa mancanza (a) definirò le varie forme di aspettative del paziente legate alla terapia, (b) presenterò i risultati più rilevanti rispetto alle ricerche condotte da me, i miei colleghi e studenti, (c) riassumerò i risultati in un approccio terapeutico integrato che sottolinei le aspettative come esplicative di costrutti di esperienze correttive per i pazienti e (d) evidenziando le direzioni delle future ricerche per accrescere o comprendere la natura e le funzioni del costrutto delle aspettative

Abstract

Neste artigo eu discuto uma faceta do meu programa de investigação compreensivo focado nas espectativas dos pacientes relacionadas com a psicoterapia.

Apesar de ser geralmente considerado como um fator psicoterapêutico comum, as expectativas tem vindo a ser subvalorizadas conceptualmente, empiricamente e clinicamente. Numa tentativa para abordar este aspeto, irei (a) definir as várias formas de expectativas de pacientes relacionadas com a psicoterapia, (b) apresentar dados relevantes de investigação que colegas, alunos e eu próprio recolhemos, (c) sumariar uma abordagem psicoterapêutica integrativa que sublinha as expectativas como um constructo útil para as experiências corretivas de pacientes, e (d) salientar direções futuras de investigação para aumentar a nossa compreensão da natureza e função do constructo das expectativas.

Abstract

Keywords:

• patient expectations
• outcome expectations
• common factors
• corrective experiences
• psychotherapy process and outcome

Acknowledgements

I am deeply honored to have received the 2010 Outstanding Early Career Achievement Award from the Society for Psychotherapy Research. In many ways, this award reflects extraordinary mentorship. In this sense, I am deeply indebted to Louis Castonguay for his time, guidance, wisdom, inspiration, friendship, and unwavering support. I also thank Bruce Arnow, Roger Greenberg, Leonard Horowitz, Rachel Manber, and Elizabeth Pinel, who provided influential training at critical junctures in my early career. I would also like to acknowledge the support and collaboration of additional mentors, colleagues, and students, including, but not limited to: Stewart Agras, Rebecca Ametrano, Lynne Angus, Samantha Bernecker, Thomas Borkovec, James Boswell, Noah Bruce, Kenneth Critchfield, Joan DeGeorge, Marvin Goldfried, Martin Grosse Holtforth, Laurie Heatherington, David Kraus, Holly Laws, Gregory MacEwan, Michelle Newman, Christopher Overtree, Sofiya Penek, Alberta Pos, Lotte Smith-Hansen, Henny Westra, and Kelly Wilson.