An exploratory study of inducing positive expectancies for psychotherapy

Abstract

Objectives: The goal of this study was to determine whether explicit presentation of outcome data about the effectiveness of psychotherapy among older adults increased positive expectancy for treatment.

Method: The study included an ethically diverse sample of 50 adults over age 60 who screened positive for depression and agreed to participate in the BRIGHTEN Program, an interdisciplinary geriatric mental health program. Prior to treatment initiation, we presented participants with outcome data about psychotherapy, asked participants to rate and respond to the data, and asked participants about prior experience with mental health treatment. These data were collected via semi-structured interviews.

Results: Higher importance ratings for the outcome data were significantly associated with starting psychotherapy (r = 0.30, p = 0.04). Depression severity predicted importance assigned to the outcome data (ß = 0.36, p = 0.03), more severely depressed participants rated the outcome data as more important. Qualitative analyses indicated that the presentation of outcome data increased hopefulness for successful treatment. In a hierarchical regression analysis, hopefulness in the data predicted data importance ratings, above and beyond the influence of depression severity (ß = 0.50, p < 0.01).

Conclusion: Our results suggest that information about the effectiveness of psychotherapy was important to participants and was associated with starting psychotherapy. High importance ratings for the data were primarily driven by the data increasing hopefulness for successful treatment outcomes. Although this study was exploratory, it suggests that explicit presentation of the effectiveness of psychotherapy may create positive expectancies for treatment among older adults.

Keywords:

• mental health
• decision making
• age factors
• clinical psychology

Acknowledgments

Portions of this study were presented at the 63rd annual scientific meeting of the Gerontological Society of America. The authors thank the BRIGHTEN program Project Coordinators, Laurie Bederow, LCSW and Grisel Rodriguez-Morales, MSW, LSW, who assisted with participant recruitment.

Funding: This study was funded by a George Bennett Postdoctoral Grant to the first author from the Foundation for Informed Medical Decision Making (FIMDM 0145-1). The participants for this study were recruited from the BRIGHTEN program. BRIGHTEN is funded by the Substance Abuse and Mental Health Services Administration Center for Mental Health Services (SM058673).

Declaration of interest: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government.

Notes

Note

Erin Woodhead is now at the VA Palo Alto GRECC, supported by funding from the VA Special Fellowship Program on Advanced Geriatrics.