The Relationship Between Trainee Therapists' and Clients' Initial Expectations and Actual Treatment Duration and Outcomes

• Published in: Practice innovations (Washington, D.C.) D.C.), 2018-06, Vol.3 (2), p.84-93
• Main Authors: Swift, Joshua K, Derthick, Annie O, Tompkins, Kelley A
• Format: Article
• Language: English
• Subjects: Client Characteristics; Expectations; Female; Human; Male; Psychotherapeutic Processes; Test Construction; Therapist Attitudes; Therapist Characteristics; Therapist Trainees; Treatment Duration; Treatment Outcomes
• ISSN: 2377-889X; 2377-8903
• DOI: 10.1037/pri0000065

The purpose of this study was to examine the relationship between trainee therapists' and clients' duration and outcome expectations and actual treatment duration and outcomes for clients. Eleven therapists-in-training completed measures of duration and outcome expectations for clients in general at the start of the study. After the intake sessions, trainee therapists and their clients (N = 34) completed the same expectation questions applied to the specific case. Results indicated that clients' expectations and student therapists' specific case expectations were significantly more positive than student therapists' general expectations for psychotherapy. Results further indicated that taken together, trainee therapists' (general and specific) and clients' expectations did not significantly predict actual treatment duration; however, they were able to significantly predict treatment outcomes, explaining 11% of the variance in client change. Student therapists' specific expectations were the only significant unique predictor of change. These results suggest that therapists should be aware of their own expectations when working with clients in order to make sure that any negative beliefs do not impact the quality of care that they provide. Clinical Impact Statement The results of this study indicate that trainee therapists' outcome expectations for their specific clients predict actual treatment outcomes above and beyond clients' expectations and their general expectations about the effectiveness of psychotherapy. The results suggest that therapists should pay close attention to how their own prognostic beliefs might play a role in their work with clients, especially in relation to other possible mediating and/or moderating variables (e.g., optimism, confidence, clinical experience).