Treatment expectancies, patient alliance, and outcome: further analyses from the national institute of mental health treatment of depression collaborative research program
Abstract
Prior analyses from the National Institute of Mental Health Treatment of Depression Collaborative Research Program indicated that patients' expectancies of treatment effectiveness (S. M. Sotsky et al., 1991) and the quality of the therapeutic alliance (J. L. Krupnick et al., 1996) predicted clinical improvement. These data were reanalyzed to examine the hypothesis that the link between treatment expectancies and outcome would be mediated by patients' contribution to the alliance. Among 151 patients who completed treatment, this hypothesis was supported, suggesting that patients who expect treatment to be effective tend to engage more constructively in session, which helps bring about symptom reduction. Therapists' expectancies for patient improvement also predicted outcome, although this association was not mediated by the alliance. None of the expectancy scales interacted with alliance ratings in the prediction of clinical improvement.
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Clinical studies with in- or outpatient populations may vary substantially from non-help-seeking patients in the community.
“For example clinical studies with in- or outpatient populations may vary substantially from nonhelp-seeking patients in the community. [34-37]”
From The more it is needed, the less it is wanted: Attitudes toward face-to-face intervention among depressed patients undergoing online treatment (2013) · cites this paper as [34]
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Abrishami, G. F. (2013) · Journal of Child and Adolescent Behaviour · doi:10.4172/2375-4494.1000110 · Cited by 16 · see citing works
Yoo, S., Hong, S., Sohn, N., & O'Brien, K. (2014) · Asia Pacific Education Review · doi:10.1007/s12564-014-9320-2 · Cited by 15 · see citing works
“, Bohart and Tallman 2010), and client’s expectations of treatment effectiveness are one of the powerful predictors of counseling outcomes across samples and treatments (Constantino et al. 2012; Meyer et al. 2002).”
BackgroundSasso, K. E., & Strunk, D. R. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.04.007 · Cited by 15 · see citing works
“…as depressed clients’ perceived logicalness of therapy, therapeutic expectations, and orientation to change have been found to predict subsequent treatment outcomes (Carter et al., 2011; Lewis, Simons, & Kim, 2012; Meyer et al., 2002) and dropout (Callahan, Aubuchon-Endsley, Borja, & Swift, 2009).”
BackgroundL’alliance thérapeutique en psychothérapie : apports de la recherche empirique
Rodgers, R. F., Cailhol, L., Bui, E., Klein, R., Schmitt, L., & Chabrol, H. (2010) · L Encéphale · doi:10.1016/j.encep.2010.02.005 · Cited by 15 · see citing works
Treatment expectancy for anxiety change and response to cognitive behavioral therapy for OCD
Vorstenbosch, V., & Laposa, J. M. (2015) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2015.02.003 · Cited by 14 · see citing works
Treatment Modalities and Perceived Effectiveness of Treatment Among Adults With Depression
Alang, S. M., & McAlpine, D. (2020) · Health Services Insights · doi:10.1177/1178632920918288 · Cited by 14 · see citing works
Delgadillo, J., Moreea, O., Murphy, E., Ali, S., & Swift, J. (2015) · Journal of Clinical Psychology · doi:10.1002/jclp.22228 · Cited by 14 · see citing works
Women and Men With Mental Illnesses
Scheyett, A., & McCarthy, E. (2006) · Affilia · doi:10.1177/0886109906292114 · Cited by 14 · see citing works
“…therapy factors, such as warmth, respect, genuineness, and the provision of hope, may be the most important component in effective therapy (Chatoor & Krupnick, 2001; Duncan, Miller, & Sparks, 2004; Krupnick et al., 1996; Luborsky, McLellan, Woody, O’Brien, & Auerbach, 1985; Meyer et al., 2002).”
BackgroundGoldberg, J. F., McIntyre, R. S., Swartz, H. A., Freeman, M. P., Mago, R., Citrome, L., Rosenblat, J., Thase, M., Tohen, M., Vieta, E., et al. (2026) · JAMA Network Open · doi:10.1001/jamanetworkopen.2026.0043 · Cited by 13 · see citing works
Slowed Processing Speed Disrupts Patient Expectancy in Late Life Depression
Rutherford, B. R., Choi, C. J., Choi, J., Mass, B., He, X., O'Boyle, K., Sneed, J., Brown, P. J., Brickman, A., Wall, M., et al. (2020) · The American journal of geriatric psychiatry · doi:10.1016/j.jagp.2020.11.001 · Cited by 13 · see citing works
Waters, A. M., Candy, S. G., Zimmer‐Gembeck, M. J., Groth, T. A., Craske, M. G., Bradley, B. P., & Mogg, K. (2019) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-019-00551-4 · Cited by 15 · see citing works
- Authors
- Meyer, B., Pilkonis, P. A., Krupnick, J. L., Egan, M. K., Simmens, S. J., & Sotsky, S. M.
- Affiliations
- Georgetown University (US)
- George Washington University (US)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2002
- Volume
- 70
- Issue
- 4
- Pages
- 1051-1055
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W1977873119
- Cited by
- 322
- References
- 0
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 3 · 2023: 12 · 2022: 5 · 2021: 13 · 2020: 18 · 2019: 14 · 2018: 12 · 2017: 11 · 2016: 21 · 2015: 20 · 2014: 19 · 2013: 20 · 2012: 22
- FWCI
- 12.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- treatment expectancy, therapeutic relationship, depression, treatment outcomes, mediation, patient engagement, psychotherapy
- MeSH terms
- Adult, Attitude to Health, Major Depressive Disorder, Female, Humans, Male, Mental Health Services, Middle Aged, Patient Compliance, Professional-Patient Relations, Treatment Outcome
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