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Maintenance vs. change of critical expectations towards psychotherapy

Project information 

Treatment expectation is one of the main factors for therapy outcome (Greenberg, Constantino, & Bruce, 2006). This has been shown in studies in the medical sector (Auer et al., 2016; Rief et al., 2017) and in studies with psychotherapeutic interventions for different mental disorders (Rief et al., 2015). 

Although psychotherapeutic interventions are considered to be very successful in the treatment of mental disorders and are therefore anchored in the treatment guidelines, their reputation in the general population and among patients is party very low (Angermeyer, Dietrich, & Angermeyer, 2006; Ten Have et al., 2010).  For persons with a mental disorder, a low therapy expectation also means a high risk of not receiving adequate therapy (Jorm et al., 2000). Patients who, for example, are suffering from an addictive disorder repeatedly relapse into old behaviour patterns in the course of their illness, which in turn reduces the expectation of symptom improvement and therapy motivation.

To date, the emergence, maintenance and changeability of therapy expectations have not been summarized and evaluated in any model. However, the Violex model (Rief et al., 2015; Rief & Glombiewski, 2017) describes how expectations are generally formed and which processes are involved in maintaining and changing expectations. The process of immunization is a decisive factor in maintaining expectations despite information to the contrary (Rief & Glombiewski, 2017). Whether and how this model can map changes in therapy expectations and retention has not yet been investigated.

In the project "Maintenance vs. change of critical therapy expectation" we therefore deal with the following questions:

  1. What do (negative) therapy expectations look like, especially in the general population and in disorders with low therapy expectations (e.g. addiction)?
  2. Are therapy expectations changeable? If so, through which interventions?
  3. Can the change in therapy expectations be represented by the Violex model (Rief et al., 2015)?

Current project status

The first two studies have been completed. The third study is currently in progress (until 2020).

Team 

References

  • An overview of relevant literature 

    Angermeyer, M. C., Dietrich, S., & Angermeyer, M. C. (2006). Public beliefs about and attitudes towards people with mental illness: a review of population studies. Acta Psychiatr Scand Blackwell Munksgaard Acta Psychiatr Scand, 113(113), 163–179. https://doi.org/10.1111/j.1600-0447.2005.00699.

    Angermeyer, M. C., Matschinger, H., & Schomerus, G. (2013). Attitudes towards psychiatric treatment and people with mental illness: Changes over two decades. British Journal of Psychiatry. https://doi.org/10.1192/bjp.bp.112.122978

    Auer, C. J., Glombiewski, J. A., Doering, B. K., Winkler, A., Laferton, J. A. C., Broadbent, E., & Rief, W. (2016). Patients’ Expectations Predict Surgery Outcomes: A Meta-Analysis. International Journal of Behavioral Medicine, 23(1), 49–62. https://doi.org/10.1007/s12529-015-9500-4

    Greenberg, R. P., Constantino, M. J., & Bruce, N. (2006). Are patient expectations still relevant for psychotherapy process and outcome? Clinical Psychology Review, 26, 657–678. https://doi.org/10.1016/j.cpr.2005.03.002

    Jorm, A. F., Medway, J., Christensen, H., Korten, A. E., Jacomb, P. A., & Rodgers, B. (2000). Public beliefs about the helpfulness of interventions for depression: effects on actions taken when experiencing anxiety and depression symptoms. Australian and New Zealand Journal of Psychiatry Anthony F. Jorm, Professor (Correspondence Research Assistant Senior Fellow; Ailsa E. Korten, Research Officer; Patricia A. Jacomb, Research Assistant, 34, 619–626.

    Jorm, A. F., Medway, J., Christensen, H., Korten, A. E., Jacomb, P. A., & Rodgers, B. (2000). Public beliefs about the helpfulness of interventions for depression: effects on actions taken when experiencing anxiety and depression symptoms. Australian and New Zealand Journal of Psychiatry Anthony F. Jorm, Professor (Correspondence Research Assistant Senior Fellow; Ailsa E. Korten, Research Officer; Patricia A. Jacomb, Research Assistant, 34, 619–626.

    Rief, W., & Glombiewski, J. A. (2016). Erwartungsfokussierte Psychotherapeutische Interventionen (EFPI). Verhaltenstherapie, 26, 47–54. https://doi.org/10.1159/000442374

    Rief, W., & Glombiewski, J. A. (2017). The role of expectations in mental disorders and their treatment. World Psychiatry, 16(2), 210–211. https://doi.org/10.1002/wps.20427

    Rief, W., Glombiewski, J. A., Gollwitzer, M., Schubö, A., Schwarting, R., & Thorwart, A. (2015). Expectancies as core features of mental disorders. Current Opinion in Psychiatry, 28(5), 378–385. https://doi.org/10.1097/YCO.0000000000000184

    Rief, W., Shedden-Mora, M. C., Laferton, J. A. C., Auer, C., Petrie, K. J., Salzmann, S., … Moosdorf, R. (2017). Preoperative optimization of patient expectations improves long-term outcome in heart surgery patients: results of the randomized controlled PSY-HEART trial. BMC Medicine, 15(1), 4. https://doi.org/10.1186/s12916-016-0767-3

    Ten Have, M., De Graaf, R., Ormel, J., Vilagut, G., Kovess, V., & Alonso, J. (2010). Are attitudes towards mental health help-seeking associated with service use? Results from the European study of epidemiology of mental disorders. Social Psychiatry and Psychiatric Epidemiology, 45, 153–163. https://doi.org/10.1007/s00127-009-0050-4

Collaborations

Funding