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Patient–Therapist Expectancy Convergence and Outcome in Naturalistic Psychotherapy

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Abstract
Aim: Research on close relationships demonstrates that dyadic convergence, or two people becoming more concordant in their experiences and/or beliefs over time, is commonplace and adaptive. As psychotherapy involves a close relationship, patient–therapist convergence processes may influence treatment-specific outcomes. Although prior research supports that patients and therapists tend to converge on their alliance perspectives over time, which associates with subsequent patient improvement, no research has similarly examined belief convergence during therapy. Accordingly, this study focused on patient–therapist convergence in their outcome expectation (OE), a belief variable associated with patient improvement when measured from individual participant perspectives. I predicted both that significant OE convergence would occur and relate to better posttreatment outcome. Method: Data derived from a trial of naturalistic psychotherapy. Patients and therapists repeatedly rated their respective OE through treatment, and patients rated their symptom/functional outcomes at posttreatment. For dyads (N = 154) with the requisite OE data, I tested my questions using multilevel structural equation modeling. Results: There was no discernable OE convergence pattern over treatment (g100 = 0.02, SE = 0.04, p = .275) and OE convergence was unrelated to outcome at the between-dyad (b02k = 1.86, SD = 10.08, p = .406) and between-therapist (g002 = -0.06, SD = 3.54, p = .473) levels. However, higher early patient OE was significantly associated with better outcome at the between-dyad level (b05k = -0.04, SD = 0.01, p < .001). Discussion: Results suggest that OE may be more of a facilitative patient versus relational process factor.
Type
thesis
Date
2022-02
Publisher
License
License
http://creativecommons.org/licenses/by-nc-nd/4.0/