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Open Access

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Master of Science (M.S.)

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Psychotherapy, expectations, alliance, credibility, outcome


The clinical relevance of patients’ psychotherapy outcome expectations has been substantiated by a fairly robust correlational literature. Furthermore, as a related yet distinct construct, patients’ treatment credibility beliefs have also been associated with positive treatment outcomes. Addressing several methodological limitations of past research, the current study examined the influence on early adaptive process (patient-psychotherapist alliance quality) and early treatment outcome (patient distress level) of patients’ outcome expectations and credibility beliefs, measured both statically and dynamically with a psychometrically sound self-report instrument. Patients were 110 adult outpatients receiving naturalistically delivered psychotherapy in a community mental health training clinic. The primary research questions were tested with a series of hierarchical multiple regression models, which revealed: (a) An increase in patients’ initial outcome expectations (from baseline to post-session 1) was positively associated with patient rated alliance quality at session 7 (B = 1.28, p < .05), and (b) early (post-session 1) outcome expectations (B = 1.13, p < .05) and credibility beliefs (B = .83, p < .05) significantly predicted patient rated early alliance. The findings further underscore the clinical importance of patients’ treatment beliefs, and they are discussed with respect to their empirical and clinical implications.


First Advisor

Michael J Constantino