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Psychotherapy (Chic). 2018 Dec;55(4):473-485. doi: 10.1037/pst0000169.

A meta-analysis of the association between patients' early treatment outcome expectation and their posttreatment outcomes.

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Department of Psychological and Brain Sciences, University of Massachusetts Amherst.
Department of Psychology, University of Zurich.
Department of Psychology, University at Albany, State University of New York.


Patients' outcome expectation (OE) represents their belief about the mental health consequences of participating in psychotherapy. A previous meta-analysis of 46 independent samples receiving the treatment of at least 3 sessions revealed a significant association between more optimistic baseline, or early treatment, OE and more adaptive posttreatment outcomes (weighted r = .12 or d = .24; Constantino, Glass, Arnkoff, Ametrano, & Smith, 2011). The present study represents an update to that meta-analysis. To be included, articles published through June 2017 had to (a) include a clinical sample, (b) include a therapist-delivered treatment of at least 3 sessions, (c) include a measure of patients' own OE, (d) include at least 1 posttreatment mental health outcome not explicitly referenced as a follow-up occasion, and (e) report a statistical test of the OE-outcome association. The updated meta-analysis was conducted on 81 independent samples (extracted from 72 references) with 12,722 patients. The overall weighted effect size was r = .18, p < .001, or d = .36, with high heterogeneity (I2 = 76%) and no evidence of publication bias. Several variables (patient age, measure type, and treatment manual used) moderated the OE-outcome association. These robust, replicated meta-analytic findings are discussed in light of methodological limitations and with regard to their practice implications. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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