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Psychotherapy (Chic). 2018 Dec;55(4):486-495. doi: 10.1037/pst0000168.

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

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


Patients' perception of treatment credibility represents their belief about a treatment's personal logicality, suitability, and efficaciousness. Although long considered an important common factor bearing on clinical outcome, there have been no systematic reviews of the credibility-outcome association. The present study represents a meta-analysis of the association between patients' credibility perception and their posttreatment outcomes. To be included, articles published through August, 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 early treatment credibility perception, (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 credibility-outcome association. The meta-analysis was conducted on 24 independent samples (extracted from 19 references) with 1,504 patients. The overall weighted effect size was r = .12, p < .001, or d = .24, with high heterogeneity (I2 = 57%) and no evidence of publication bias. There were no significant moderating effects on the credibility-outcome association for any of the potential moderators that we evaluated. The 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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