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A blind spot for secondary gain affecting therapy outcomes
1Psychiatric Hospital Brinkgreven, Pikeursbaan 3, 7411 GT Deventer, The Netherlands. jvanegmond@adhesie.nl
Summary
Psychiatric outpatients expecting secondary gain from therapy often experienced poorer outcomes. Patients rarely disclosed these expectations to their psychiatrists, indicating a "veiled motive" impacting treatment results.
Area of Science:
- Psychiatry
- Clinical Psychology
- Health Services Research
Background:
- Investigated the association between secondary gain expectations and therapy outcomes in psychiatric outpatients.
- Explored patient and clinician perspectives on anticipated benefits from therapy.
Purpose of the Study:
- To determine if expecting secondary gain influences psychiatric therapy outcomes.
- To understand the prevalence and disclosure of secondary gain expectations.
Main Methods:
- Surveyed 166 psychiatric outpatients and clinicians using questionnaires.
- Assessed patient anticipation of specific benefits from therapy.
- Examined the relationship between secondary gain expectations and treatment results.
Main Results:
- 42.2% of patients expected secondary gain from therapy.
- A significant association was found between expecting secondary gain and poorer therapy outcomes.
- Patients rarely expressed secondary gain expectations to psychiatrists (6%).
- Expectations for secondary gain were not linked to Axis I or Axis II diagnoses.
Conclusions:
- Secondary gain acts as a "veiled motive" for seeking therapy, often unexpressed to clinicians.
- Unexpressed secondary gain expectations significantly impact therapy results.
- Understanding veiled motives is crucial for improving therapeutic effectiveness.