Impact of psychotherapist expectations on client outcomes

Recent investigations have implicated client expectations of psychotherapy as a strong predictor of premature termination; however, there is reason to believe psychotherapist expectations may also impact client outcomes. This study sought to address this gap in the literature by examining the association of psychotherapists' expectations to clients' psychotherapy outcomes, including termination status. Participants were 54 current and recent trainee psychotherapists at a Southern public university, who completed delay discounting measures to assess their expectations of the effectiveness of psychotherapy. Data were also drawn from 300 adult clients who had received at least 2 sessions of individual psychotherapy from the participating psychotherapists of this study, and had previously completed the Outcome Questionnaire 45.2 prior to each individual therapy session. Psychotherapists were found to hold significantly higher expectations for client improvement than anticipated, based on existing literature, and these high expectations were found to be positively correlated with clinically significant change in clients. Moreover, psychotherapists' expectations were found to explain 7.3% of the explainable variance in whether or not clients experienced clinically significant change during psychotherapy. Implications for improving client retention and treatment outcome are discussed.