Warm Communication Style Strengthens Expectations and Increases Perceived Improvement

Communication, both verbal and nonverbal, between healthcare providers and patients has been shown to affect treatment outcomes in clinical settings. Separately, accumulating research suggests a role for response expectations in altering treatment outcomes, especially in the context of inert or placebo treatment. However, few studies have examined which aspects of patient-provider communication strengthen expectations, leading to better treatment outcomes. The goal of this study is to test the effect of both verbal and nonverbal aspects of communication on response expectations and treatment outcomes in the context of a placebo exercise program. In a 2 × 2 between-subjects analogue study design, 89 healthy adults were randomly assigned to interact with a trainer with either a warm or a neutral communication style. Each group also received from their trainer either basic or enhanced information about the placebo training program. Participants performed coordination and balance tests before and after the placebo training program, and expectations were assessed after the training but prior to the second series of tests. Participants in the warm condition had significantly higher expectations of treatment effects and reported more improvement in their performance. No such differences were found between the enhanced and basic information conditions. There were no significant effects of communication style or information on actual balance and coordination performance. These results shed light on the importance of nonverbal communication, especially facial expression and tone of voice, in strengthening expectations and increasing subjective improvement.