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Optimizing Expectations Leads to Enhanced Efficacy of a Mindfulness-Based Intervention in Individuals With
Stefan Salzmann1,2, Frank Euteneuer3, Christiane A Melzig4
1Clinical Psychology and Psychotherapy, Marburg University, Marburg, Germany.
Journal of Clinical Psychology
|July 21, 2026
Summary
Optimizing treatment expectations enhanced mindfulness intervention effects for those with low initial expectations. However, high baseline expectations may reduce benefits, potentially due to expectation violation.
Area of Science:
- Psychology
- Behavioral Science
- Clinical Psychology
Background:
- Treatment expectations are key drivers of the placebo effect and can enhance intervention outcomes.
- It is not fully understood if optimizing these expectations benefits all individuals.
Purpose of the Study:
- To investigate if optimizing treatment expectations augments mindfulness intervention efficacy.
- To determine if baseline participant expectations moderate the intervention's effects.
Main Methods:
- A pilot randomized controlled trial with 66 participants in three groups: expectation optimization, neutral instruction, and control.
- Primary outcomes included changes in positive and negative affect; secondary outcomes covered expectations, stress, and mindfulness.
- Baseline expectations were analyzed as a moderator.
Main Results:
- The expectation optimization group showed significantly greater reductions in positive affect compared to neutral and control groups.
- Participants with low baseline expectations showed improved outcomes in the expectation optimization group.
- Individuals with high baseline expectations experienced less benefit from expectation optimization.
Conclusions:
- Inducing positive treatment expectations can be advantageous for individuals with low baseline expectations, possibly via placebo response.
- For those with high baseline expectations, positive expectation induction may be counterproductive, potentially due to expectation violation.
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