Todaya Asor, Lillian Glushka, Michael J Constantino, Dana Elberg, Mark B Weiser, Dana Tzur Bitan
Individuals engaged in psychotherapy completed the Expectations of Active Processes in Psychotherapy Scale twice, once for their general change process expectations and once for their personal therapy experience. Participants reported significantly higher general change process expectations compared with their personal therapy expectations. The highest gap was observed for the expectation that therapy will provide tools for cognitive control (t=8.17, df=269, p<0.001), and the lowest gap was for the expectation that therapy will allow for the exploration of unexpressed content (t=4.02, df=269, p<0.001). Prior therapy experience and distress level significantly moderated the disparity between general and personal change process expectations, with highly experienced and highly distressed individuals reporting greater gaps.
OBJECTIVE: People have different beliefs about what leads to therapeutic success; however, not much is known about differences between individuals' general change process expectations (CPEs) and the way those expectations operate during their own therapy experience (i.e., personal CPEs). The primary aim of this study was to examine these differences; a secondary aim was to evaluate whether a person's previous therapeutic experience and distress level moderate these differences.
METHODS: Individuals currently engaged in psychotherapy (N=270) completed the Expectations of Active Processes in Psychotherapy Scale twice, first with reference to their general CPEs and then with reference to their own therapy.
RESULTS: For each therapy process, participants reported significantly higher general CPEs compared with CPEs for their own therapy. The highest gap was observed in the expectation that therapy will provide tools for cognitive control (t=8.17, df=269, p<0.001), whereas the lowest gap was observed in the expectation that therapy will allow for the exploration of unexpressed content (t=4.02, df=269, p<0.001). Prior therapy experience (F=3.73, df=2 and 267, p=0.025, η2=0.029) and distress level (F=3.10, df=2 and 267, p=0.040, η2=0.020) significantly moderated this disparity, such that highly experienced and highly distressed individuals reported greater gaps (in the same direction) between their general and personal CPEs.
CONCLUSIONS: The results suggest that patients, especially those with more severe problems, may require strong, personalized efforts to instill confidence in the therapeutic process.