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The role of outcome expectancy and credibility beliefs in the outcome of Cognitive Behavioural Therapy

Austermann, Maria (2018) The role of outcome expectancy and credibility beliefs in the outcome of Cognitive Behavioural Therapy.

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Abstract:Background. A patient’s outcome expectancy and treatment credibility beliefs are considered as non-specific factors having explanatory value for the outcomes of different psychological approaches. A consensus about their impact on the outcomes of Cognitive Behavioural Therapy (CBT) is missing to date. The present study provides a systematic review on existing findings about the roles of expectancy and credibility in the outcomes of CBT. Method. The systematic search of articles identified 14 longitudinal studies that measured the relationships between CBT outcomes and expectancy or credibility. Most studies (N = 13) referred to patients with affective disorders. A careful check of the variety of measuring tools utilized to assess expectancy (N = 5) and credibility (N = 5) revealed that two of the 14 studies had interchanged the conceptions of both constructs and that one further study had disregarded their conceptual distinction. Findings from this latter study were subsequently excluded from analysis. The remainder of analysis was conducted with 13 studies, six solely measuring credibility, five solely measuring expectancy and two measuring both constructs. Results. Weak (e.g. ß = - .17) to very strong (e.g. r = - .71) associations between CBT outcomes and expectancy as well as credibility were found. Expectancy appeared to be a robust, moderate predictor of general symptoms of anxiety and was more frequently and more strongly related to the outcomes of CBT for anxiety disorders than credibility. Credibility was more frequently and more strongly related to the outcomes of CBT for anxiety disorders than to the outcomes of CBT for depression. Credibility weakly to moderately predicted very specific outcome variables (e.g. coping skills), whereas its effects on general symptoms of anxiety and depression were only weak or insignificant. One study showed that homework compliance mediated the expectancy-outcome relationship. Another study showed that adherence mediated the credibility-outcome relationship. Single studies further revealed that alliance was moderately related to expectancy and very strongly related to credibility. Conclusion. Non-specific factors are not as non-specific as originally believed. Expectancy and credibility appear to be related, but distinct, patient characteristics having different explanatory values for the outcomes of CBT that vary across mental disorders and types of outcomes. Both might exert their ameliorative effects through a greater involvement with CBT techniques and may be more meaningful to the outcomes of CBT than the widely accepted non-specific factor alliance. Expectancy could be a more robust predictor of changes in general symptoms than credibility. Yet, credibility seems to be relevant for specific outcome variables which may reflect the effectiveness of specific CBT techniques. Keywords: outcome expectancy, credibility beliefs, CBT, outcome, non-specific factors
Item Type:Essay (Bachelor)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology BSc (56604)
Link to this item:http://purl.utwente.nl/essays/75286
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