How to Optimise Patient Outcomes through Managing Patient Expectations
Summary
You've reached the end of the course. Here's a short recap of what we covered.
What Expectations Are, and Why They Matter
Expectations are future-directed beliefs about what's ahead — about timeline, self-efficacy, the therapist's role, the process, and the outcome of treatment. Especially process and outcome expectations are linked to how treatment goes: negative outcome expectations at the initial assessment are associated with higher dropout, less treatment initiation, and poorer treatment outcomes. That's why negative expectations need to be addressed early.
The PIE Model
Three steps help shift patients' expectations during the initial assessment:
- Professional and warm rapport — warmth (validation, ‘we’ language, eye contact, smiling) and professionalism (a clear, confident tone and demonstrated expertise) both improve therapeutic alliance and expectations.
- Inspect experiences and expectations — ask about previous experiences with psychotherapy, and about current expectations regarding the process and outcome of this treatment, so negative expectations don't go unnoticed.
- Enhance expectations with evidence and rationale — explain that psychotherapy is effective, how it works (mechanism), set realistic expectations about non-linear progress, and personalise the explanation with case examples and the patient's own strengths.
