Study: Patients Believe More in Psychotherapy When Practitioners Show Warmth and Competence


According to new research, therapists who demonstrate both warmth and competence can shape patient expectations of practitioner expertise by instilling more positive beliefs about therapy effectiveness. The results of this research have been published in the journal Clinical Psychological Science.

This behavioral guidance could be particularly helpful in improving expectation violation, a process by which patients with pre-existing negative beliefs about therapy can learn to view treatment more positively, said Anna Seewald, who co-authored this. research with Winfried Rief (Philipps-University of Marburg). Highly skilled and warm therapists can also stimulate patients’ willingness to continue therapeutic treatment, strengthen the therapeutic alliance between patients and practitioners, and even improve clinical outcomes, Seewald added.

Seewald and Rief explored the relationship between practitioner characteristics and outcome expectations for therapy through a study of 187 participants in Germany who had not been diagnosed with a mental health condition and were not currently receiving psychological treatment. . As part of the study, participants were encouraged to imagine that they were undergoing therapy themselves. At the start of the study, participants listened to an audio recording of a patient telling his therapist about how he was experiencing work-related stress. In a second recording, designed to lower participants’ expectations of the effectiveness of psychotherapy, the patient described a negative experience with therapy in which a different therapist told them that there were only a few proven treatments. for stress management.

In the final part of the study, participants viewed one of four videos of the next part of the mock date. The videos were filmed over the shoulder of an anonymous patient to encourage perspective taking. In these videos, the current therapist discussed possible stress treatments while demonstrating either low skill/low heat, low skill/high heat, high skill/low heat, or high heat/high skill. In therapy, warmth can involve smiling, nodding, and making a clear effort to understand what the patient is saying, Seewald explained in an interview, and competence can be communicated using a clear, confident tone, taking notes and demonstrating expertise.

At this point, participants rated the warmth and competence of the therapist and indicated both how strongly they perceived the treatment offered by the therapist and how likely they thought the therapy was to help them lower their level. of stress. Warmth and competence independently influenced participants’ expectations for outcomes, with the high warmth/high competence scenario inspiring the most positive expectations, the most motivation to begin psychotherapy with this hypothetical practitioner, and the most comfort with their therapeutic alliance. Therapy for conditions such as generalized anxiety disorder, substance abuse and chronic pain often involves encouraging patients to develop more positive expectations by challenging their existing negative and unrealistic beliefs and attitudes, Seewald and Rief explained. Practitioner characteristics such as skill and warmth could be one of the reasons why patients respond differently to the same therapy implemented by different practitioners, they added.

“A highly understanding and experienced therapist can violate negative expectations and raise patients’ positive expectations of treatment efficacy and thereby improve clinical outcomes,” the researchers wrote. The importance of warmth to competence, however, may vary depending on the population in question. Unlike previous research with participants who experienced mental health issues, this study found that high-skill/low-heat therapists inspire more positive expectations in participants than high-heat/low-skill therapists, Seewald noted. This suggests that people may react differently to characteristics of practitioners depending on their mental health status.

“Heat might be even more important in clinical samples, or preference for warmth and proficiency might differ across different disorders and other clinical challenges,” Seewald said. “In future studies, we should aim to investigate optimal expectation change using heat and skill for specific disorders.” (ANI)

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