Expectations About Therapy

Development of Construct of Expectations

Oswald Kulpe and Edward B. Titchener formulated the concept of an expectation as a cognitively mediated preparatory set or disposition to behave in a particular manner in a given situation. Narziss Ach named this disposition a “determining tendency,” thereby emphasizing the effects of expectations on perception and behavior. By definition, therefore, expectations influence perceptual and judgmental processes, learning, and behavior.

Jerome Bruner, Leo J. Postman, and Harry Helson elaborated the role of expectations in influencing behavior. Bruner and Postman theorized that the process of perception begins with an expectation or hypothesis. Helson viewed expectations as critical determinants of people's “adaptation level” (i.e., the cognitive norms people use in interpreting sensory information). Learning theorists such as Edward C. Tolman (cognitive theory), Clark L. Hull and Kenneth Spence (drive reduction theory), and Julian B. Rotter (social learning theory) viewed learning as a function of the reinforcement of one's expectancies regarding the outcome of behavior in a given situation.

Social psychologists incorporated expectancies as a central construct in explaining social cognition. Cognitive expectancies (i.e., preparatory sets) are viewed as primary determinants of behavior in George A. Kelly's personal construct theory, Kurt Lewin's aspiration theory, Leon Festinger's cognitive dissonance theory, and Theodore Newcomb's attraction theory.

Expectations in Counseling and Psychotherapy

Theorists also viewed expectations as central to the success of psychotherapy. Clients' expectations influence their decision to enter into and remain in therapy and they moderate the effectiveness of therapy. Clients approach therapy with expectancies regarding the nature of therapy and the roles they and their counselors will assume. Counselors' and clients' expectations are important determinants of their behavior in counseling.

Arnold P. Goldstein distinguished between prognostic expectations (e.g., beliefs concerning the probability of success in counseling) and participant role expectations (i.e., beliefs regarding the behaviors that will be displayed by the client and counselor). Bernard Apfelbaum suggested that clients expect one of three basic types of counselors. The critic is a cold, rigid, judgmental therapist who gives advice, but is not concerned with whether the client uses it. The model is a tolerant, accepting, permissive therapist. The nurturont therapist is giving, guiding, and protective. Expectations such as these influence people's choice of a help giver, their perceptions of their therapists, the quality of the communication process, their persistence in counseling, and the effectiveness of counseling. Most of these theoretical assertions have been supported by empirical research.

Placebo Effect of Expectancies

The placebo effect was named after the practice in medical research of prescribing a benign treatment (e.g., a “sugar pill”) to a control group of patients. This allows researchers to determine whether spontaneous, non-treatment-related improvements occurred during the study. It is possible that the mere act of entering therapeutic treatment could stimulate improvement. Some psychologists theorized that all of the gain from therapy was the result of a placebo effect.

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