title: Therapy was not what I expected: a preliminary qualitative analysis of concordance between client expectations and experience of  cognitive-behavioural therapy.
abstract: Expectancy violations have generally been neglected in psychotherapy research but may have important implications for therapy process and outcome. A qualitative approach was used to examine discrepancies between actual experience and expectations in client posttreatment accounts of cognitive-behavioural therapy. Nine good- and nine poor-outcome cases were included. Good-outcome clients frequently reported disconfirmation of process expectations, including surprise that therapy was collaborative, that they had the freedom to direct therapy, and that they were comfortable and could trust the process. Poor-outcome clients generally failed to report such experiences. Good-outcome clients also reported gaining more from treatment than expected, whereas poor-outcome clients reported being disappointed. These findings suggest an important role for expectancy disconfirmation in therapy.
authors.affiliation: Department of Psychology, York University, Toronto, Ontario, Canada. hwestra@yorku.ca
authors.forename: Henny Alice
authors.initials: HA
authors.lastname: Westra
authors.forename: Adi
authors.initials: A
authors.lastname: Aviram
authors.forename: Marissa
authors.initials: M
authors.lastname: Barnes
authors.forename: Lynne
authors.initials: L
authors.lastname: Angus
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D016896:Treatment Outcome; D055815:Young Adult