title: Treatment expectations, alliance, session positivity, and outcome: an investigation of a three-path mediation model.
abstract: OBJECTIVE
  The aim of this study was to test a 3-path mediation model, in which the effect of treatment expectations on outcome is mediated first by the alliance and then by session positivity.
  
  
  METHODS
  Archival process and outcome data were used for this investigation. These data had been collected from 116 clients (70% female, 81% White, mean age = 24.1 years), who sought psychotherapy for a variety of reasons at a university-based clinic.
  
  
  RESULTS
  Correlation analyses established that clients' treatment expectations, the therapeutic alliance, session positivity, and outcome were significantly related to each other. A bootstrap (data resampling) procedure was employed to test the hypothesized 3-path mediated effect. The results of this analysis were consistent with the hypothesis that high treatment expectations enhance the therapeutic alliance, which contributes to clients feeling positive at the end of sessions and in turn facilitates improvements in symptoms and functioning.
  
  
  CONCLUSIONS
  The current research is the first to provide evidence for this particular model, and thus helps to shed light on the intricacies and underlying dynamics of psychotherapy.
authors.affiliation: Ohio University.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: McClintock
authors.forename: Timothy
authors.initials: T
authors.lastname: Anderson
authors.forename: Allison
authors.initials: A
authors.lastname: Petrarca
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D015146:Midwestern United States; D010044:Outpatient Clinics, Hospital; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000379:methods*; D057566:Self Report; D016896:Treatment Outcome; D014495:Universities; D055815:Young Adult
keywords: alliance/therapeutic alliance; expectancy; psychotherapy; treatment outcome