Читать книгу Ethics in Psychotherapy and Counseling - Kenneth S. Pope - Страница 63

The process of psychotherapy itself creates and uses different forms of power. Most therapies recognize the force of the client’s expectation that the therapist’s interventions will be able to induce beneficial change. One aspect of this expectation is the placebo effect, a factor that must be considered when studying the efficacy and effectiveness of interventions. The client’s investing the therapist with power to help bring about change can become a significant part of the change process itself. Conversely, the therapist’s expectations, including optimism and belief in the client’s capacity to change, are powerful as well. Miller et al. (1995) reviewed the research and noted that

As a factor in outcome, technique matters no more than the “placebo effect” … The creation of such hope is greatly influenced by the therapist’s attitude toward the client during the opening moments of therapy. Pessimistic attitudes conveyed to the client … are likely to minimize the effect of these factors. In contrast, an emphasis on possibilities and a belief that therapy can work will likely counteract demoralization, mobilize hope and advance improvement.

On the basis of their research, Connor and Callahan (2015) reported:

Psychotherapists were found to hold significantly higher expectations for client improvement than anticipated, based on existing literature, and these high expectations were found to be positively correlated with clinically significant change in clients. Moreover, psychotherapists’ expectations were found to explain 7.3% of the explainable variance in whether or not clients experienced clinically significant change during psychotherapy (p. 351).

Similarly, research conducted by Swift et al. (2018) found that student therapists’ expectations were a “significant unique predictor of change. These results suggest that therapists should be aware of their own expectations when working with clients in order to make sure that any negative beliefs do not impact the quality of care that they provide” (p. 84).