Category: Treatment - CBT
Outcome expectancy, an individual’s prognostic belief that therapy will be effective, has a small but significant positive effect (d = .24) on symptom reduction following a variety of treatments for a variety of disorders (for meta-analysis, see Constantino et al., 2011). Investigations into specific persuasion techniques to increase outcome expectancy, however, are limited (Constantino, Ametrano, & Greenberg, 2012). As a part of a larger project involving MRI, the current study examined the extent to which outcome expectancy for social phobia treatment increases among people with social anxiety disorder after watching a video-delivered treatment rationale and to which this relation is associated with symptom severity. Participants were recruited from the downtown Atlanta community via flyer and radio advertisements. 18 participants met diagnostic criteria for social anxiety disorder based on the Mini International Neuropsychiatric Interview (MINI; Lecrubier et al., 1997) and were safe for MRI. Participants were, on average, 21.5 years old (SD = 6.1). The sample was 83.3% female and 16.7% male. Participants identified as 61.1% Black/African-American, 16.7% White/Caucasian, 11.1% Hispanic, 5.6% Asian, and 5.6% Multiracial. Participants completed the Anxiety Change and Expectancy Scale (ACES; Dozois & Westra, 2005) and the Credibility Expectancy Questionnaire (CEQ; Devilly & Borkovec, 2000) to assess baseline outcome expectancy for psychotherapy. Participants then viewed a 15 minute professionally recorded video in which a clinical psychologist described cognitive behavior therapy for social anxiety (Ametrano et al. (2015) while inside an MRI. Finally, participants completed outcome expectancy measures for a second time, as well as the Liebowitz Social Anxiety Scale-Self Report (LSAS-SR; Fresco, et al., 2001). Matched-pairs t tests between baseline and post-video scores on the ACES and expectancy subscale of the CEQ demonstrate a significant, moderate increase in self-reported outcome expectancy (ACES: t = 3.804, p = .001, d = 0.45; CEQ Expectancy: t = 5.16, p < .001, d = 0.64). Additionally, LSAS-SR scores showed a significant negative correlation with pre-post change on the CEQ Expectancy subscale (r = -.624, p = .006), such that higher social anxiety severity predicted a lower level of pre-post change. This relationship was not found with pre-post change on the ACES. Results from this study suggest that a video-delivered treatment rationale can increase outcome expectancy for psychotherapy among people with social anxiety disorder.