Learning from other patients – A feasibility study to establish an ecologically valid paradigm to modify negative expectations in depression through authentic psychotherapeutic treatment reports

Abstract

Background

Patients’ expectations about psychotherapy are of great importance, since they can influence the outcome of psychotherapy. Thus, it is important to ensure that patients have positive expectations about the outcomes of psychotherapy. This is particularly relevant in patients with major depression, since they often hold (unrealistically) negative expectations and tend to maintain these expectations despite novel positive information. Here, we test the feasibility of a novel, ecologically valid experimental paradigm to investigate how depressed patients learn from other patients’ experiences with psychotherapy, and which cognitive mechanisms hinder the integration of novel positive information.

Method

N = 17 outpatients diagnosed with a major depressive disorder watched videotaped experience reports of five acting patients. Each acting patient was shown twice: first, before receiving psychotherapeutic treatment, where they reported on feeling depressed and pessimistic about their future; second, at the end of psychotherapy, where they reported on feeling better and having overcome the challenges they used to struggle with. Before and after watching the videos, participants rated their expectations for positive and negative future life events.

Results

Results indicate that the paradigm is well applicable and the videos were perceived as credible, interesting and helpful. Descriptive results show that the video reports led to a slight modification of expectations.

Conclusion

The results indicate that our new paradigm is a suitable tool to investigate expectation change in response to other patients’ experiences with psychotherapy. Furthermore, our paradigm is suitable to investigate potential cognitive mechanisms involved in expectation change in depression.