What Happens in Therapy? Adolescents' Expectations and Perceptions of Psychotherapy

Abstract

An empirically based measure of adolescent pre-treatment expectations and perceptions of psychotherapy is provided with supporting literature from service-use models, common factors research, evidence-based practice principles, and expectancies. The development of the Psychotherapy Expectations and Perceptions Inventory (PEPI) is described with initial psychometric properties reported based on data from 546 adolescents (age 14-18). Results indicate adequate internal consistency and a 3 factor structure measuring negative expectancies, process/outcome expectancies, and expectancies for a positive therapeutic relationship. Boys reported greater negative expectancies, but also greater expectancies for a positive therapeutic relationship. Girls reported greater therapy process/outcome expectancies. Level of contact with mental illness was not a significant predictor for any factors. An item response report is provided. Clinical and educational implications are discussed. Clinicians might be advised assess adolescent expectancies in treatment to facilitate greater rapport and engagement in the therapeutic process in order to foster more therapeutic change.