The effects of videotaped preparatory information on clients' expectations, anxiety and psychotherapy outcome : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University

Abstract

The aim of the present study was to determine the effects of videotaped preparatory information on the accuracy of clients' expectations about psychotherapy, state anxiety, and psychotherapy outcome using a Solomon four-group design. The relationships among these variables were also investigated. One hundred and thirty-eight adult clients attending for their first psychotherapy session with a clinical psychologist participated in the research. Clients were randomly assigned to either the experimental condition where the preparatory video was seen prior to the session, or to the control condition where clients followed usual clinic procedure and waited to be seen prior to their first session. Half of the clients completed both pre- and posttest [sic] measures while half completed posttest [sic] measures only. At the end of the first session, symptom severity and target complaint measures were completed by the psychologist. After two months, or at the completion of treatment if this occurred sooner, follow-up measures were completed by both clients and psychologists. The results confirmed that clients who viewed the video had more accurate expectations about psychotherapy and experienced a significant reduction in state anxiety when compared to control group subjects. These differences were not maintained at two month follow-up. Expectations did not mediate the effects of preparation on state anxiety. In addition, at follow-up there was significantly greater improvement on only one of the ten outcome measures for the group viewing the preparatory video. To conclude, the video preparation had immediate effects on the accuracy of clients' expectations and reduced state anxiety. The relationships between these variables were not as hypothesised and need further clarification. Longer-term effects of the preparation on psychotherapy outcome were almost nonexistent. It is argued that long-term effects may be difficult to detect because they are relatively small and most studies which incorporate alternative treatments in their design have insufficient power. Changes in the accuracy of clients' expectations and state anxiety which occur naturally over the course of psychotherapy may also contribute to the lack of consistent long-term benefits being found as result of pretherapy preparations.