Parent and Adolescent Pre-Treatment Outcome Expectations and Therapeutic Outcomes Among Adolescents with Depression

Abstract

Patient expectancy, particularly pre-treatment outcome expectations, is a well documented yet understudied factor influencing psychotherapy outcomes, especially in youth populations. This study examined parent and adolescents’ expectations regarding the leading treatments for adolescent depression and whether adolescents’ and parents’ baseline expectations predicted therapeutic outcomes in a clinical trial for adolescent depression. Participants included 90 adolescents receiving either usual care or interpersonal psychotherapy for depressed adolescents (IPT-A), and one parent per adolescent. Expectations were assessed for therapy, medication, and combination treatment and outcome measures included depression symptoms, parental relationships, and peer relationships. Both adolescents and parents expected grater improvement from combination treatment and therapy alone than form medication alone. However, parents generally reported higher expectations than adolescents across most treatment types, particularly for therapy and combined approaches. Additionally, parental, but not adolescent, expectations significantly predicted improvements in improvements in depressive symptoms. Expectations were not significantly related to changes in parent or peer relationships. These findings highlight the distinct role of parental expectancy in treatment response and underscore the value of addressing expectations early in the therapeutic process.