Objetivos.

1) Conocer las expectativas que tenían los sujetos antes de su primera entrevista, 2) Identificar si se cumplieron sus expectativas, 3) Determinar si se relaciona el cumplimiento de las expectativas con la asistencia a la segunda sesión, 4) Conocer las razones de los sujetos para asistir a dos o más sesiones, 5) Comparar las características que percibieron los sujetos en sus terapeutas cuando regresaron versus cuando no regresaron a la segunda sesión.

Método.

Se contactó con 39 sujetos que alguna vez fueron con un psicoterapeuta. El promedio de edad fue de 32.05 años en un rango de 20 a 63 años; de los cuales 26 eran solteros y 13 casados. Dada la naturaleza exploratoria de esta investigación se usó como instrumento un formato de entrevista semi-estructurada para indagar qué expectativas tuvieron los sujetos antes de su primera entrevista terapéutica, si éstas se cumplieron o no, razones para asistir a dos o más sesiones y qué características percibieron en sus terapeutas. Las respuestas de los sujetos fueron codificadas en distintas categorías y posteriormente se cuantificaron sus frecuencias.

Resultados.

En los sujetos predominaron las expectativas sobre el terapeuta antes de la primera entrevista; esperaron que éste les apoyara, escuchara o fuera amigable. En segundo lugar tuvieron expectativas sobre los resultados de la primera entrevista, es decir, esperaron solución a su problema y a sus dudas así como sentirse en confianza. Después de la primera entrevista en 12 sujetos se cumplieron sus expectativas y en 27 no. Se encontró que el cumplimiento de las expectativas se relacionó de forma moderada y significativa con la asistencia a la segunda sesión.

Las principales razones para asistir a dos o más sesiones fueron tener que seguir el tratamiento o querer sentirse mejor. Por el contrario, ejemplos de las razones para no asistir fueron que el terapeuta no escuchó o no fue agradable.

Los sujetos que asistieron a la segunda sesión percibieron en sus terapeutas más características positivas (p. ej. amable, confiable, puntual) que negativas (p. ej. inexperto, agresivo). Por el contrario, los sujetos que no asistieron percibieron en forma predominante características negativas en sus terapeutas (p. ej. impuntual, poco amable, autoritario). Finalmente, los que asistieron a la segunda sesión percibieron a sus terapeutas como más expertos que los que no asistieron.

Conclusiones.

Se encontró que las expectativas guardaron una relación moderada y significativa con la asistencia a la segunda sesión; esto contradice otros estudios. También se encontró que cuando el terapeuta no escuchó los sujetos no asistieron a más sesiones, lo cual concuerda con otras investigaciones. Finalmente, en congruencia con otros reportes, los sujetos que asistieron a la segunda sesión percibieron en sus terapeutas más características positivas mientras que cuando no asistieron percibieron más características negativas. Esto sugiere profundizar el estudio de las expectativas y la percepción en estudios prospectivos.

Method.

Thirty-nine subjects who attended a psychotherapy session at any time were contacted. The average age was 32.05 years (range from 20 to 63 years), 26 were single and 13 were married. Since this was an exploratory study, an open questions interview was used. Questions included: what expectations did you have before your therapeutic interview? Were your expectations met? Did you return after your first interview? Why did you attend two or more sessions? What qualities did you perceive in your therapist? All of the answers subjects gave were encoded and frequencies were computed. The responses of subjects who attended two or more sessions were compared with answers of subjects who did not.

Results.

Before the first interview, subjects expected therapists would be attentive, supportive, friendly, and honest. Second, subjects expected concrete results from the first interview: they expected solutions to their problems and doubts, and to feel better in general. They also expected they would be able to confide in their therapists. Last, subjects expected that their pain would be eased, that they would be able to talk about their problems, and that they would not be afraid.

When patients' expectations were met they explained that their therapists were attentive listeners. They described their therapists as kind, objective and reliable. They also felt that their therapists were able to help them, often by offering another perspective on their problems. These subjects felt better after the session. On the contrary, when patients' expectations were not met they explained that their therapists did not listen, were critical, acted as if conducting a test, and arrived late to the session. Also, subjects did not feel that they could confide in their therapists and were disappointed that they did not help them to solve their problems.

After the first interview, 19 subjects returned for a second session and eight did not. Twelve of these subjects reported having their expectations met on the first interview, while 27 subjects reported that their expectations were not met. Having one's expectations met was significantly correlated with attending a second session (r = +.34, p < .05).

The main reasons subjects reported when asked why they attended two or more sessions were the following: I had to continue the treatment, I wanted to feel better, I wanted to overcome my problems, I needed help, I thought the therapist would improve in the next session, and the therapist helped me. Reasons subjects gave for not attending were: the therapist did not listen to me, the therapist was not friendly, I did not like the therapist, the therapist criticized me, I learned that the best way to solve my problems is by my self, the therapy was expensive, I had to study, and I had to work.

Subjects who attended a second session perceived more positive qualities in their therapists (e.g. the therapist was kind, reliable, punctual, intelligent, respectful, understanding) than negative (e.g. arrived late, unkind, authoritarian, aggressive, impulsive, incompetent). Subjects who did not attend a second session perceived more negative qualities in their therapists. Finally, those who attended a second session perceived that their therapists were more experienced than subjects who did not attend a second session.

Conclusions.

Having one's expectations met was significantly correlated with attending a second session, a finding that contradicts other studies. In addition, when patients perceived therapists did not listen to them, they were less likely to attend additional sessions, a finding that is consistent with other research. Finally, also in agreement with other studies, subjects who attended a second session perceived more positive qualities in their therapists than those who did not attend a second session for these perceived more negative qualities in their therapists.

One problem that sometimes arises when drop out subjects are interviewed, is that they may lie because they do not want to have any problems with the institution providing them the service or because they do not want to meet their therapists again. However, it is likely that this was not the case for this research. Since interviews were not conducted in a consulting room or a psychological services setting, it is also likely that the "social desirability" was reduced. That is, subjects had the opportunity to speak the truth because the researcher did not know the therapists or institutions they were talking about.

One important limitation to this study was that subjects were asked retrospectively about events that took place prior to the interview. So, it is possible that subjects' answers were distorted due to the effect of time on memory. Clearly, more research is needed in prospective studies to explore the relationship between the attendance of more than one session and patient's expectations of therapy sessions and their perceptions about therapists.