Maintenance (vs. Change) of Critical Attitudes Towards Psychotherapy

The aim of the study is to evaluate the effectiveness of a video intervention, which was designed to improve therapy expectation of persons with critical attitudes towards psychotherapy via violating their expectations about therapy. Therefore, 120 participants will be recruited and randomized to two groups:

(1) An experimental group that is watching a video with patients (actors) that are giving oral information about their therapy and the mostly positive therapy outcome, (2) a control group that is watching a video with the same patients before therapy or after the first therapy session who are giving information about symptoms and their expectation on therapy. The primary outcome is the Milwaukee Psychotherapy Expectation Questionnaire (MPEQ) collected before and after the video.

Therapy expectation is one of the main predictors of therapy outcome. This could be shown through many results in the medical sector as well as in studies that are focusing on psychotherapeutic interventions across different mental disorders. Although psychotherapy is a successful treatment for many disorders it is still hold in low esteem by some parts of the population and from some patient groups in particular. This can cause (that) patients who are in need of treatment not being recommended to the right therapy. Furthermore patients with low therapy expectation are more likely to (prematurely) abandon their therapy or having a lower therapy outcome. So therapy expectation should definitely be addressed in the very first therapy sessions because of it´s high impact.

The Violex-model gives an overview on how expectations in general are developed, maintained or modified. The model postulates that a process called immunization can lead to maintenance of expectation even if they receive information that contradicts their expectation. However no trial has yet examined weather the suggestions of the model are adaptable to therapy expectation. Therefore the investigators are recruiting participants with critical attitudes towards psychotherapy and trying to provoke expectation violation via an online experiment containing videos with patients reporting about their mostly positive outcome of psychotherapy. A control group is watching a video with patients who are just giving information about their symptoms and their first impressions on psychotherapy. The primary outcome is the Milwaukee Psychotherapy Expectation Questionnaire (MPEQ) collected before and after the video. Furthermore the participants are asked about their attitudes towards psychotherapeutic treatment (QAPT, German Version FEP), their own experience with psychotherapy and experiences of relevant others, behavioral intensions towards seeking psychotherapy, their mental wellbeing and demographic data. Before watching the video participants are also asked to formulate one to three individual expectations on psychotherapy. After watching the video they are asked how much they still believe in their individual expectation.

The investigators are aiming to modify low therapy expectation by generating expectation violation and paying particular attention to the issue of persistence of expectations via having a closer look on possible immunization strategies. For doing so they developed immunization items (data- and construct-orientated) that are shown at the end of the experiment.

Eligibility Criteria:
Inclusion Criteria:

* Age: 18 years or older
* Critical attitude towards psychotherapy (self-selection)
* ability to speak and read German
* access to the internet

Exclusion Criteria:

* known major mental disorder, such as schizophrenia or another psychotic disorder, or drug or alcohol addiction or dementia (based on self-report)
* medication that influences cognitive processes substantially (benzodiazepine)