Trial reportPsychology and psychotherapy2025
Associations between treatment credibility, patient expectancies, working alliance and symptom trajectory in cognitive behaviour therapy for pathological health anxiety.
Trial report in Psychology and psychotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Therapeutic alliance across delivery modalities: a systematic narrative review of alliance strength and outcome prediction in face-to-face, online, and blended psychotherapy.Journal of Zhejiang University. Science. B · 2026Pooled it
- Predictors of Improvement in Subjective Executive Functioning Following an Internet-Delivered Cognitive Enhancement Intervention for Adults in Remission From Depression.Acta psychiatrica Scandinavica · 2026Trial
- Associations between treatment credibility, patient expectancies, working alliance and symptom trajectory in cognitive behaviour therapy for pathological health anxiety.Psychology and psychotherapy · 2025Trial
- The self-directed patient in guided internet-delivered CBT: a qualitative study of patient role expectations.Frontiers in psychology · 2026Article
- Pre-treatment consent framing shapes how laypeople evaluate CBT: a cross-cultural comparison of China and the United States.Frontiers in psychology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
Abstract
objectivesTo evaluate how treatment credibility, the expectancy of improvement and the relationship with the therapist (the working alliance) change in relation to symptoms in cognitive behaviour therapy (CBT) for pathological health anxiety.
designSecondary study of a randomised controlled trial of Internet-delivered (n = 102) and face-to-face CBT (n = 102) for health anxiety.
methodsThe trial was conducted at a primary health care clinic in Stockholm, Sweden, between December 2014 and July 2018. Both treatments lasted 12 weeks. Health anxiety was measured using the 18-item Health Anxiety Inventory. Credibility/expectancy (Borkovec credibility/expectancy scale) and the strength of the working alliance (Working Alliance Inventory) were self-reported by the participant at weeks two and eight. Symptom slopes from a linear mixed model were related to these process scales.
resultsCorrelations between the process variables (credibility/expectancy, working alliance) and the overall, 12-week pre- to post-treatment, reduction in health anxiety were small to moderate, and slightly higher based on data from week 8 (rs = 0.33-0.41) than week 2 (rs = 0.17-0.29). In the whole sample, week 2 credibility/expectancy and working alliance were significant predictors of subsequent symptom reduction. In secondary subgroup analyses, the process variables predicted improvement in Internet-delivered CBT, but not in face-to-face CBT. Direct between-format tests were not significant. Week 8 credibility/expectancy and working alliance were more closely related to previous than subsequent symptom reduction.
conclusionsThe patient's early ratings of credibility/expectancy and the strength of the working alliance appear to be predictive of subsequent symptom reduction. Later ratings appear to be of more limited predictive utility.
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