{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T17:48:05Z","timestamp":1783532885175,"version":"3.55.0"},"reference-count":75,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T00:00:00Z","timestamp":1656892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clin Psychol"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>There is limited information on how a change in patients' expectations over time results in symptom change in psychotherapy. This study aimed to investigate the changes in patients' expectations and symptoms during treatment and across follow\u2010up as well as to determine the within\u2010 and between\u2010patient relationships between two types of patient expectations, that is, self\u2010efficacy and outcome expectation, and symptom change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants (80 participants\u2009\u00d7\u20096 repeated measures; 480 observations) with generalized anxiety disorder were treated using cognitive behavioral therapy and the within\u2010 and between\u2010patient scores of self\u2010efficacy and outcome expectation were evaluated in multilevel models as predictors of symptom change.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients' self\u2010efficacy and outcome expectation increased, whereas severity of their symptoms reduced during and after treatment. At the within\u2010patient\u00a0(WP) level, an increase in self\u2010efficacy was associated with a decrease in worry and depressive symptoms, and an increase in outcome expectation was associated with a decrease in depressive symptoms. The between\u2010patient (BP) effect, however, was contrary to the WP effect, that is, self\u2010efficacy was positively correlated with worry and outcome expectation was positively correlated with depressive symptoms<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results highlight the importance of disaggregating the WP variability from BP variability in psychotherapy process\u2013outcome research as they exhibit different associations at the within\u2010 and between\u2010patient levels.\u00a0Clinical Trial Registration: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/ClinicalTrial.gov\">ClinicalTrial.gov<\/jats:ext-link>\u00a0(NCT03079336).<\/jats:p><\/jats:sec>","DOI":"10.1002\/jclp.23407","type":"journal-article","created":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T18:13:37Z","timestamp":1656958417000},"page":"86-104","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Within\u2010 and between\u2010patients associations between self\u2010efficacy, outcome expectation, and symptom change in cognitive behavioral therapy for generalized anxiety disorder"],"prefix":"10.1002","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4812-2106","authenticated-orcid":false,"given":"Andreea","family":"V\u00eesl\u0103","sequence":"first","affiliation":[{"name":"Department of Psychology University of Z\u00fcrich  Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1978-2044","authenticated-orcid":false,"given":"Mathias","family":"Allemand","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Z\u00fcrich  Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3058-5815","authenticated-orcid":false,"given":"Christoph","family":"Fl\u00fcckiger","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Z\u00fcrich  Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,4]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"267e281","volume-title":"Second international symposium on information theory","author":"Akaike H.","year":"1973"},{"key":"e_1_2_10_3_1","volume-title":"Social learning theory","author":"Bandura A.","year":"1977"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.37.2.122"},{"key":"e_1_2_10_5_1","volume-title":"Self\u2010efficacy, the exercise of control","author":"Bandura A.","year":"1997"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/1745691617699280"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01663995"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v067.i01"},{"key":"e_1_2_10_9_1","volume-title":"Introduction to multilevel modeling","author":"Bauer D. 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