Credibility and expectancy associated with ultra-brief and standard-length digital treatments: A preliminary examination of impact on treatment outcome.
Melanie Seshadri, Blake F Dear, Madelyne A Bisby
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In 30 seconds
This secondary analysis of a randomized controlled trial examined whether treatment credibility and outcome expectancy differed between ultra-brief and standard-length digital cognitive behavioural transdiagnostic treatments, and whether they predicted symptom improvement. Among 152 participants, perceptions of credibility and expected effectiveness did not differ between treatment options. For standard-length treatment only, higher credibility and expectancy were associated with greater odds of clinically meaningful improvement, defined as a ≥ 30% symptom reduction, in both anxiety and depression. Their predictive value diminished when considered together, and treatment preference may have moderated outcomes.
Key findings
- Credibility and expectancy ratings did not differ between ultra-brief and standard-length digital treatments.
- For standard-length treatment, credibility predicted clinically meaningful anxiety improvement (OR = 1.68 [95% CI 1.15, 2.44]) and depression improvement (OR = 1.45 [95% CI 1.02, 2.05]).
- For standard-length treatment, expectancy predicted clinically meaningful anxiety improvement (OR = 1.50 [95% CI 1.11, 2.02]) and depression improvement (OR = 1.34 [95% CI 1.03, 1.76]).
- Credibility and expectancy had diminished predictive value when modelled together; treatment preference may also have moderated outcomes.
Why it matters
Perceived suitability and expected effectiveness may be relevant to outcomes in standard-length digital treatment, while their role in ultra-brief formats remains uncertain. The findings also suggest these perceptions overlap, so their individual predictive contributions may be difficult to distinguish. Understanding these relationships could inform further evaluation of how treatment perceptions and preferences relate to symptom change.
What to keep in mind
This was a secondary analysis, and the authors state that larger samples are needed to clarify the influence of credibility and expectancy in ultra-brief digital treatment.