Role Expectancies, Race, and Treatment Outcome in Rural Mental Health

This study is the first report examining the relationship between pretreatment expectancy and treatment outcome in Osage Native Americans receiving mental health services. Results reveal that in Native American participants, high expectations for advice and approval in therapy may lead to poor treatment outcomes. Conversely, low expectancies may be risk factors for poor outcomes among White American individuals. Therefore, practitioners should consider client race during assessment and appropriately address problematic pretreatment expectancies to prevent poor treatment outcome. Given differences in direction of effects between races, it may be best to increase advice and approval therapeutic roles when working with Native American clients, whereas it may be best to increase pretreatment expectancies with White American clients. Results are particularly notable given that Native American clients are pervasively under-researched and under-served.