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Managing expectations in therapy

Associate Prof. Rachel Handley

Tuesday, 17 September 2024


Effective therapy requires effective engagement of clients to achieve the outcomes they value and agreement on the goals and tasks of therapy is thought to enhance therapeutic alliance. Identifying, understanding and managing expectations that both clients and therapists bring to therapy is fundamental to maximising this collaboration. This workshop will use CBT as an example to consider areas where managing expectations is critical to therapy including engagement in the style and nature of therapy (e.g., collaborative empiricism), “doing” not just “talking" therapy, use of outcome measures to monitor symptoms and direct therapy, setting goals, completing between-session tasks, making and reviewing recordings, working on the most emotionally salient (challenging) material, exposure to that which is normally feared or avoided, therapist and service boundaries, modality of therapy (e.g. remote or face-to-face) duration and ending of therapy, and considering life after therapy. 

The event will be equivalent to 2 hrs of CPD.


This practically focussed, 2-hour webinar will describe some of the pitfalls and opportunities in expectation management in therapy. Using CBT as an example, it will describe key points throughout therapy where expectation management occurs and techniques to help achieve effective collaboration that put patient goals at the heart of therapy. The webinar will also consider common challenges and managing disappointed expectations for both therapist and clients and surviving systems where our own expectations of the care we would like to give may be challenged.

Learning Objectives

To be able to identify common areas for expectation management
To be able to engage clients transparently and collaboratively (using the style and format of CBT as an example)
To be able to manage challenges arising from unrealistic or unfulfilled expectations

Training Modalities

The webinar will be interactive and will include powerpoint presentation, self-practice and self-reflection, Q&A, video examples and polls.

Key References

Ekberg, S., Barnes, R.K., Kessler, D.S., Mirza, S., Montgomery, A.A., Malpass, A. & Shaw, A.R.G. (2015). Relationship between Expectation Management and Client Retention in Online Cognitive Behavioural Therapy, Behavioural and Cognitive Psychotherapy, 43, 732-742

Ekberg, S., Barnes, R.K., Kessler, D., Malpass, A, & Shaw, A.R. (2014). Managing clients’ expectations at the outset of online Cognitive Behavioural Therapy (CBT) for depression, Health Expectations, 19, 557-569

About the presenter

Professor Rachel Handley is Consultant Clinical Psychologist at the Ministry of Defence, UK and has her own private practice as a clinician, supervisor, educator, and speaker.  She is an Honorary Associate Professor of Clinical Psychology at the University of Exeter. She is a highly expert Clinical Psychologist having worked as a Research Clinical Psychologist in David Clark and Anke Ehlers’ prestigious clinical research team, completed a Beck Scholarship at the Beck Institute and directed numerous clinical training programmes, including the Doctorate in Clinical Psychology and Improving Access to Therapies (IAPT) programmes at the University of Exeter alongside national PTSD and CBT trainings.  She is passionate about working with and promoting evidence-based approaches to mental health disorders, in particular anxiety and PTSD. Outside of work she is a busy Mum of three and enjoys family life, friendships and the beauty of the South West of England - all of which provide a happy backdrop to her work!

Who should attend

This event is suitable for all mental health psychological practitioners who wish to reflect on and improve their practice in engaging clients in therapy. Please note that the example used will be CBT so having an understanding of CBT approaches may be helpful.

Details coming soon

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