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Winfried Rief
Professor of Clinical Psychology and Psychotherapy, Philipps University of Marburg & Head of the Clinic for Psychological Interventions

Expectancy focused psychotherapy

Placebo research has shown that patient’s expectancies are one of the most potent predictors of treatment outcome in various medical conditions. Therefore interventions focusing on the change of expectations might be most effective. However, this could be of relevance not only for outcome expectations, but also for disease-specific, problem-specific and treatment-specific expectations.
I will present latest results on disorder-specific expectations, e.g. in depression. Psychotherapy will be reformulated as an intervention that should target expectation violation of disorder- and treatment specific expectations. Patient strategies how to devalue learning effects in expectation violation situations are exemplified, and ways how to optimize expectation-violating effects are highlighted.
As a practical example, data from a large RCT (= 126) are shown confirming the effect of a presurgery optimization of expectations in patients scheduled for heart surgery (CABG). Disability scores 6 months later confirmed best outcome for heart surgery patients who participated in preoperative psychological interventions is optimizing expectations. Practical aspects of the intervention will be presented, and perspectives how to implement these procedures to optimize outcome in medical interventions will be discussed.

Biosketch

Professor of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Germany. Head of the Clinic for Psychological Interventions. License for psychotherapy and supervision. Dr. Rief worked for many years in hospital settings (e.g., Roseneck Hospital for Psychosomatic Medicine, Prien a. Ch.). He is specialized in placebo- and nocebo effects, perception and coping with somatic symptoms, optimization of clinical studies and interventions. He was guest professor at Harvard Medical School, Boston (2004/2005), University of Auckland Medical School (2002), and University of California San Diego (2009/2010). Additionally, he was nominated for the expert committee of WHO/APA for the revision of the classification of mental disorders according to DSM-5, and he is co-chairing the WHO working group on chronic pain diagnoses in ICD-11. Dr. Rief is elected coordinator for grant applications to the German Research Foundation and he is spokesperson of the DFG-research unit on placebo and nocebo mechanisms. His publication record summarizes more than 400 articles, in particular in the field of behavioral medicine and somatoform disorders. He received the Distinguished Researchers award in Behavioral Medicine in 2014.