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Self-fulfilling prophecies in the clinical context: Review and implications for clinical practice
Institution:1. Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy;2. Psychiatry Unit, Department of Medical Sciences, University of Foggia, Italy;3. Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Italy;4. Internal Medicine Unit, Department of Medical Sciences, University of Foggia, Italy;1. Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, AOUP “Paolo Giaccone”, Palermo, Italy;2. Department of Neurosurgery, University Hospital Federico II, Naples, Italy;1. Department of Infectious Diseases, University Medical Centre Ljubljana, Japljeva 2, 1525 Ljubljana, Slovenia;2. Institute for Microbiology and Immunology, Medical Faculty, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia;1. Department of Brain and Behavioural Sciences, Medical and Genomic Statistics Unit, Università degli Studi di Pavia, Pavia, Italy;2. Institute of Population Genetics, National Research Council of Italy, Sassari, Italy;3. Institute of Molecular Genetics, National Research Council of Italy, Pavia, Italy;1. Department of Neurosciences, University of California, San Diego School of Medicine, La Jolla, California;2. Department of Pediatrics, University of California, San Diego School of Medicine, La Jolla, California;3. Rady Children''s Hospital–San Diego, San Diego, California;1. Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands;2. Department of Health, Medical and Neuropsychology Leiden University, Leiden, The Netherlands;3. Laboratory of Cognitive Science and Immersive Virtual Reality, Second University of Naples, Naples, Italy
Abstract:The expectancies a therapist and client bring into the clinical relationship can act as self-fulfilling prophecies. This article reviews the literature bearing on three types of self-fulfilling prophecies in a clinical context. First, I look at how the initial expectancies held by a therapist may bias the diagnosis and treatment of the client. Second, I look at the client's own self-expectancies for improvement and how they can enhance or impede progress. Last, I look at how receiving mental health treatment may be regarded as a stigma by others, resulting in negative social interactions for the client. For each of these domains, practical examples and implications are discussed, and suggestions are offered to therapists for how they can avoid or minimize damaging effects of negative self-fulfilling prophecies.
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