What do you expect from psychological care? A qualitative study of depressed patients’ expectations treated in mental healthcare settings

Depression is one of the main reasons for seeking mental health services; however, few studies have focused on the perspective of depressed patients to understand what they expect from this instance. This study aims to develop a comprehensive model of patients' initial expectations regarding psychological treatment in mental healthcare settings. Semi-structured interviews were conducted with sixteen depressed adult patients referred to psychological care before their first session. Data was analyzed using grounded theory and consensual qualitative methods. Patients had expectations regarding the characteristics of psychological treatment, the psychologist, and changes. Patients expect psychological care to have a clear purpose and to last the time required until they feel better. They expect the psychologist to be an active and responsive professional. Regarding changes, patients expect to understand why they have depression, develop personal resources, and improve their self-esteem and mood. Facilitating factors (e.g., preferences for psychological support over medical treatment) and hindering factors (e.g., institutional constraints) were identified in achieving these expectations. Based on patients' expectations, a helping relationship that is more responsive to their needs is underlined. Therapeutic skills and contextual factors are key facilitating elements to meet these expectations. The findings discuss how addressing expectations can serve as input for delivering more satisfactory treatment to patients.