Portuguese validation of the credibility/expectancy questionnaire in routine practice


This study aimed to validate and explore the psychometric properties of the credibility/expectancy questionnaire (CEQ) for the Portuguese population in the context of routine practice. The sample includes 87 clients from a university psychotherapy clinic. All clients completed self-report measures to assess credibility and expectation (CEQ), as well as measures of general mental health, depressive symptoms and therapeutic alliance in session 1 and session 2. The exploratory analysis revealed the existence of two factors in CEQ for the Portuguese population, factor 1 credibility and factor 2 expectation. The measure demonstrated good internal consistency, test-retest reliability and good adjustment in the confirmatory analysis. In terms of convergent validity, no significant correlation was found between credibility and expectation and the therapeutic alliance. The results corroborate the CEQ psychometric qualities for the Portuguese population, also showing its applicability in a context of routine practice.



PlumX Metrics


Download data is not yet available.


Ardito, R., & Rabellino, D. (2011). Therapeutic alliance and outcome of psychotherapy: historical excursus, measurements, and prospects for research. Frontiers in Psychology, 2, 1-11. DOI: https://doi.org/10.3389/fpsyg.2011.00270

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association. DOI: https://doi.org/10.1176/appi.books.9780890425596

Ametrano, R. (2011). Patient outcome expectations and credibility beliefs as predictors of the alliance and treatment outcome. Masters Theses, February. Retrieved from: http://scholarworks.umass.edu/theses/658

Andersson, G., Johansson, C., Nordlander, A., & Asmundson, G. J. G. (2012). Chronic pain in older adults: A controlled pilot trial of a brief cognitive-behavioural group treatment. Behavioural and Cognitive Psychotherapy, 40(2), 239-244. DOI: https://doi.org/10.1017/S1352465811000646

Barkham, M., Bewick, B., Mullin, T., Gilbody, S., Connell, J., Cahill, J., Mellor-Clark, J., Richards, D., Unsworth, G., & Evans, C. (2013). The CORE-10: A short measure of psychological distress for routine use in the psychological therapies. Counselling and Psychotherapy Research, 13(1), 3-13. DOI: https://doi.org/10.1080/14733145.2012.729069

Brown, T. (2015). Confirmatory factor analysis for applied research. In The American Statistician (Vol. 62, Issue 1). doi:10.1198/tas.2008.s98. DOI: https://doi.org/10.1198/tas.2008.s98

Cohen, M., Beard, C., & Björgvinsson, T. (2015). Examining patient characteristics as predictors of patient beliefs about treatment credibility and expectancies for treatment outcome. Journal of Psychotherapy Integration, 25(2), 90-99. DOI: https://doi.org/10.1037/a0038878

Constantino, M. J., Arnkoff, D. B., Glass, C. R., Ametrano, R. M., & Smith, J. Z. (2011). Expectations. Journal of Clinical Psychology, 67(2), 184-192. DOI: https://doi.org/10.1002/jclp.20754

Constantino, M. J., Coyne, A. E., Boswell, J. F., Iles, B. R., & Visla, A. (2018). A meta-analysis of the association between patients’ early perception of treatment credibility and their posttreatment outcomes. Psychotherapy, 55(4), 486-495. DOI: https://doi.org/10.1037/pst0000168

Constantino, M. J., Visla, A., Coyne, A. E., & Boswell, J. F. (2018). A meta-analysis of the association between patients’ early treatment outcome expectation and their posttreatment outcomes. Psychotherapy, 55(4), 473-485. DOI: https://doi.org/10.1037/pst0000169

Constantino, M. J., & Westra, H. A. (2012). An expectancy-based approach to facilitating corrective experiences in psychotherapy. Transformation in Psychotherapy: Corrective Experiences across Cognitive Behavioral, Humanistic, and Psychodynamic Approaches, 121-139. DOI: https://doi.org/10.1037/13747-008

Coste, J., Tarquinio, C., Rouquette, A., Montel, S., & Pouchot, J. (2019). Cross-cultural adaptation and validation of the French version of the credibility/expectancy questionnaire. Further insights into the measured concepts and their relationships. Psychologie Francaise, 1-12.

Costello, A. B., & Osborne, J. W. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research and Evaluation, 10(7).

Devilly, G. J., & Borkovec, T. D. (2000). Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 31(2), 73-86. DOI: https://doi.org/10.1016/S0005-7916(00)00012-4

Fabrigar, L. & Wegener, D. (2012). Exploratory factor analysis. New York, NY: Oxford University Press.

Falkenström, F., Hatcher, R. L., Skjulsvik, T., Larsson, M. H., & Holmqvist, R. (2015). Development and validation of a 6-item working alliance questionnaire for repeated administrations during psychotherapy. Psychological Assessment, 27(1), 169-183. DOI: https://doi.org/10.1037/pas0000038

Field, A. (2017). Discovering Statistics Using IBM SPSS Statistics (5th ed). London: SAGE Publications.

First, M.B., Williams, J.B.W., Karg, R.S., & Spitzer, R.L. (2016). Structured clinical interview for DSM-5 disorders, clinician version (SCID-5-CV). Arlington, VA: American Psychiatric Association.

Greenberg, R. P., Constantino, M. J., & Bruce, N. (2006). Are patient expectations still relevant for psychotherapy process and outcome? Clinical Psychology Review, 26(6), 657-678. DOI: https://doi.org/10.1016/j.cpr.2005.03.002

Kaya, C., Tansey, T., Chan, F., Bezyak, J., Melekoğlu, M., Çakıroğlu, O., & Köse, S. (2015). Dimensionality of the Turkish version of the self-stigma of seeking help scale: results from exploratory and confirmatory factor analyses. International Journal for the Advancement of Counselling, 37:105-116.

Kline, R. B. (2016). Principles and practices of structural equation modelling (4th Ed.). New York, NY: The Guilford Press.

Mertens, V. C., Goossens, M. E. J. B., Verbunt, J. A., Köke, A. J., & Smeets, R. J. E. M. (2013). Effects of nurse-led motivational interviewing of patients with chronic musculoskeletal pain in preparation of rehabilitation treatment (PREPARE) on societal participation, attendance level, and cost-effectiveness: Study protocol for a randomized controll. Trials, 14(1). DOI: https://doi.org/10.1186/1745-6215-14-90

Mertens, V. C., Moser, A., Verbunt, J., Smeets, R., & Goossens, M. (2017). Content validity of the credibility and expectancy questionnaire in a pain rehabilitation setting. Pain Practice, 17(7), 902-913. DOI: https://doi.org/10.1111/papr.12543

Newman, M. G., & Fisher, A. J. (2010). Expectancy/credibility change as a mediator of cognitive behavioral therapy for generalized anxiety disorder: mechanism of action or proxy for symptom change? International Journal of Cognitive Therapy, 3, 245-261. DOI: https://doi.org/10.1521/ijct.2010.3.3.245

Marôco, J. (2014). Análise de equações estruturais: Fundamentos teóricos, software e aplicações (2nd Ed). Pêro Pinheiro, Portugal: ReportNumber.

Marôco, J. (2018). Análise estatística com o SPSS Statistics (6ª ed). Pêro Pinheiro, Portugal: ReportNumber.

Nock, M. K., Ferriter, C., & Holmberg, E. (2007). Parent beliefs about treatment credibility and effectiveness: assessment and relation to subsequent treatment participation. Journal of Child and Family Studies, 16(1), 27-38. DOI: https://doi.org/10.1007/s10826-006-9064-7

Sales, C. M. D., Moleiro, C. M. de M., Evans, C., & Alves, P. C. G. (2012). Versão Portuguesa do CORE-OM: tradução, adaptação e estudo preliminar das suas propriedades psicométricas TT - The Portuguese version of the CORE-OM: translation, adaptation, and preliminary study of psychometric properties. Revista de Psiquiatria Clínica (São Paulo), 39(2), 54-59.

Smeets, R. J. E. M., Beelen, S., Goossens, M. E. J. B., Schouten, E. G. W., Knottnerus, J. A., & Vlaeyen, J. W. S. (2008). Treatment expectancy and credibility are associated with the outcome of both physical and cognitive-behavioral treatment in chronic low back pain. Clinical Journal of Pain, 24(4), 305-315. DOI: https://doi.org/10.1097/AJP.0b013e318164aa75

Sochting, I., Tsai, M., & Ogrodniczuk, J. (2016). Patients’ perceptions of treatment credibility and their relation to the outcome of group CBT for depression. Archives of Psychiatry and Psychotherapy, 18(4), 7-15. DOI: https://doi.org/10.12740/APP/66485

Soto-Pérez, F., & Franco-Martín, M. (2014). PsicoED: Una alternativa online y comunitaria para la psicoeducación en esquizofrenia. Psicoperspectivas, 13(3), 118-129. DOI: https://doi.org/10.5027/psicoperspectivas-Vol13-Issue3-fulltext-416

Stinson, E. J., Perez, M., Ohrt, T. K., Von Schell, A., & Bruening, A. B. (2018). The association between program credibility, expectancy, and acceptability with baseline pathology and outcome for a body acceptance prevention program. Journal of Clinical Psychology, 74(12), 2161-2172. DOI: https://doi.org/10.1002/jclp.22654

Thompson-Hollands, J., Bentley, K., Gallagher, M., Boswell, J., & Barlow, D. (2014). Credibility and outcome expectancy in the unified protocol: relationship to outcomes. Journal of Experimental Psychopathology, 5(1), 72-82. DOI: https://doi.org/10.5127/jep.033712

Timulak, L, Keogh, D, McElvaney, J., Schmitt, S., Hession, N., Timulakova, K., Jennings, C., & Ward, F. (2020). Emotion-focused therapy as a transdiagnostic treatment for depression, anxiety and related disorders: Protocol for an initial feasibility randomised control trial. HRB Open Research, 3, 7. DOI: https://doi.org/10.12688/hrbopenres.12993.1

Tompkins, K. A., Swift, J. K., Rousmaniere, T. G., & Whipple, J. L. (2017). The relationship between clients’ depression etiological beliefs and psychotherapy orientation preferences, expectations, and credibility beliefs. Psychotherapy, 54(2), 201-206. DOI: https://doi.org/10.1037/pst0000070

Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. (2010). A randomized clinical trial of acceptance and commitment therapy vs. progressive relaxation training for obsessive compulsive disorder. Journal of Consulting and Clinical Psychology, 78(5), 705-716.

Van Prooijen, J. W., & Van der Kloot, W. A. (2001). Confirmatory analysis of exploratively obtained factor structures. Educational and Psychological Measurement, 6, 777-792. DOI: https://doi.org/10.1177/00131640121971518

Wahbeh, H., Goodrich, E., & Oken, B. S. (2016). Internet-based mindfulness meditation for cognition and mood in older adults: a pilot study. Alternative Therapies in Health and Medicine, 22(2), 44–53.

Tools validation
Credibility, expectation, validation, routine practice, psychotherapy.
  • Abstract views: 148

  • PDF: 30
  • HTML: 0
How to Cite
Silva, S., Barbosa, E., Salgado, J., & Cunha, C. (2021). Portuguese validation of the credibility/expectancy questionnaire in routine practice. Research in Psychotherapy: Psychopathology, Process and Outcome, 24(1). https://doi.org/10.4081/ripppo.2021.495