Abstract

Depression is one of the main reasons for seeking mental health services; however, few studies have focused on the per-spective 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 health care settings. Semi-structured interviews were conducted with sixteen depressed adult patients referred to psy-chological care before their first session. Data was analyzed using grounded theory and consensual qualitative methods. Patients had expectations regarding the characteristics of psychological treat-ment, the psychologist, and changes. Patients expect psychologi-cal 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 un-derstand 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 un-derlined. Therapeutic skills and contextual factors are key facili-tating elements to meet these expectations. The findings discuss how addressing expectations can serve as input for delivering more satisfactory treatment to patients.