Research has shown that the idea behind the self-fulfilling prophecy is true. People who believe they'll succeed put in more effort. They're more willing to try new things, take some risks and keep trying after failures or setbacks. People with negative attitudes take the first failure or setback as confirmation that whatever they're trying won't work or isn't possible, and give up. Why waste time and effort on something that's doomed to failure anyway?
Research on attitudes of rehab patients show this to be true in recovery as well. A review of 23 articles looking at outcomes for shoulder pain found a few interesting things. First, patients who expected to recover and believed that they had some control of the outcome, ended up doing better than those who didn't. Second, optimistic patients were found to have less pain and disability after completing rehab. Third, patients who believed they'd have pain and disability after surgery tended to have - you guessed it - pain and disability after their surgery. Research says that patients tend to get what they expect.
Patient attitudes are important, but what about therapists'? There isn't much research specific to PT, but there is a study done in elementary schools that might give us some clues. Two psychologists - Rosenthal and Jacobs did a study that found teacher expectations had an influence on student performance. They told teachers that randomly selected students in their classes were tested and found to be "late bloomers". These students were expected to show large improvements in academic performance during the school year. When the students were tested 8 months later, the students the teachers believed would improve the most, did.
It's pretty easy to see how this could cross over into a PT clinic. If A PT thinks a patient can get better, they'll probably put more effort into designing a program, spend more time with them and push them harder than someone they don't believe has a lot of room for improvement.
When the patient and therapist both expect a good outcome, they usually get one.
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