Introduction: Gene therapy is currently being developed for people with cystic fibrosis (CF), a life-threatening condition for which there is no cure. The UK CF Gene Therapy Consortium are preparing for a multi-dose gene therapy trial of sufficient duration that clinical benefit may be seen. Aims: The current study aimed to explore the expectations and beliefs of cystic fibrosis (CF) patients involved in the preparatory phase of the gene therapy trial (the Run-in study), from which participants will be selected for the multi-dose actual gene therapy trial. Method: Twelve participants (six with mild and six with moderate CF) were interviewed using a semi-structured interview. Interviews were recorded, transcribed verbatim and then analysed using a Constructivist Grounded Theory approach. Results: Since entering the Run-in study, half of the patients had increased their expectations of gene therapy being an effective future treatment. Most of the participants hoped to derive clinical benefit from the trial itself though half were unsure of what to expect. Whilst half of the participants expressed the hope of a future cure for CF, the remainder saw gene therapy only in terms of an improved treatment. Participants used several strategies to manage their expectations including not thinking too far ahead and trusting the research team. Discussion: The findings indicate that participants in the Run-in trial are generally eager to be involved in the gene therapy trial and have developed a strong sense of trust in the research team conducting the trials. The levels of optimism expressed for personal benefit from trial were higher than those from earlier studies. Some of the positive expectations were unlikely to be met by the gene therapy trial and participants risk disappointment. However other patients participated with apparently realistic expectations and it seems likely that some patients would have participated even without prospect for personal benefit. Possible areas of psychological support are discussed e.g. a standard clinical interview for all those not accepted for the gene therapy trial; screening for anxiety pre-, during and post-participation.

The effectiveness of an educational psychotherapy presentation on Asians' therapy expectations and help-seeking attitudes was investigated. Subjects were foreign-born Asian university students. Compared to a non-Asian American normative sample, the Asian group demonstrated significantly less accurate expectations about therapy and less positive attitudes about seeking help for psychological problems. A psychotherapy presentation was used to modify expectations and attitudes. It consisted of an audiotaped lecture on therapist and client roles and the types of problems discussed in therapy. It also included a written transcript of therapist-client dialogues for subjects to read. The experimental group, which received the presentation, was compared to placebo control and delayed-treatment control groups. The psychotherapy presentation did not modify Asians' expectations or attitudes more than the control groups. Instead, all three groups showed improvement at posttest. Because there is a clear need to assess further the therapy expectations and attitudes of Asians, future research was recommended.