[2] The formulation given by Appelbaum et al. in 1987 was the following: “To maintain a therapeutic misconception is to deny the possibility that there may be major disadvantages to participating in clinical research that stem from the nature of the research process itself.”[3] Therapeutic misconception did not receive great attention until the early 2000s, when references to the concept expanded significantly.
[4] Originally only used in the context of randomized controlled trials, the term is now commonly used among sociologists, neuroscientists, and clinical investigators.
Strategies to minimize therapeutic misconception include giving a clear description of the research procedures and goals (e.g. explaining study design, treatment allocation and the possibility of receiving a placebo since the allocation is randomized) and having a comprehensive discussion, with the subject, about the voluntary nature of participation and of available alternatives.
It is possible for subjects to maintain optimism, while demonstrating an understanding of both the nature of research and the probability of important risks and benefits.
The expert medical community typically don't view optimism as ethically problematic largely because an optimistic outlook can help in a patient's healing process while still allowing them the understanding necessary to provide valid informed consent.