In this article, we specifically focus on the identification and management of patient beliefs and expectations during consultations with health-care professionals (HCPs). In examination of the nature and purpose of communication during consultations, we evaluate the research relating to doctora??patient communication, present the Calgarya??Cambridge framework and highlight the identification and management of the patient s beliefs and expectations as a key part of this process. Having identified what can go wrong, we identify the characteristics of effective consultations and consider strategies for improving communication. In recommending a clear and more focussed approach to the identification and management of patient beliefs and expectations, we consider not only the nature of the therapeutic climate, but also the style and content that could enhance the effectiveness of the communication. Having identified techniques for facilitating self-disclosure, we conclude by offering suggestions on how to a??close downa?? the consultation and hand over responsibility to the patient.