Power of Clients’ Feedback in Therapy

Most therapists believe they understand how their clients are feeling about therapy, but in fact research consistently shows that therapists and clients often have divergent viewpoints. This helps explain those rather common surprising therapy dropouts. Years of research conclusively prove that when clients give feedback about how they feel therapy is going, the therapeutic alliance–one of the best predictors of successful outcome–is more positive, therapy dropouts are reduced, and those clients whom therapists predict will do poorly in therapy actually do better than expected.

In this day and age, clients – like most modern consumers – are used to giving feedback (online) whether they are being asked for it or not. Quick, easy feedback forms are available for therapists to give to clients, preferably at the end of each session. These forms not only put therapists and clients on the same page, but they can enrich and deepen therapy. The feedback becomes part of the ongoing process of therapy, and that works better for all therapists, whether CBT, psychodynamic, postmodern or client-centered. Today’s informed therapist knows how to deliberately ask for feedback and what to ask about.

Client feedback has also become an important part of supervision and training. Today’s supervisors and trainers should consider becoming familiar with client feedback tools and consider encouraging their trainees and supervisees to utilize these forms in their therapy sessions and bring the results to supervision. Doing this not only enhances therapists’ skills but opens up deeper levels of processing and discovery.

Did you know?

• Consumers routinely post their feedback online at YELP and other sites. Giving feedback seems a normal part of life.
• Consistently, clients are looking for goal attainment, agency amenities, counselor helpfulness, and improvement in the issues for which one came to therapy.
• In a study of couples in couples therapy, those who gave feedback showed nearly four times the rate of clinically significant change over couples who didn’t give feedback.
• A study of 13 randomized, controlled trials by Scott Miller finds that routine outcome monitoring and feedback can decrease client dropout rate by up to 50%.
• Therapists who use client feedback as part of their own supervision have better client outcomes and show greater self-efficacy than therapists who do not.
• Therapists in training who received client feedback after sessions were twice as effective as therapists in training who did not in terms of the strength of the therapeutic alliance and the accuracy of their perceptions of their own clinical skills.