Eliciting feedback is so closely related to the therapeutic relationship. Why?

First, let’s talk about the therapeutic relationship. You already know it’s one of the best predictors of progress. In this article (which I highly recommend), they note that:

• 54% of the variance of outcomes in therapy can be tied directly to the relationship

• Client change is due to the relationship 7x more than it is due to any specific therapeutic modality.

• client ratings (not the therapist’s!) of the relationship are better predictors of outcomes.

• clients who express even low levels of disagreement/dissatisfaction with their therapist have better progress and relationship.

So what does the article add to this conversation?

Again, the therapeutic relationship is QUEEN. And, our assessment of it doesn’t matter as much as our client’s. The article also notes that relationships in which a therapist has access to client’s opinions on outcome and alliance are less likely to deteriorate, more likely to last longer, and 2x as likely to reach clinically significant outcomes for the client.

So what do we elicit feedback on? How do we get access to the client’s take on things? How do we get that negative feedback? I first learned some of these skills from one of my clinical mentors, Susie Snyder, LCSW. Here are a few of her handouts that are basically gold. [Handout 1, Handout 2]. Best practices include eliciting feedback regularly in a way that feels authentic and organic to you and your client.

Some examples:

How’s our relationship feel for you? (do they feel heard, understood, respected)

How confident are you that therapy will help you change?

How certain are you that I will be helpful to you?

Did we talk about what you wanted to today? What did we miss?

Where am I understanding you most/least?

Which parts of my approach are a good fit for you? Which parts are neutral or even a bit negative?

Where do we agree on how change will happen for you?

What are our shared goals here?

Bottom line: When we’re eliciting feedback, we’re not effing around. We’re ensuring our clients reach their goals of establishing safe and stable housing, connecting more with their truest self, experience sobriety or stability, deepen healing, find liberation or whatever other life-changing experiences they are seeking.