A on asking for client feedback during therapy in response to my Twitter poll last week, where 42% of folks who've been in therapy for suicidal thoughts/behaviors were NEVER asked for feedback by their therapists and another 29% were asked only rarely 1/ https://twitter.com/KellyLGreenPhD/status/1346118359532920832

Even more concerning, of those who were asked for feedback in therapy, 22% said their therapist NEVER made changes in response and 56% said the therapist made changes only sometimes. https://twitter.com/KellyLGreenPhD/status/1346118872827617281?s=20 2/

I notice this when training therapists and listening to their sessions; asking for feedback is a critical skill for development. Therapists may assume that their client will give them any feedback they need without having to ask, but this usually doesn't happen. 3/

The onus is on us as therapists to ask for feedback, both positive *and* negative AND adjust ourselves/the therapy in response. Feedback should happen in every session, both during the session and at the end to get summary feedback on the session as a whole. 4/

Here are some examples of feedback during a session:

1. “I want to make sure I have this right; what am I missing?” after a lengthy summary/reflection

2. “How helpful does this sound to you as something to try?” after discussing the rationale for a potential plan/skill 5/

3. “What would be more helpful?” or “How could we change it to make it more helpful” in response to negative feedback.

4. “How do you feel about our progress on this problem/area/topic?” 6/

At the end of session, it’s important to talk about what the helpful/not helpful aspects of the session and whether there are any adjustments that should be made in future sessions. Specifically ask for negative feedback to increase the likelihood your clients tells you! 7/

For example:

“What were the most and least helpful parts about today’s session?”

“Is there anything that you would like for me to do differently in future sessions?”

“Is there anything that we should change about future sessions?” 8/

Being open and humble to feedback is paramount. When a client gives me difficult feedback, I always make sure to express how glad I am that they told me so that we can work together to make therapy more effective and helpful for them. 9/

Finally, never ignore client feedback and overlook the importance of making changes in response to feedback. If you’re not sure what changes to make, discuss this with your client (collaboration is key) or get consultation from someone else. #CBTWorks 10/end