Learning from clients: A qualitative investigation of psychotherapists' reactions to negative verbal feedback

To explore how therapists experience, react to, and learn from negative feedback from their clients.

Eighteen experienced therapists' written descriptions of episodes where they had received negative verbal feedback from clients were analyzed according to the Consensual Qualitative Research methodology.

Receiving feedback was experienced as challenging, but educational. Learning was manifested in different ways: (a) Immediately Applied Learning-therapists improved the following therapy process by changing their behavior with the client, (b) Retrospectively Applied Learning-therapists made changes in their way of working with subsequent clients, and (c) Non-Applied Learning-new ideas generated by the experience had not been translated into behavior. We compared cases describing these manifestations of learning and found differences in the nature of the feedback and how therapists understood, reacted, and responded to it.

The therapists benefitted from obtaining and being open to specific feedback from their clients, regulating their own emotional reactions, accommodating dissatisfied clients, and considering how they themselves contributed to negative therapy processes.