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.
a Department of Tiller DPS , St. Olavs University Hospital , Trondheim , Norway.|b Department of Neuroscience, Faculty of Medicine , The Norwegian University of Science and Technology (NTNU) , Trondheim , Norway.
Heidi
0000-0002-4872-4652
H
Brattland
c Competence and Resource Center for Service Experience and Service Development Mid-Norway , Trondheim , Norway.
Juni R
JR
Høiseth
a Department of Tiller DPS , St. Olavs University Hospital , Trondheim , Norway.
Olav
O
Burkeland
a Department of Tiller DPS , St. Olavs University Hospital , Trondheim , Norway.
Tryggve S
TS
Inderhaug
d Faculty of Psychology , University of Bergen , Bergen , Norway.
Per E
PE
Binder
b Department of Neuroscience, Faculty of Medicine , The Norwegian University of Science and Technology (NTNU) , Trondheim , Norway.|e Department of Østmarka , St. Olavs University Hospital , Trondheim , Norway.
Valentina C
VC
Iversen
D000328:Adult; D030141:Feedback, Psychological; D006282:Health Personnel / Q000193:education / Q000523:psychology*; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D017060:Patient Satisfaction; D017064:Process Assessment, Health Care; D011613:Psychotherapy / Q000193:education; D036301:Qualitative Research
alliance; client feedback; process research; psychotherapist training/supervision/development; qualitative research methods; therapist difficulties