Feedback in Therapy: Giving and Receiving

Feedback is part of the therapeutic process. It is an exchange between you and your therapist about what is helping, what is not, and what may need to change.

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The Therapeutic Relationship: Foundation for Feedback

The therapeutic relationship is structured differently from other relationships in your life. It is confidential, and it is bounded by professional and ethical standards. Forming a close working relationship with someone in a professional and paid setting is unusual, and those boundaries are part of what makes it possible to speak plainly in it.

The relationship is deliberately one-sided: the focus stays on you and your needs, not on the therapist’s. That structure is one reason difficult topics, and feedback in both directions, can be easier to raise here than elsewhere. It is a setting in which you can raise sensitive things without being judged for them.

Feedback within the Therapeutic Relationship

• Honest exchanges: The professional boundaries support a directness that is harder to reach in other relationships. Feedback your therapist offers is given with your interests in mind.
  
• A place for difficult conversations: You can say things in therapy that you would usually hold back, and hear a considered response to them.
  
• Not a simple transaction: The interaction is not an exchange of service for payment alone. The trust and safety built into the relationship let you work on things in more depth than everyday conversation allows.

The Importance of Feedback in Therapy

• Shaping the work: Feedback influences how your therapy is conducted. It helps keep the work aligned with what you actually need, and it gives you a say in the direction your sessions take.
  
• Clearer communication: Feedback improves how you and your therapist understand each other, and helps you both stay aligned on goals and expectations.

How to Give Feedback in Therapy

• Timing and honesty: Choose a moment when you feel settled, often at the start or the end of a session. Be honest and respectful. Say what you are finding helpful, and where you feel stuck.
  
• Give examples: Specific examples help your therapist understand your experience. Saying "I felt particularly supported when we discussed..." or "I struggle to connect with the method we used last session" is clearer than a general impression, and easier for your therapist to work with.
  
• What holds you back: Talking about what stops you from giving or receiving feedback is itself useful work. Many people worry about being judged or misunderstood by their therapist. Raising that worry in the session is often where something opens up.

Receiving Feedback from Your Therapist

• Hearing what is difficult to hear: Feedback from your therapist can be uncomfortable. Taking it as information about yourself, rather than as a verdict on you, gives you something you can work with.
  
• Taking time with it: Reflect on feedback after the session, in a journal, through meditation, or in whatever way suits you, so you can consider what it means for you and what you want to do with it.

An illustration. Suppose your therapist observes that avoiding conflict may be affecting your relationships, and your progress in therapy. That may be uncomfortable to hear at first. Looking back at interactions inside and outside therapy, you may start to recognise a pattern of stepping away from disagreement.

Discussing it openly, you could look at times when avoiding conflict left something unsaid, or led to a misunderstanding. That becomes a starting point for working on how you approach disagreement.

Your therapist might then suggest a role-play exercise: practising, in the session, how you would say a difficult thing to someone. Role-play is a common enough technique that you can ask for it by name. Work of that kind gives you something to try rather than only something to think about.

Challenges in Feedback Exchange

• Emotional reactions: It is common to react strongly to feedback, particularly when it touches on something sensitive or on a long-held belief about yourself. You might feel defensive, anxious, or upset. Recognising those responses as an ordinary part of the process matters. In therapy you can work on ways to manage them, such as slowing your breathing, pausing before you respond, or looking at what sits underneath the reaction.
  
• Misunderstandings: Feedback can be taken differently from how it was meant, particularly when it is not clearly put, or when it lands on a hard day. Ask for clarification whenever feedback is unclear or surprising. Checking what your therapist meant costs a minute and prevents a misreading that could otherwise sit for weeks.

Practical Tips for Effective Feedback

• Set goals from the feedback: Turn what you discuss into something specific. If the conversation points to a need for more self-care, you might agree on particular activities to build into your week. That gives you a clear direction and something to review later.
  
• Regular check-ins: A set point in your sessions to discuss what is working and what is not lets adjustments happen in good time. It also makes feedback a routine part of the work rather than something that only surfaces when there is a problem.

Key Takeaways

• Feedback shapes the work. It lets you adjust the therapy to your needs, and gives your therapist information about your experience and your reactions.
  
• Open communication is what makes feedback useful. Being honest in what you say, and open to what you hear, is the whole of it.
  
• Strong reactions are part of the process. Learning to notice and manage them makes it easier to stay in the conversation rather than close it down.
  
• Misunderstandings can be reduced by asking. Seek clarification during feedback so that you and your therapist mean the same thing.
  
• Regular feedback keeps therapy aligned with what you need. Raising it as you go, rather than only when something has gone wrong, means adjustments can be made while they still make a difference.

FAQ

How should I prepare to give feedback in my next therapy session?

Reflect on recent sessions and note any feelings or reactions you had. Think about what you found helpful or challenging, and be ready to discuss these observations openly.

What if the feedback from my therapist makes me uncomfortable?

Share your discomfort with your therapist. Why a particular piece of feedback is uncomfortable is often worth discussing in its own right.

How can I tell if the feedback I'm giving is constructive?

Constructive feedback is specific, stays with your own feelings or reactions, and says what you might need differently from your therapist.

Is it normal to feel defensive about feedback?

Yes, it is a common reaction. Noticing defensiveness and discussing it in therapy can help you understand where it comes from and how to manage it.

How often should feedback be exchanged in therapy?

This varies. Feedback works best as an ongoing dialogue that happens as needed throughout the therapy. Regular check-ins can make it a structured part of your sessions.

Can feedback lead to changes in the therapy approach?

Yes. Feedback can prompt adjustments to therapeutic techniques and focus areas, and can lead you and your therapist to reassess the goals of the work so that they stay aligned with your needs.

What if I disagree with the feedback provided by my therapist?

Say so. Openly discussing a disagreement can itself help you and your therapist understand each other’s perspectives better.

Additional Resources

Simmons, A. R. (2016). The Importance of Learning to Give and Receive Critical Feedback. Psychotherapy Bulletin, Society for the Advancement of Psychotherapy. A clinician-facing piece on why giving and receiving feedback is difficult, and what gets in its way.

British Association for Counselling and Psychotherapy. What is counselling? BACP, United Kingdom. A client-facing overview of what happens in therapy, which includes giving your therapist honest feedback on how you feel about the work, and what to do if you cannot raise a concern with them directly.