A therapist finishes a session, reviews the SRS feedback, and notices the client’s rating is lower than expected.
The natural reaction may be surprise, concern, or even uncertainty.
However, in Feedback-Informed Treatment, unexpected feedback is not viewed as a problem to avoid. It is valuable information that allows therapists and clients to explore the experience together.
A low SRS score is not a final judgement about the therapist or therapy.
It is an invitation to understand the client’s perspective.
Explain:
- SRS captures the client’s experience of the session.
- It provides information about areas such as feeling understood, agreement on goals, approach, and overall session experience.
- A lower score may indicate something the therapist and client need to explore.
Possible reasons:
- The client did not feel fully understood.
- The session moved away from what mattered most to them.
- The pace or approach did not feel right.
- The client experienced something differently than the therapist expected.
Important message:
The score creates a starting point for conversation, not an automatic conclusion.
Discuss:
- The therapeutic alliance is consistently associated with psychotherapy outcomes.
- Clients may not always directly express concerns.
- Structured feedback creates a safer opportunity for discussion.
Connect to FIT:
Feedback helps therapists remain responsive to the individual client rather than relying only on assumptions.Instead of immediately explaining or defending, therapists can approach feedback with curiosity.
Possible responses:
- “Thank you for sharing that with me.”
- “I would like to understand more about your experience.”
- “Can you help me understand what did not feel helpful today?”
Emphasise:
The goal is understanding, not convincing the client that therapy was helpful.
Questions could include:
Did the client feel understood during the session?
Explore whether the client felt heard and whether their perspective was central.
Were we working on what the client felt was most important?
Goals may shift, and therapy may need to adjust.
Did the pace or approach fit the client’s needs?
Sometimes the issue is not the goal but how therapy is being delivered.
Is there something the client has not felt comfortable sharing?
Feedback may reveal concerns that have not surfaced in regular conversation.
Discuss:
A lower rating does not necessarily mean the relationship is damaged beyond repair.
In many cases, openly discussing feedback can strengthen collaboration.
Explain:
- acknowledging feedback;
- exploring misunderstandings;
- adjusting the approach;
- rebuilding shared understanding.
This section is strategically important because it positions FIT as a tool for improving relationships, not evaluating therapists.
Taking feedback personally
Feedback is information about the client’s experience, not a judgement of the therapist’s worth.
Trying to convince the client they are wrong
The purpose is understanding their perspective.
Ignoring small signs of dissatisfaction
Small concerns can become larger barriers if they are not explored.
Using the SRS only as a score collection exercise
The value comes from the conversation that follows.
The most important part of feedback is not the number itself.
It is the opportunity to ask:
- What is the client experiencing?
- What can we learn?
- What might need adjustment?
- How can therapy become more helpful?
A low SRS score may feel uncomfortable, but it can provide valuable information about the client’s experience.
When therapists respond with openness and curiosity, feedback can strengthen collaboration, improve alignment, and support more responsive care.
