Preventing Psychotherapy Dropouts with Client Feedback

Preventing Psychotherapy Dropouts with Client Feedback

by Tony Rousmaniere

One beginning therapist shares his success with the Session Rating Scale in improving his practice.
“You understand me thirty percent of the time.”
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Tony RousmaniereTony Rousmaniere, PsyD, is a psychologist in private practice in Seattle and Clinical Faculty at the University of Washington. He is the editor of the forthcoming edited volume The Cycle of Expertise: Using Deliberate Practice in Supervision, Training, and Independent Practice (with co-editors Rod Goodyear, Scott Miller, and Bruce Wampold; Wiley Press), author of  Deliberate Practice for Psychotherapists: A Guide to Improving Clinical Effectiveness (Taylor & Francis), and co-editor of Using Technology for Clinical Supervision: A Practical Handbook (ACA Press).

Dr. Rousmaniere provides clinical training and supervision to therapists around the world, with an emphasis on using deliberate practice to improve the effectiveness of clinical skill development.
Loved your article! I just went back to actually list your 4 rules for my own clarity: 1. Use the paper SRS form and "make a big deal" out of getting the feedback from the client. 2. Don't interpret the client feedback but make it about you, the therapist. 3. Focus most on the feedback that seems inaccurate, confusing or creates internal anxiety for you. Use video and consultation to explore these, especially. 4. Make appropriate course corrections in your therapy process and/or discuss the feedback with the client. As I consider incorporating the SRS form into my therapy practice I worry about my own desire to "please" the client at the risk of not being effective. The truth is that if I know what the feedback is, I will be able to actually look at this issue to see if it is truly a problem.
Monica Stone MFT
I really appreciate your assistance with the SRS. I have just started using the scale and needed your input to implement it better. I hope it will help me become a more responsive and responsible therapist. It helps that I am in the middle of reading the book, "Mistakes Were Made (but not by me)" by Tavris & Aronson. It is a perfect accompaniment.
Susan Boyes
Excellent article! Thank you for your transparency.
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