As an addiction counselor, have you not imagined that your client feedback is such that its depth and reasoning opens brilliant insights and lasting solutions? Yet, in reality such imagined feedback usually has little effect. It has to bother you when clients don’t listen to your comments. You might even become frustrated or angry? Well, we all have these types of feelings. And, if some of these things have happen to you, perhaps instead of blaming your client, your feedback style may need an adjustment. This research to practice column addresses that possibility.

The composition of feedback

Research has demonstrated that the feedback is a simple matter, but requires a complex set of skills and understanding. For one thing, feedback has many faces (Claiborn, et al., 2002). It can come in the descriptive form where you observe and express back to a client what you observe. For example, “Today, you are not you’re usual talkative self.”
Inference is another form of feedback. Here you don’t directly see something instead you make an assumption about a client thought or behavior. This is close to interpreting. For instance, “I get the impression that you like the danger of the streets, the rush, the pulse of that life, and you don’t want to give all that up.”

Next is mirroring. In this case, you give a client a sample of their own expressed behavior or comments. You say or do exactly what a client says or does. Don’t do it in mocking manner, but as exactly as they talk or act. If the client accuses you of being disrespectful to them, let them know that what you did or said was only meant to be a mirror of their behavior. Then, let them ponder the feedback.

Another form of feedback is an emotional reaction to a client’s behavior. For example, you clearly observe that a client is under duress, but he/she denies any problems. Feedback in this case would consist of you saying, “I feel like I am getting mixed messages from you. On the one hand, you state you are OK, but clearly you’re not.” As in the above feedback forms, give the client a little time to mull over about your feedback.

Variables that impact feedback

Again, feedback is a little more complex than just blurting out the first thought that comes to your head. A fair amount of research has been conducted on variables that make both a positive and negative impression on clients.

One of these impact variables is you, the therapist. A big influence as to whether your feedback will make an impression on a client has to do with your credibility. This is the client’s perception that you have the social power, knowledge, skills, credentials, even attractiveness and likeability that make you worth listening to (Claiborn, et al., 2002).
Another impact variable deals with the content and style of your feedback. Of particular note is that which is called valence, or the positive or negative nature of the feedback. A consistent research finding is that positive feedback is more accepted than the negative variety. Studies have shown that the positive feedback to be more credible, desirable, helpful, and meaningful to clients, particularly in group settings. Moreover, other studies have indicated that positive feedback is seen as more accurate than the negative variety (summarized in Claiborn, et al., 2002).

This is not to say you should avoid all forms of negative feedback, but that type of feedback may make more of an impact if it is sequenced. That is, sandwich negative feedback between positive statements. Negative feedback has a tendency to more accepted when presented in this manner. Research has also demonstrated that clients tend to receive negative feedback better if it is preceded by a positive feedback form (not the other way around) (Claiborn, et al., 2002).

One last impact variable is obviously the client. There are a number of client elements to consider before delivering your feedback. One client element is the client’s mood. For example, if your client is really depressed, you may want to hold on to your feedback until the depression abides somewhat.

Overall, clients tend to recall more negative forms of feedback than normal populations. So, while in a typical session you give a variety of positive and negative feedback, a depressed or otherwise stable client would interpret most of the feedback as negative (Claiborn, et al., 2002).

Parallel to the client’s mood and feedback is his/her self-esteem and accuracy in perceiving feedback. In this case, the common sense belief would be that those clients with high esteem would be more prone to judge any feedback as more positive; and visa versa for clients with low esteem. If you thought that, you are right. Clinically, you may wish to be cautious with both positive and negative esteem clients. For the positive clients, your feedback may be interpreted as more positive than it was intended, while the negative esteem clients could interpret more negatively than intended (Claiborn, et al., 2002).

Finally, the client’s desire for feedback plays a part on its impact. For example, and especially for clients with an addiction, there may not be a particularly high desire for clients to listen to your feedback no matter how badly you want to give it. Should you insist on giving your feedback, the data indicates that you could actually decrease their desire for additional counseling. So, instead of pushing your agenda, take a look at the suggestions listed below.
Corey (2004) and Claiborn, et al., (2002) have outlined a number of tested feedback methods you may wish to try.

• Prepare your client for feedback. Perhaps the most important element to do before you start giving feedback is to create a sound and solid counseling relationship.
• Global feedback has been found to be next to useless. You know the type (“Things will turn out all right”, or “Don’t give up.”) Instead, address your feedback to specific behaviors so the client has an immediate assessment they can compare with their own perceptions.
• Feedback is best directed toward something the client can do something about, or has control over.
• Try not to impose your feedback on others. For example, if a client is not receptive to your feedback such feedback is probably not going to have much of an effect, no matter how strongly you want to give it.
• Consider that your feedback may sometimes be in error. Believe it or not, counselors sometimes don’t see things the way they really are, and end up giving false feedback. So, following a burst of feedback it is always a good idea to discuss it with the client.

The “try it yourself” section

As always, this is the “take a crack at research” section of the column. For our subject, you may want to examine the difference between the way you presented feedback in the past and a modified version that includes some or all of the suggestions listed. For example, create a baseline of what clients actually think about your feedback. This would include creating a few questions about the quality, timing, or meaning of your feedback. (You can certainly ask other questions.)

With each question the client would get a chance to rate you feedback quality, timing, or significance. And, you could place such ratings on a five or seven point likert scale.
Create the questionnaire and administer it to a sample of your clients. Then modify your feedback using the suggestions noted above for a few weeks and administer your questionnaire again. Finally, compare the scores.

This is not rigorous research, but it is such that any results could be of service to you and your clients.

References
Claiborn, C.D., Goodyear, R.K., & Horner, P.A. (2002). Feedback. In J.C.
Norcross Ed. Psychotherapy relationships that work (pp.217-233). New York: Oxford University Press.
Corey, G. (2004). Theory and practice of group counseling (6th Ed.).
Belmont, CA: Thomson Brook/Cole.

Michael J. Taleff, PhD, CSAC, MAC is an instructor at the University of Hawaii Manoa and West Oahu campuses. He can be contacted at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it



This article is published in Counselor,The Magazine for Addiction Professionals, April 2005, v.6, n.2, pp.58-59

No one has commented on this article.

Please keep your comments brief and on topic, and remember that this is not a discussion thread.
Name :
Comment(s) :

J! Reactions 1.09.00 • Professional Site License
Copyright © 2006 S. A. DeCaro

---