Receiving feedback can be a stressful experience for all of us. There's always a chance that we'll be told something that hurts or surprises us or that we don't want to hear. While you don't have full control over the way feedback is given, you can still take steps to help move the conversation in a positive direction. If the feedback is unsolicited, notice whether you feel comfortable receiving it in the current situation. If you feel rushed, distracted or upset, ask to postpone the discussion.

As you receive feedback, make an effort to gather the information that will be most useful to you. If the person is not providing all the facts you'd like to hear, ask for them. For example, suppose you ask a client for feedback on your work with them and they respond with an opinion: "You give a great treatment." While this may feel good to hear, it's unclear exactly what the person means. Try asking for more specific details about what they've felt or observed. You'll learn much more from facts such as, "I like your treatment because you give exactly the amount of pressure that I feel I need, when you work deeply you don't hurt me, and I'm never sore after I leave."

When the feedback is critical, work to fully understand what the client is saying before sharing your own thoughts on the issue. Ask the person to give you small amounts of information at a time and paraphrase what they say to verify that what you're hearing is what they intended.

Once you've heard and acknowledged the client's point of view, there are a variety of different responses that might be appropriate, depending on the situation:

• Thank the client. The power differential in the therapeutic relationship makes it challenging for any client to give critical feedback to a therapist. Taking a risk to say what they don't like takes a good deal of courage and often warrants an expression of gratitude (provided you're able to give it sincerely).
• Clarify facts. If the client is mistaken about any of the relevant facts, provide clarification. Be sure to keep your voice tone neutral, without any defensiveness or hostile edge.
• Apologize. If you've made a mistake, big or small, it's always a good idea to say you're sorry. Even if you acted with the best of intentions and even if you never could have predicted that the client would react negatively, you can still apologize for the unintended consequence of your behavior. Apologizing for having a negative impact on the person does not mean admitting to having bad intentions.
• Discuss possible solutions. If the client doesn't volunteer a suggestion for what you might do differently in the future, ask for their ideas or share your own ideas and ask for their input. Work together to find a solution that works well for both of you.

Sample Dialogue: Feedback from a Dissatisfied Client

Client: Oh no, is that it?

Practitioner: Yes, that's the end of the session. It sounds like you're disappointed. Is that right? [Clarifying what the client said.]

Client: Well, yes. I had asked you to focus on my back and you didn't spend much time on my back at all. You just kept working on my feet.

Practitioner: You're right, I did focus more on your feet and I didn't explain why or ask whether that was okay with you. I'm very sorry about that. [Apology] I was using a reflexology technique that's designed to relieve back pain through certain points on your feet. [Clarifying facts.] Does your back feel any better?

Client: Actually, I guess it does. I don't know if it was that foot thing, though.

Practitioner: I'm hearing that you're not sure whether my work on your feet was helpful. Is that right? [Clarifying what the client said.]

Client: Yeah, I can't really see how that would affect my back.

Practitioner: I felt the same way when I first learned about reflexology; it's very counterintuitive to think that working only on your feet could affect a part of your body that's so far away There are a number of different ways I could work on your back and I want to be sure you're comfortable with the methods I use. Would it be helpful for me to give you something to read about reflexology, as well as the other techniques I offer? Then you can make a fully informed decision about the type of treatment you receive. [Proposing a possible solution.]

Client: Yes, I'd like to look at that information.

Practitioner: Great. I'll gather some articles for you. And I want to thank you for speaking up when the treatment wasn't what you expected. [Thanking the client.] If anything about a session is ever disappointing to you or doesn't feel right, please let me know and I'll do my best to address it.

Points to ponder

If this client had not given any feedback, how might their unspoken dissatisfaction have affected the therapeutic relationship? How might the relationship have been affected if the therapist responded defensively? 

Editor's Note: Adapted from the new forthcoming edition of The Ethics of Touch by Ben E. Benjamin and Cherie Sohnen-Moe.