August 2025 Clinical Supervision Topic: Eliciting Feedback and Motivational Interviewing
It’s easy to assume clients will tell us if something isn’t working. But most won’t…at least not directly. They might show up less engaged, try to push through, or quietly stop coming. We can prevent a lot of that by making feedback a regular part of the process, early and often.
Therapists who build space for honest feedback tend to have stronger alliances, better client retention, and better outcomes overall.
A few things we know about feedback:
Outcomes improve when we ask. Inviting client feedback using simple tools or open-ended questions significantly improves therapy outcomes and reduces dropout rates.
The best therapists get the most negative feedback. Not because they’re doing something wrong, but because they’ve created enough safety for clients to be honest.
Most clients won’t tell you directly. Especially if they think it might hurt your feelings. We have to actively invite it.
Motivational Interviewing is especially helpful here. It’s grounded in the belief that clients are the experts on their experience, including their experience of us. MI gives us a way to ask for feedback without making it feel clinical or pressured.
One MI framework I find especially helpful is OARS:
Open-ended questions
Affirmations
Reflections
Summaries
Each of these helps feedback feel collaborative rather than evaluative. For example:
Open-ended question: “What’s been most helpful—or not helpful—about today?”
Affirmation: “I really appreciate you saying that; it helps me understand how to support you better.”
Reflection: “It sounds like I might’ve missed what felt most important there.”
Summary: “So what I’m hearing is that this pace feels fast, and you’d like a little more time to process?”
Here are some other sentences that can gently open the door to process feedback:
“How is this feeling so far?”
“Did I miss anything important just now?”
“What’s been helpful today—and what hasn’t?”
“Is there anything I’m doing that gets in the way?”
“What do you wish I better understood about where you’re at?”
These questions are simple, but they matter. They let clients know their experience of the work—and of us—is part of the work. And when we respond with curiosity instead of defensiveness, it strengthens the alliance rather than threatening it.
