Tips for Teens: Feedback Informed Treatment (OR: How to Find the Right Therapist for You)

Interested in counseling? You should make sure your therapist is willing to get your feedback.

One of the things I do as an LCSW is incorporate my clients' feedback into session. At the start of each session, I have my client tell me how their week was, how stuff has been with family and friends, how work/school has been, and an overall score for the week on a 1 to 10 scale. I want to make sure that things are staying the same or improving for my clients week to week, because that's how we can track if I'm an effective fit for them. This is called an "Outcome Rating Scale."

Step 2: Let your therapist know how THEY'RE doing.

At the end of every session I listened very specific feedback on how my listening was, how important what we did in session was, how much they liked what we did in session, and the overall score. And while this can be uncomfortable, especially if you feel anxious about potentially being seen as "judgy" or "rude," you should make sure your therapist welcomes the input.

I know that it's impossible for me to be the best fit for everyone - and that's why I want to be sure that we're collaborating together to make sure that our session time is a good, healthy, helpful use of time for you.

What the research shows:

Scott D. Miller and the International Center of Clinical Excellence have found that the best predictor of clinical change is that relationship you have with your therapist. (You can find a whole presentation about it here).

I work on building that relationship each session, and I assess it through those two measures, developed by Scott Miller.

Maybe you already have a therapist, and you think they're kind of terrible.

So what's the sign of a terrible therapist? If they're not open to your feedback, and they're not open to tailoring their treatment to you, it might not be the best fit for you clinically.

I would be wary of any therapist who will automatically let you know that they know better than you on everything. There absolutely are times when my clinical judgement is different than my client's judgment. But I'll make sure that my clients can tell me what it's like as well. I want clients to be able to make decisions independent of me, and build skills they use in real life. 

And, terrible for you may not mean terrible for someone else.

Everyone has a different preference when it comes to clinical approach. So if you don't gel with your college counselor, your school guidance counselor, or an outside therapist, even if they came highly recommended, see if there's someone else you can go to for a different approach.

Curious to hear more about how Kelsey works with anxiety and anger management in teens and college students? You can reach her at compassionatecounselingstl@gmail.com. Kelsey works with kids and teens from age 4 through college, and uses her feedback-informed approach to tailor session content to her client's needs. Her office is located in Webster Groves, and she works with clients throughout the St. Louis area.