What is Feedback-Informed Treatment & Why Is It So Important?

Feedback-Informed Treatment

Constructive, well-timed feedback can be incredibly valuable to professional therapists, and a critical way to enhance the quality of care they provide. But how does feedback-informed treatment work, and how does it differ from a casual, sporadic therapy feedback form now and then?

If you’re curious about delivering feedback informed therapy, this guide covers all the basics. We’ll explore the key forms that can help you develop strong, working relationships with your clients, and show you how to integrate them into your therapy or counseling solutions.

Before you start, we think you’ll enjoy our 30 day practitioner trial of Quenza’s therapy toolkit. Quenza’s user-friendly digital tools will help you engage, assess, and empower your clients, and include everything you need to deliver feedback-informed treatment online, simply.

What is Feedback-Informed Treatment?

Feedback-informed Treatment (FIT) is based on the idea that feedback from therapy clients can be used to improve their treatment.

It involves regularly and systematically seeking out patients’ feedback to help practitioners understand:

  • How their therapy is going
  • Their thoughts and feelings about their professional relationship with the provider, and
  • Their overall wellbeing.

Therapists, psychiatrists, counselors, and other healthcare practitioners can then use this evidence to identify ways how their processes and approach can be improved.

Its goals are to help therapists deliver more effective treatments, enhancing their client’s outcomes, and ultimately improving their wellbeing.[1]

But does it work in practice? To better understand how feedback is used as a strategy for improving practitioner performance, we can start by looking at between-provider feedback in healthcare settings.

Practitioner Audit and Feedback in Healthcare

The idea of using feedback to guide better clinical performance and potentially improve patient outcomes has been around for a while.

In the past decade alone, hundreds of randomized trials have looked at its efficacy – in particular by examining how audit and feedback approaches can drive practical professional improvements.

Considering over 140 randomized trials, Ivers and colleagues have found that feedback-informed treatment can lead to “small, but potentially important improvements in professional practice.” The key to effectively using feedback to enhance performance, it seems, is to implement a considered process for integrating audit into e-therapy, with careful thought around how feedback will be provided.[2]

According to the research, audit of professionals and the resulting feedback is most effective when:[3]

  1. Feedback comes from supervisors or colleagues
  2. Professionals receive feedback more than once
  3. Feedback is both verbal and written, and
  4. It involves clear goals and a plan of action.

For therapists who want to improve their mental health treatments based on client feedback, these best practice pointers can be a very helpful guide.

Why is Feedback in Therapy Important?

Using feedback to inform therapy can have important advantages regardless of a practitioners treatment approach or theoretical orientation.

The range of ways that feedback in therapy can improve client wellbeing is considerable, with studies suggesting that its advantages can be realized regardless of a practitioner’s preferred treatment approach or theoretical orientation.[1]

It can be especially important where patients are more likely to end therapy early, as it may help them remain in treatment through more informed practitioner delivery of mental health solutions.

Some of the advantages of feedback in therapy include:

  1. Improved retention rates in therapy[4]
  2. Fewer no-shows at appointments
  3. Better patient health outcomes, including lower separation and divorce rates in couples therapy and higher treatment gains in psychotherapy[5][6], and
  4. Lower deterioration rates regarding patients’ mental health challenges or problems.

Just as feedback from colleagues can help healthcare providers improve their practice, then, collecting formal feedback from clients can be a highly effective way to enhance therapy.

How To Use Feedback As An Intervention

Feedback-informed treatment involves a little more than asking patients for their views, as it requires routine inquiry so that practitioners can adjust their treatments throughout the therapy process.

But as a therapist, integrating formal audit and feedback can be as simple as laying the groundwork with a few strategically placed feedback interventions.

With the right feedback tools at various stages in your treatments, it’s possible to unlock a wealth of insights from the very first session. From here, you can use feedback interventions to guide your solution design and treatment plans, delivering a more aligned and client-centered therapeutic experience for better outcomes.

So how do you get started?

Crafting Your Own Therapy Session Feedback Form

According to FIT expert Dr. Jason Siedel, there are two particularly critical feedback-informed therapy tools; you’ll find both of these pre-made templates in Quenza’s Expansion Library:

  1. The Session Rating Scale: which explores the strength of a therapeutic alliance, and
  2. The Outcome Rating Scale: which assesses four areas of patient functioning that a therapeutic intervention is designed to address.

If you’re ready to try practicing feedback-informed treatment in your practice, these pre-made templates can be shared with your clients after each session.

But if you’re looking for more specific information, crafting your own therapy session feedback form may provide more specific insights.

Simply open one of these forms in your Library and use Quenza’s easy drag and drop Activity Builder tools to edit a copy with different fields, create page breaks, insert text, or custom multimedia:

Quenza Therapy Feedback Questionnaire
Use Quenza’s Session Rating Scale or Outcome Rating Scale as templates to create your own feedback-informed treatment questionnaires with simple drag and drop Activity Building tools.

Once you’ve used your Activity Builder to create a custom therapy feedback form that suits your goals, you’ll be able to send it manually after each online session.

Alternatively, you can send them automatically at pre-determined intervals in your client’s care pathways.

Asking & Giving Feedback To Clients: 5 Strategies

Asking for feedback may not come naturally at first, but with practice it will become central to how you deliver FIT.

The following tips from experts may help:[7]

  1. Learn to listen: If you’re seeking verbal feedback or using live chat to gather a patient’s feedback, genuinely attend to what your client is saying. Try to avoid planning your response, pause and think before you respond, and your patient will feel more comfortable sharing their views.
  2. Ask for clarification when things are unclear: If you’re using digital feedback informed treatment questionnaires, you might follow up at a pre-scheduled time on Quenza Chat to ask about key points.
  3. Embrace feedback as an opportunity to improve your professional practice: Assume your client’s feedback is constructive, before thinking about how to use the most valuable data they’ve provided. To identify actions and create a plan, try considering your own actions in the context of a client’s comments.
  4. Show that you’re invested in improving: Validate your patient’s feedback by inviting examples, details, and/or specifics about their input. By accepting their comments positively, you can build trust and encourage even more constructive openness.
  5. Be proactive: As well as soliciting client feedback regularly throughout therapy, you can make notes about any improvements you’ve made along the way. Identify what worked, and how you’ve improved, then don’t be afraid to follow up with your client to share how their feedback helped you.

Most Effective Software and App To Use

When you’re comfortable with the idea of using regular client feedback to inform your practice, there are many ways Quenza can help you implement your strategy.

We’ve already seen how Quenza’s Activity Builder is a great way to customize key feedback informed treatment forms from Expansion Library templates, but you can also create your own therapy feedback forms from scratch, too.

Simply head to your Activity Builder to create a blank template and start designing your own evaluation forms from the same easy-to-use tools, as shown below:

Quenza Activity Builder Feedback Informed Therapy
Quenza’s Activity Builder is a quick and convenient way to craft feedback informed therapy forms from text boxes, multiple choice scales, check boxes, drop down menus, and more.

With your custom professional forms designed, you can think about where they should go in your treatment plans or care pathways. You may want to send them at regular biweekly intervals to correspond with your client’s sessions, for example, or integrate them into a therapy pathway as Pathway Steps, as below:

Feedback Informed Therapy Form Quenza
Insert Session Rating Scales, Outcome Rating Scales, and other Evaluation Forms as Pathway Steps (shown here) to automate their delivery between interventions.

Quenza’s Pathway Builder can be used to automatically share therapy feedback forms between specific steps of a digital treatment plan, as we’ve done here, and you can pre-schedule the delivery of your entire care pathway in advance.

Your patients can easily fill these out on their smartphone’s client portal, and all your feedback is collected and stored in your HIPAA-compliant Quenza platform in real-time.

Feedback Questionnaires & Forms: 3 Examples

The following Quenza Expansion forms are great examples of other feedback-informed therapy tools:

  1. Quenza’s End of Therapy Evaluation Form
  2. The Coach Evaluation Form, for mental health or health coaching, and
  3. The Session Notes for Clients template, which your patients can use to note down insights and other important notes from each session.

Sending Group Therapy Feedback Forms

By incorporating forms as steps, Quenza Pathway are also a useful way to ensure all participants receive group therapy feedback forms at the same key stages of certain programs.

Because all your clients’ responses are automatically gathered and stored on your Dashboard, you can keep track of them easily in one centralized space.

This makes it much easier to spot recurring themes in your client responses, and with Quenza’s re-send or notifications feature, you can follow up on missing forms automatically for a more complete picture.

Final Thoughts

Giving and receiving constructive feedback is a critical skill for therapists, but harnessing it to improve your practice – and your patients’ outcomes – is even more powerful.

Starting with a few basic, but strategically shared therapy feedback forms, you might discover all kinds of potential ways to enhance your professional performance, ultimately enhancing your client experience and the wellbeing gains they enjoy.

Why not give it a go?

We hope you enjoyed reading this article. To leverage patient feedback and enhance your blended care, don’t forget to start your 30-day, 1 dollar Quenza trial.

Our software will help you design patient-centered e-therapy solutions at any stage of your healthcare journeys, and gives you everything you need to craft digital feedback forms, session rating scales, and more to improve your clients’ outcomes.


  1. ^ Miller, S. D., Bargmann, S., Chow, D., Seidel, J., & Maeschalck, C. (2016). Feedback-informed treatment (FIT): Improving the outcome of psychotherapy one person at a time. In Quality Improvement in Behavioral Health (pp. 247-262). Springer, Cham.
  2. ^ Ivers, N., Jamtvedt, G., Flottorp, S., Young, J. M., Odgaard‐Jensen, J., French, S. D., & Oxman, A. D. (2012). Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, (6).
  3. ^ Hysong, S. J. (2009). Meta-analysis: audit & feedback features impact effectiveness on care quality. Medical Care, 47(3), 356.
  4. ^ Lambert, M. J., Harmon, C., Slade, K., Whipple, J. L., & Hawkins, E. J. (2005). Providing feedback to psychotherapists on their patients' progress: clinical results and practice suggestions. Journal of Clinical Psychology, 61(2), 165-174.
  5. ^ Reese, R. J., Norsworthy, L. A., & Rowlands, S. R. (2009). Does a continuous feedback system improve psychotherapy outcome?. Psychotherapy: Theory, Research, Practice, Training, 46(4), 418.
  6. ^ Anker, M. G., Duncan, B. L., & Sparks, J. A. (2009). Using client feedback to improve couple therapy outcomes: a randomized clinical trial in a naturalistic setting. Journal of Consulting and Clinical Psychology, 77(4), 693.
  7. ^ Hardavella, G., Aamli-Gaagnat, A., Saad, N., Rousalova, I., & Sreter, K. B. (2017). How to give and receive feedback effectively. Breathe, 13(4), 327-333.

About the author

Catherine specializes in Organizational and Positive Psychology, helping entrepreneurs, clinical psychologists and OD specialists grow their businesses by simplifying their digital journeys.

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