Do you send a follow-up message or feedback form to your clients after therapy has ended, to check on their progress? Should you? We look at the pros and cons.
I would say every good therapist asks for feedback from
clients whilst they are undertaking therapy, whether it’s formal (a
questionnaire/pro forma) or informal (a chat during the session). In fact, there
is evidence [1] to show that FIT (Feedback Informed Treatment) boosts the
effectiveness of therapy, improves clients’ general sense of wellbeing and reduces
dropout rates and no-shows. That's probably because client feedback helps you
to focus on what’s important, adapt your therapy to their changing circumstances, and build on the approaches the client feels are most
relevant or successful and so on.
But not everyone contacts the client at some point after the therapy has
ended to see how they are doing how well they thought the therapy went, once they have the benefit of hindsight.
Benefits of using a client satisfaction survey
- You can check whether the work you did together is still
helping when the client doesn’t have the reassurance or reinforcement of
attending regular sessions.
- You can offer further help if it’s needed, although you need
to be careful how you phrase this. People may give inaccurate answers if, for
example, they believe that admitting they have gone back to smoking or regained
weight might lead to a ‘hard sell’ conversation about having more sessions.
- Emotional and subjective
feedback from clients helps in your reflective practice.
- You can ask if the feedback can be used as a testimonial (assuming you use them).
- The longer-term feedback (where positive) improves your
confidence, especially when you are newly qualified. It’s lovely to hear that your
clients are doing well.
- Even not so positive feedback is useful. It helps you to learn from your clients’ experiences and improve your service, and it may also signpost where further training is needed (see this article for more on that topic).
Drawbacks of using a client satisfaction survey
- As said above, people may not give you accurate feedback
if they worry about your response or their mood/circumstances on the day
they complete the survey might affect their answers.
- Not all clients will bother responding (more on this later).
Some feel they are bombarded with too many surveys, others forget or simply can’t
be bothered.
- Those with strong feelings about how things went (both positive and
negative) are the most motivated to respond, so the feedback is not necessarily
representative of your overall results.
- Surveys are not great for collecting objective data and small
sample sizes – which you will have to begin with at least - mean the data
cannot be generalised. For example, saying that 100% of your clients have quit
smoking if you’ve only seen one client for this issue is meaningless. This is one reason that information collected via surveys cannot be used to calculate
your personal quit smoking success rates. [2] This ruling technically
only applies to smoking cessation clients but, to be fair, the same principle applies to
other issues too.
- You need time to analyse and use the feedback, or there is no point in collecting it.
Improving feedback response rates
CustomInsight, a US company that designs and administers
surveys, offered the following comments regarding the link between response
rates and survey types:
Response rates vary widely for different types of surveys. Customer satisfaction surveys and market research surveys often have response rates in the 10% – 30% range. [3]
That’s not very high so you need to improve your response
rate as much as possible, to justify the time you spend on collecting and
analysing the data. It can be a good idea to mention to clients at their final
session that you’ll be sending it, when and how. Explain why it’s important for
them to return it and thank them in advance for doing so.
- Short surveys get more responses than longer ones. Give
people an idea of how long it will take them to complete the survey before they
begin.
- Send a reminder to those who don’t respond. The best time is
around ten days after the original request.
- Offering an incentive to complete the feedback (a free tip sheet or audio, perhaps, or a reduced rate relaxation session) can improve response rates by
10-15%. One study showed that including a gift voucher with a request for
feedback was twice as effective as promising that people would get a voucher
after they had completed the survey.
- Personalising the message that requests feedback can improve rates by around 7%.
Designing your feedback form
Once you decide to introduce a feedback form, there is plenty of advice online about designing a good
customer satisfaction survey, and many places offer templates. However, these
thoughts will also get you started.
- Having the client’s permission to use their data for therapy
doesn’t necessarily give you the right to use it for other purposes such as
surveys. The GDPR offers options that would cover it, such as legitimate
interests or consent. But you need to meet a couple of specific conditions for the legitimate interest option to apply, so consent is probably the best. [4] Include a
mention of your intent to send a follow up to clients in your privacy policy.
- The GDPR says ‘there must be specific purposes for
processing the data’ and that you ‘must collect and process only the personal
data that is necessary to fulfil that purpose’. [5] Consider your questions
carefully. What use will you make of the answers? If the answer is ‘none’ then
don’t ask.
- Use mostly rating questions so responses are consistent and
can be compared, but allow a freestyle box as well so they can include comments
that don’t fit elsewhere.
- Try to be innovative in your approach and your ratings. One
expert says “Slightly dissatisfied” is not an emotional state many real human
beings can relate to. “I had some real problems” or “Your service made me mad”
will elicit a much better response. [6] I love this and think you could really be
creative in naming your rating scales.
- Automate the system if you can, to minimise the time you
spend sending things out.
- Use your clean language skills when wording questions. My husband was recently asked to complete a survey in which one of the questions read ‘Do you agree that X should happen? If you choose ‘no’ or ‘don’t know’, please give your reasons.’ It was pretty clear that the answer they wanted was ‘yes’.
Collecting feedback - email, text, or phone?
You could always ask each client how they would like to
receive the survey and stick with their preferences, but if you want to restrict
yourself to one method for everyone consider the following:
- Email has low response rates compared to other methods. Your email can get lost among many others, or could be missed by a busy client. On the other hand, it’s simple and familiar for clients, and both the request and reminder can easily be automated to save you time.
- Many people answer texts more quickly and more often than
emails, and using a free service like survey monkey allows surveys to be sent by text. Bear in
mind, though, that whilst most people spend a lot of time on their phones, some
still don’t use mobiles and may need an alternative.
- Phoning puts clients on the spot and you could have phoned at an inconvenient time. Making an appointment is one option to avoid this. They might be less inclined to offer honest criticisms when speaking to you directly, skewing your results. However, phoning is more personal and you can listen for paralanguage as well as words when chatting to the client, or ask them to explain if their answers don’t quite fit your questionnaire.
Do you already use post-therapy feedback forms? Does this
article make you consider it if not? What’s your experience of using them? Let
me know by posting in the comments box.
References
[1] Psych Central. (2016). Feedback-Informed Treatment:
Empowering Clients to Use Their Voices. [online] Available at:
https://psychcentral.com/lib/feedback-informed-treatment-empowering-clients-to-use-their-voices#1
[Accessed 2 Nov. 2021].
[2] That’s one reason that information collected via surveys
cannot be used to calculate your quit smoking success rates. (ASA ruling, Dune
Hypnotherapy Group, 5 November 2003.) Another is the issue of potentially
inaccurate feedback.
[3] PeoplePulseTM - Online Survey Software | Australian
Survey Software. (n.d.). Survey Response Rates. [online] Available at:
https://peoplepulse.com/resources/useful-articles/survey-response-rates/.
[4] I’m not an expert on the GDPR, if in doubt get advice
from someone who is rather than relying on me.
[5] European Commission. (2019). What data can we process
and under which conditions? [online] Available at:
https://ec.europa.eu/info/law/law-topic/data-protection/reform/rules-business-and-organisations/principles-gdpr/what-data-can-we-process-and-under-which-conditions_en.
[6] Customer Thermometer. (n.d.). Customer Satisfaction
Survey App | Email Survey Tools. [online] Available at:
https://www.customerthermometer.com/ [Accessed 2 Nov. 2021].
Other resources
Customer Thermometer. (2017). Improve Survey Response Rate -
Customer Feedback Questionnaire. [online] Available at: https://www.customerthermometer.com/customer-surveys/14-ways-improve-survey-response-rate/
[Accessed 2 Nov. 2021].
Customer Thermometer. (2019). Average Survey Response Rate -
What You Need to Know. [online] Available at: https://www.customerthermometer.com/customer-surveys/average-survey-response-rate/.
[Accessed 2 Nov. 2021].
DeFranzo, S.E. (2012). Advantages and Disadvantages of
Customer Satisfaction Surveys. [online] Snap Surveys Blog. Available at:
https://www.snapsurveys.com/blog/advantages-disadvantages-customer-satisfaction-surveys/.
DialogTech. (2013). Should I Use Phone Surveys or Email
Surveys? [online] Available at:
https://www.dialogtech.com/should-i-use-phone-surveys-or-email-surveys/
[Accessed 2 Nov. 2021].
Ramshaw, A. (2017). The Pros and Cons of Surveys That Are
Critical to Success. [online] Genroe. Available at:
https://www.genroe.com/blog/pros-and-cons-of-surveys/11471.
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Author: Debbie Waller is an experienced hypnotherapist and hypnotherapy trainer. She is the author of The Hypnotherapist's Companion and Their Worlds, Your Words and a co-writer of the Hypnotherapy Handbook, all of which are available from Amazon.
Find out more about Debbie's services on
Yorkshire Hypnotherapy Training - multi accredited hypnotherapy practitioner training, taster days and foundation levels.
CPD Expert - accredited CPD and other therapy training (online and workshops options), expert and qualified hypnotherapy supervision
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