Richard Niolon, Ph.D.
08/01

This assumes that at the outset of the evaluation you spelled out exactly who gets the results (e.g., your therapist and doctor), what roles are played by the people involved (e.g., the therapist will discuss more detailed results with the client), and what expectations are possible (e.g., the evaluator will not be assigned the case as a therapy case).

Set the client at ease by discussing any feelings such as anxiety or depression over the feedback you will be offering. You might want to ask if there was anything they wanted to offer or clarify about the testing before you begin.

Remind the client of the assessment questions and solicit any additions to this they have considered since the last appointment. likewise, any crises situations may need to be addressed first.

One way to explain the data is that the test results are a kind of communication from the client about the client's view of the world. They reflect how they make sense of senseless things, how they express their own ideas, how their opinions compare to those of many different groups. They are not infallible, but offer one view, and the point of feedback is to sharpen that view.

Answer the client's assessment questions.

Begin with something positive. People can hear weaknesses better if they also hear strengths. Don't tell everything; select findings carefully. Begin with findings the client will accept. Gradually move on to something they may have considered, but have not fully reflected on or recognized. Finally, offer one thing you think they were not expecting to hear to see how they can handle this information. If they do well, they may be able to handle more difficult feedback. If they do not, then there is no need to upset them or assault their defenses with other information they are not ready to hear. Tailor your language to the particular client. I read a study once where they presented statistics on chemotherapy versus operations for cancer. In the first half, they emphasized that more people died from operations while all lived after chemotherapy, and most everyone chose chemotherapy. In the second half, they emphasized that fewer of the people who had chemotherapy were alive at the end of five years, while more who had the operation were. People chose the operation more frequently then. The language can make quite a bit of difference… Likewise, an audiotape, written letter, or their notes can help them remember this and make use of it. Be sure to answer the referral question as best you can, and make sure the client understands as much of this as they can. Writing down some of it may be helpful, especially in clients with memory impairments. End with some positive note.

After each finding, enlist the client in verifying or modifying test findings. Do others sometimes say the same thing? Can they think of any situations in which the feedback might be true? Can they think of any characteristics they might have in common with people for whom these statements would be true?

Pause and support the client's affective reactions as they occur. This may be hard to hear or understand. Even if they knew it, hearing it from a stranger or realizing they revealed this to a stranger is still discomforting. Never argue with a client about a test finding. The data says what it says. Some of it may be very true, some of it may be less true. Some of it may be very true in some settings but not in others. If the client starts to argue with you, fall back on this and do not push their defenses.

Do not omit a test finding simply because it seems embarrassing to discuss. They may be waiting for an opening to talk to someone about it and this could lead to a referral that would be very helpful.

Close the feedback session. Check for distortions in what the client heard/understood. Clarify who now gets the report, and include the "what if…" situations like a subpoena, an request after one year, a request by a non-psychologist…. Verify that the client is still giving consent for this. Give permission for the client to contact you in the future, and say good-bye.

Check-in with yourself after the feedback session

What are you containing? What did you learn?