Journal of Consulting and Clinical Psychology, Vol 93(12), Dec 2025, 804-813; doi:10.1037/ccp0000974
Objectives: Therapists vary widely in their use of feedback, which may reflect differences in how they incorporate feedback into their clinical judgment—especially when their evaluations diverge from their patients’. This process, often referred to as belief updating, involves adapting one’s perspective based on new information and is thought to be a key mechanism underlying feedback effect on therapy outcomes. This study investigates whether therapists who align their ratings more closely with patient feedback—reflecting stronger integration and potential belief updating—benefit more from feedback. Method: Cross-lagged effects of patient (PR) and therapist (TR) symptom severity and well-being ratings were analyzed from 1,019 therapist–patient dyads (729 received feedback) using dynamic structural equation modeling. Feedback integration was operationalized as the cross-lagged relationship between PR and subsequent TR under feedback conditions compared to no feedback. Results: PR were significantly associated with TR in the subsequent session. Feedback as a condition was not found to predict this cross-lagged association. Therapists showed significant variability (3.64%) regarding the association between PR and their own TR. Therapists’ degree of feedback integration moderated the effect of feedback on patient outcomes under feedback conditions. Conclusions: Therapists who incorporated patient feedback benefited more from feedback interventions. This integration aligns with the belief updating process, hypothesized to be central to feedback effect. By adjusting their clinical judgments to reflect patient perspectives, therapists may improve treatment effectiveness. These findings emphasize the importance of therapist-specific factors and highlight how feedback and belief updating interact to shape therapeutic outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved)