Expecting Less and Getting It: The Role of Rejection Sensitivity in Feedback Seeking and Supervisory Relationships in Mental Health Services

Background: Clinical supervision and the ability to seek and receive feedback have been widely recognized as important factors in the effective provision of community-based mental health services. Several studies highlight how the supervisory process can be even more critical than training itself because of the role that receiving feedback plays in developing practice skills. While there is an extensive literature on the strengths of different supervisory models, we have relatively limited understanding of how the relational capacity of front-line staff (e.g., rejection sensitivity) may impact how they receive and seek feedback from their supervisor. This study examines how mental health providers and front-line staff’s own rejection sensitivity influences the supervisory relationship and the ways in which job feedback is sought and received in community-based mental health settings.

Methods: Data was collected from 156 frontline staff of three mental health agencies as part of a larger study investigating the implementation of Trauma-Informed Care. Selected agencies were beginning to implement the Attachment, Regulation, and Competency Model (ARC), a trauma-informed intervention. Staff were administered a survey using validated measures related to supervision, feedback, and staff relational capacities. Participants mainly identified as female (84%). 17% of the staff identified as Black, 3% Asian, 6% multiracial, 16% as Hispanic, and 58% as White. 6% of staff reported having a high school diploma or GED, 10% completed some college, 24% graduated from college, and 52% had completed their master’s degree. Staff positions/roles included clinicians, representing 40% of the sample, program managers (25%), residential associates (16%), childcare workers (4%), supervisors (2%), case managers (1%) and other support staff (12%).

Two different dimensions of feedback were measured:1) perception of supervisor’s feedback and 2) self-report of feedback seeking, using a scale developed by Preston (Preston, 2013; Preston, 2015). Rejection sensitivity was measured using the Rejection Sensitivity Questionnaire, Adult version (A-RSQ), an 18-item scale that measures the cognitive-affective processes of how rejection-prone one is to situations and experiences. We conducted ordinary least squared regression analyses to investigate the relationship between rejection sensitivity and the three dependent variables measuring the supervisory relationship, specifically perception of job feedback (model 1), job feedback sought (model 2) and feelings about the supervisor (model 3).

Results: We found staff with a higher rejection sensitivity (RS) were less likely to actively seek supervisor feedback about their performance and when feedback was received, were more likely to rate its quality as poor. Additionally, staff with a higher RS were more likely to perceive their supervisor and the supervisory relationship negatively. This effect disappears, however, when a worker’s attitudes toward trauma-informed care (TIC) are considered.

Implications: This is the first study to examine whether workers’ relational capacities, as expressed through higher rejection sensitivity, influence their perceptions of supervision and quality of feedback and their feedback seeking behaviors. These findings support a more extensive focus on the role staff relational capacities play in influencing organizational dynamics and supports. They also point to the strength of training in TIC for mitigating the impact of challenging relational styles.