Objective: To examine adolescents’ attributed relevance and experiences regarding communication, and whether discrepancies in these are associated with clients’ participation and learning processes in psychosocial care. Methods: Adolescents receiving psychosocial care (n = 211) completed measures of communication in three domains: affective communication, information provision, and shared decision-making. Participation involved clients’ attendance and adherence (professional-reported). Learning processes involved clients’ improved understanding and improved confidence (client and professional-reported). Results: Important but less often experienced affective communication was associated with low adherence (odds ratio, 95% confidence interval: 2.8, 1.1-6.8), less improvement in understanding (3.7, 1.5-9.0), and less improvement in confidence (4.5, 1.8-11.6). If information provision or shared decision-making was important but less often experienced, adolescents were more likely to demonstrate less improvement in understanding (3.1, 1.1-8.5; 4.2, 1.7-10.8). The combination ‘less important but experienced’ only had an effect regarding affective communication; these adolescents were more likely to demonstrate less improvement in confidence (6.0, 2.3-15.4). Conclusion: Discrepancies between attributed relevance and experiences frequently occur. These discrepancies negatively affect adolescents’ participation and their learning processes, although the pattern differs across communication domains. Practice implications: Care professionals should pay considerable attention to their clients’ communication preferences and adapt their communication style when necessary.