To self-disclose, or not to self-disclose? That is the perennial question. Unfortunately, the answer given in trainings and discussion groups is often a debate-dampening “it depends on the situation”. For Graham S Danzer, author of Therapist Self-Disclosure: An Evidence-Based Guide for Practitioners, this just isn’t good enough. Here, he explains how the research on self-disclosure can help us to make individual clinical decisions.
Therapist self-disclosure is among the most controversial and contentious of topics in therapeutic discussions. Yet it is seriously underrepresented in graduate education and training. Often, instruction on the topic is limited to a fairly vague and general disclaimer that therapists should only disclose when so doing will benefit the client, not the therapist.
I think this is insufficient to help therapists and trainees think through the complexities of self-disclosure. Under which clinical circumstances should we disclose? What wording should we use? How can we determine the right timing? In what ways can we follow up afterwards? Too often, attempts to address these questions stagnate on the catch-all, “depends on the situation.”
Well, of course. But this does not relieve mental health practitioners of the responsibility to reflect upon broader scholarly and clinical knowledge and wisdom from the helping professions. Looking at theory, research, and findings from like-circumstances in past practice can help us to conceptualize individual clinical circumstances in an empirically informed way.
Self-disclosure may sound like too nebulous and interactive a topic to address empirically. In fact, the scholarly literature and research is fairly abundant, diversified, and likely to be informative to practicing therapists and trainees. So what does it show?
• Research studies, therapist perspectives articles, and theoretical positions consistently indicate at least a passive and cautionary support for self-disclosure on the whole.
• Most therapists do in fact disclose at least some of the time, while disclosing can be used to support therapeutic goals in a majority of the major clinical modalities and approaches.
• Disclosures that are ethically appropriate and helpful to clients are frequently:
- Relevant to the client’s experience.
- Of an interventional and therapeutic process-related nature.
- Of low-moderate intimacy.
- More often concerning the therapist’s real-time feelings and reactions rather than historical content.
- Are quickly followed by a return to the client’s feelings and experiences.
Disclosures in this general manner may also help to improve engagement with cultural minority populations as well as individuals whose presenting disorders often predispose treatment disengagement (i.e., substance abuse, eating disorders). Emerging take-aways from the self-disclosure research and literature include:
• Unhelpful disclosures are often a result of the practitioner and not the intervention.
• Disclosures can be expected to have both positive and negative effects.
• Both self-disclosure and non-disclosure have risks and benefits.
• Therapists and clients agree on many aspects of self-disclosure but not all.
• A disclosing therapist may be perceived as less of an expert, which may have negative ramifications for the working alliance.
Of course, not all articles, research findings and perspectives are in precise agreement. In addition, emerging-converging findings and perspectives do not presume a formulaic approach to self-disclosure thinking and decision making. But I believe that recurring and emerging research findings and perspectives can help us to conceptualize a clinical scenario in which self-disclosure may be a possibility, and are therefore an essential component of decision making.
These points are elaborated upon in my new book, Therapist Self-Disclosure, An Evidence-Based Guide for Practitioners. There you’ll find a fairly comprehensive review of the self-disclosure research and literature, perspectives offered by leading self-disclosure researchers and therapists, and chapters addressing some of the self-disclosure scenarios that are among the most difficult for therapists to navigate (“Are you a Christian?” “Are you in [substance abuse] recovery?” “Why did you decide to become a therapist?”). I hope this will begin to compensate for some of the shortfalls in much of our graduate education and training on the subject, and provide helpful information to the practitioner seeking guidance from the literature.
Therapist Self-Disclosure, An Evidence-Based Guide for Practitioners, by Graham S Danzer, is published by Routledge