To disclose or not to disclose, that is the question

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Henretty, J., & Levitt, H. (2010). The role of therapist self-disclosure in psychotherapy: A qualitative review. Clinical Psychology Review, 30, 63-77. (Summarized by Laura Yoviene, University of Massachusetts at Boston Clinical Psychology Student).

The role of therapist self-disclosure and implications for mentoring relationships

Summary:

In this article, Henretty and Levitt review the long-standing and sometimes conflicted literature on therapist self-disclosure. In contrast to the once prominent belief that therapists should be a “blank screen” for their clients, recent reviews have shown that over 90% of therapists self-disclose to their clients. In light of this, Henretty and Levitt conducted a meta-analytic review of the research on self-disclosure and offer some recommendations for therapists as they consider the potential risks and benefits of this practice and discern to whom, why, when, in what form to self-disclose.

What is self-disclosure?

There are mixed opinions on the definition of therapist self-disclosure but in general it can be viewed as any self-revealing statement made by the clinician (e.g., Cozy, 1973; Weiner, 1983; Wheeless, 1976) ranging from demographic information to the sharing of a mutual experience, such as the loss of a loved one.

Risks and benefits:

Overall, therapist self-disclosure is found to be an effective intervention strategy in that it has been shown to have positive effects on clients such as:

– clients having a stronger affection for therapists that self-disclose

– clients perceived therapists as warmer

– clients self-disclosed more themselves

In contrast, unwillingness to disclose personal information, or non-disclosure, can be experienced by the client as rude, hostile, uncaring, evasive, and tantalizing and have detrimental effects on the therapeutic alliance, a crucial aspect in psychotherapy outcomes (Gatson, 1990; Gelso & Carter, 1985; Orlinsky & Howard, 1986; Truax & Mitchell, 1971; Wolfe & Goldfried, 1988).

Multiple considerations for self-disclosure:

To whom?

The review of the empirical evidence indicates that self-disclosure may be the most beneficial for clients with whom therapists already have a strong/positive relationship or clients who share membership in the same small community (i.e. LGBT community). Discretion should be taken working with clients with poor boundaries and self-identity issues.

What?

Information that may be the most appropriate to self-disclose includes the following:

– demographic information (education, orientation, professional, and marital status)

– feelings and thoughts about the client/relationship

– relevant past struggles that have been resolved

– similarities between client and therapist

When?

The timing of self-disclosure is an important consideration. Early self-disclosure can help relieve clients’ apprehensions, build alliance and rapport, but such disclosures should be limited to low intimacy information early-on while clients’ are acclimating to relationship (Geller, 2003). Self-disclosure can also be useful during termination stage of treatment to facilitate the separation and closure process.

Why?

Therapists should have a clear rational for choosing to self-disclose, such as

– promoting client self-disclosure

– fostering the therapeutic relationship/alliance

– encouraging clients’ autonomy and facilitating client self-exploration

– normalizing and promoting feelings of universality

– equalizing power

– assisting clients in identifying and labeling their emotions

– showing similarities

– building client self-esteem

How?

Self-disclosures need to be tailored to meet the needs of the individual client, made in light of a clear understanding of these needs (i.e., a need for information vs. a need for connectedness). The particular farming and wording of self-disclosures should also be based on individual client needs. Returning the focus to the client after a disclosure is important as is using self-disclosure sparingly.

Implications for Mentoring:

Although the boundaries are not as clearly and firmly drawn in mentoring relationships as they are in therapy relationships, mentors must also carefully consider what, when, and how to disclose personal information to their mentees. As with therapy relationships, self-disclosure may strengthen an already positive mentoring relationship and revealing similarities with the youth, such as membership in a minority community, or past struggles that they have successfully worked through may serve to normalize the mentee’s feelings and strengthen the mentor-mentee bond.

Some early self-disclosure is likely to be important for alleviating a youth’s initial apprehensions about the relationship, equalizing power, and encouraging the youth to share personal information with the mentor. As the relationship progresses, mentor self-disclosure may model and help facilitate the youth’s own self-exploration, encourage the identification and labeling of difficult emotions, and help to build the youth’s self-esteem.

As in therapy relationships, effective self-disclosure in mentoring relationships also requires certain interpersonal skills, such as tact, timing, patience, humility, perseverance, and sensitivity. The current review’s indication that role-play with self-disclosure is an effective training technique for therapists is worthy of consideration for mentor training as well.