What "difficult things" have you been asked? What are you worrying about being asked? What disclosures have you made that you felt were inappropriate?

    When deciding how to handle these difficult issues, we often must decide whether and how to self-disclose and how much. Self-disclosure often has a dirty name, with many people believing that self-disclosure is an ethical violation. Early psychoanalytic theories, for example, suggested that self-disclosure would interfere with transference and countertransference. Risk management workshops outlined the risks and discouraged self-disclosure, although the internet increases the probability that therapist self-disclosure will occur anyway.  Nonetheless, self-disclosure can be a powerful therapeutic technique of great value when used appropriately and in the service of the client’s treatment.

    Self-disclosure takes many forms. Benign self-disclosures are part of everyday life and include natural or routine disclosures such as accent, expressed gender, a readily recognizable disability, or office décor.

    Deliberate self-disclosure refers to the intentional disclosure by the clinician of personal information. This includes marital status, parenthood, age, religion, sexual orientation, pronouns, vacation destination, and family photographs. Deliberate self-disclosure also includes information intentionally posted online, such as photos of participation in a political rally.

    Unavoidable self-disclosure is often part of life in a small community. Small communities also exist within large metropolitan areas, such as college campuses, religious groups, or LGBTQ+ communities. This form of self-disclosure is often spontaneous, such as facial expressions revealing personal attitudes or values.

    Accidental self-disclosure occurs when a client unexpectedly witnesses the therapist in a public place, such as at a protest or a locker room.   

    Inappropriate self-disclosures are those that primarily benefit the clinician. An example may be a clinician discussing a recent loss, but it may become an ethical violation when a therapist expresses a sexual attraction to a client. In contrast, appropriate self-disclosures are intentionally used with a sound clinical rationale for the client's welfare. Therapists sharing that they also have served in the military, have a child with diabetes, or experienced discrimination may help a client feel better understood.

    Laws and political changes influence our actions in therapy, including our discussion of politically sensitive issues (e.g., abortion and gender-affirming care). Psychologists practicing in more than one state must know the rules in each state and the consequences of ignoring them.

     Questions to consider regarding self-disclosure:

        * Who is this for, me or my client?

        *  What would be beneficial for my client?

        *  Will my self-disclosure be helpful or reassuring?

        *  Will my self-disclosure interfere with treatment goals?

        *  What are other potential costs?

        *  Can self-disclosure be prevented?

        * What would be the costs of preventing self-disclosure?

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    Consider whether and why you decided to discuss George Floyd’s murder or the Dobbs decision with clients. Perhaps you self-disclosed your own feelings during that discussion. Your client’s perspective and goals might have influenced whether and how you discussed this case and shared your opinions. Self-disclosure may also be useful to encourage discussion of a different perspective. A psychologist working with a client with active war-related flashbacks disclosed her own anxiety about guns to admit the possibility of bias when discussing whether he should be carrying a gun, especially now.

    In some cases, self-disclosures about election results may have been made impulsively, while in others, disclosures may have been useful for normalizing a client’s stress or sense of outrage. With the opportunity to self-reflect, you could consider what would benefit your client and what would be helpful or reassuring. For example, you may have considered how sharing your pronouns would interfere with or enhance treatment goals or have other potential costs or benefits. Sometimes self-disclosure cannot be prevented, as when your office manager raises concerns about the election in your client’s earshot.

    While self-disclosure may have costs, not disclosing may also have costs, leaving a client wondering what is safe to discuss in session. It also models overly rigid boundaries and fails to demonstrate how self-disclosure can be used well. For all cases of potential self-disclosure, however, especially those about politically sensitive issues, whether one should self-disclose depends on several factors that can be identified through consultation or periods of self-reflection. As described above, these factors include an analysis of the client, the client’s goals, needs, and context.

 

Reference available from author