Psychotherapist self-disclosure and transparency in the Internet age.

Abstract

Summary and Recommendations Self-disclosure is a broad term that includes psychotherapists’verbal and nonverbal, intentional and unintentional, avoidable andunavoidable disclosures about themselves and their lives. Themeaning of self-disclosure can commonly be understood onlywithin the context of psychotherapy, which includes client, setting,type of psychotherapy, and psychotherapist factors. Self-disclosures that are clinically appropriate in one context may notbe in another. Some treatment plans may call for extensive self-disclosure while others may call for minimal self-disclosure. In-tentional self-disclosures must be constructed to enhance the treat-mentplanandmustfirstandforemostbeconsiderateoftheclient’swelfare.Clinicians must ensure that the self-disclosures are not done tofulfill their needs but rather those of the clients. Clinically drivenself-disclosure that is done for the welfare of the client can be verybeneficial for treatment and can enhance therapeutic alliance,the best predictor of therapeutic outcome. Any form of extensiveself-disclosure, whether intentional or unintentional, shouldbe documented and its clinical meaning should be discussed in theclinical records.Our modern “bare it all” culture and the fact that many mentalhealth clients view themselves as informed consumers rather than“patients” have created an expectation of caregivers’ transparency.Digital technologies have significantly increased psychotherapisttransparency and have drastically changed the playing field. Cli-nicians must be aware that all their online postings, blogs, or chatsmay be viewed by their clients and will stay online, in some form,forever. They should search themselves online periodically bysimply putting their names, in different combinations (i.e., Dr.Smith, Smith, PhD, or Jane Smith), into a Google search. Anothereasy way to keep track of one’s online presence is by signing upfor “Google Alerts” (at http://www.google.com/alerts?hl en) inorder to get instant alerts when one’s name is mentioned in a newposting. When clients intrude into clinicians’ personal lives, clini-cians should consider the clinical, ethical, and legal implicationsand, if necessary, consult with their professional association, ex-perts in the field, and a knowledgeable attorney, if necessary.Removing inaccurate, negative or slanderous material from theInternet can be very challenging and may require professional orlegal assistance.The effect of the Internet on self-disclosure and clinical practicehas yet to be fully understood and thoroughly studied. The threeinvited expert commentaries to follow address these and relatedchallenges, issues, and dilemmas that psychologists face regardingself-disclosure, in general, and specifically in the Internet age.