Therapist Self-disclosure Research Articles

“Me too, generally speaking”: Therapist self-disclosure of psychological problems specifically or nonspecifically similar to those of the patient.

“Me too, generally speaking”: Therapist self-disclosure of psychological problems specifically or nonspecifically similar to those of the patient.

A Phenomenological Investigation into the Use of Therapist Self-disclosure in Compassion-Focused Therapy With Forensic Clients.

Existing research has demonstrated the benefits of therapist self-disclosure (TSD) in strengthening therapeutic alliance. However, little is known about its effectiveness in the forensic context. The current research sought to address this gap by interviewing six Compassion Focused (CFT) therapists who had experience of working across a range of forensic settings. Results of an Interpretative Phenomenological Analysis (IPA) indicated that all participants advocated using TSD as a powerful therapeutic tool when working with forensic clients. However, there was a tension between balancing risk with the rewards of TSD, and participants expressed how the secure forensic environment was not conducive to its use. There was a consensus that TSD was more strongly discouraged with clients who had sexual convictions. For some, this had an impact on their own disclosures. Training on the function of TSD is recommended in forensic practice to address some of the environmental barriers to its implementation.

Transdiagnostic effects of therapist self-disclosure on diverse emotional experiences of clients with emotional disorders and schizophrenia.

Despite the clinical significance of emotional diversity, also known as emodiversity, there has been limited investigation into the therapeutic interventions that influence this construct. In the current study we examined the association between immediate therapist self-disclosure (TSD) and emodiversity among two diagnostic groups who tend to experience emotional difficulties: people with schizophrenia and people with emotional disorders (i.e., depression and/or anxiety). The sample comprised 74 clients (37 diagnosed with schizophrenia and 37 with emotional disorders) treated by 45 therapists in a university clinic setting. Following each session, clients self-reported their emotions, and therapists completed a measure of frequency and centrality of their immediate TSD during the session. Longitudinal multilevel models indicated that immediate TSD was positively associated with clients' global emodiversity, both at the within- and the between-client levels, as well as with clients' negative emodiversity at the between-client level. Moreover, clients with emotional disorders and clients with schizophrenia did not differ in the association between immediate TSD and emodiversity. In addition, across groups, clients treated by therapists who used more immediate TSD on average showed greater increases in global emodiversity during treatment. immediate TSD is associated with clients' ability to experience rich and diverse emotional experiences across different disorders. The theoretical and clinical implications of these findings are discussed.

Self-disclosure by adolescents in therapy for eating difficulties: A Q-Methodology study.

Facilitating client self-disclosure is essential to therapeutic effectiveness. Given the long-term consequences of eating difficulties for adolescents, there is a need for more research on self-disclosure in this group. This study investigated factors likely to influence adolescents' decisions to self-disclose during psychological therapy for eating difficulties using Q-methodology. Participants (n = 28), recruited through child and adolescent mental health services in the UK, completed a task that involved sorting 47 statements to represent their viewpoint on self-disclosure. The 28 completed sorts were subjected to a by-participant factor analysis in order to identify distinct viewpoints in the sample. Three distinct factors were extracted. One factor emphasised the importance of therapist self-disclosure on decisions to disclose. In contrast, another factor placed more emphasis on the influence of eating disorder identity and readiness to change on disclosure decisions. The third factor placed emphasis on the quality of the therapeutic relationship and readiness to change as having most influence. Given the absence of a unifying factor representing what influences the decision to disclose, clinicians should ensure they explore with young people what might influence their decision to disclose.

Retracted Article: Therapist self-disclosure in psychodynamic psychotherapy: A mixed methods investigation

Retracted Article: Therapist self-disclosure in psychodynamic psychotherapy: A mixed methods investigation

Therapist self-disclosure in teletherapy early in the COVID-19 pandemic: Associations with real relationship and traumatic distress.

The usefulness of therapists' self-disclosure (TSD) in psychotherapy remains controversial, and little is known regarding the potential risks and benefits of TSD in times of global crisis such as the COVID-19 pandemic and in teletherapy. We examined two independent samples of therapists (N = 1705; Study 1) and patients (N = 772; Study 2) on their perceptions of increases in TSD during the transition to teletherapy early in the COVID-19 pandemic (spring 2020). Approximately 20% of therapists and 14% of patients reported perceptions of definite increases in TSD. Therapists' top reasons for increased TSD were therapists' heightened distress and an effort to connect with patients in teletherapy. Importantly, therapist perceptions of their increased TSD were positively related to subjective vicarious trauma, real relationship, psychodynamic theoretical orientation and negatively with humanistic orientation, but not with age, race/ethnicity, length of clinical experience, working alliance, or professional self-doubt. Patients' perceptions of increased TSD were positively related with patient pandemic-related traumatic distress and their own self-disclosure, but not with patient-reported therapeutic relationship variables. Longitudinally, patients' perceptions of TSD increases predicted higher pandemic-related traumatic distress at 3-month follow-up, after controlling for their baseline traumatic distress and other variables. These results highlighted that increased TSD in teletherapy may be a potential marker for heightened distress in both patients and therapists during a global crisis and a transition to teletherapy. The findings also contrasted the literature and emphasized that therapists, but perhaps not patients, may have considered increased TSD as a reflection of genuine therapeutic connection.

Being seen: The lived experience of psychodynamic practitioners disclosing or not disclosing sight impairment

ABSTRACT The taboo of therapist self-disclosure and literature addressing disclosure and disability issues from a psychodynamic perspective is explored. Research on disclosure decisions among physically impaired practitioners is limited. Interpretative Phenomenological Analysis qualitative research methodology was employed to understand the lived experience of psychodynamic practitioners with sight impairment to understand disclosure decision-making processes in a therapeutic setting. Six participants self-identified as sight impaired psychodynamic practitioners and were interviewed using a semi-structured questionnaire. Findings showed that the experience of working as a practitioner with sight impairment is a tenacious endeavour, requiring high levels of self-awareness and determination in navigating the minefield of self-disclosure, daring to be seen by others, holding the patient’s need to be seen and journeying through loss and acceptance of the changing self. Results showed that there is an inverse relationship between likelihood to self-disclose sight impairment and the extent to which practitioners work with unconscious process and transference. Ultimately, the capacity to reclaim disavowed parts of the self, defined therapists’ ability to make therapeutic disclosure decisions. Suggestions for future research, clinical and ethical implications are provided plus recommendations for impaired practitioners and those who work with difference.

Client-therapist temporal congruence in perceiving immediate therapist self-disclosure and its association with treatment outcome

Objective: Immediate therapist self-disclosure (Im-TSD) can be a powerful intervention. When engaged in judiciously, it can provide clients with a unique opportunity to explore their interpersonal relationship in real time. Relational theories suggest that for Im-TSD to be effective, both client and therapist must have temporally congruent perceptions of its occurrence. The present study examined (a) whether clients and therapists are temporally congruent in their session-by-session ratings of Im-TSD; and (b) whether this congruence is associated with therapy outcomes. Method: After each session, clients (n = 102) and therapists (n = 60) at a university-based clinic indicated whether Im-TSD was present during the session. Before each session, clients self-reported their functioning. They rated session quality after each session. Results: Therapists’ ratings of their Im-TSD tended to be temporally congruent with their clients’ Im-TSD ratings. Greater temporal congruvdence was associated with greater improvement over time in clients’ experience of the session as helpful, but not with changes in clients’ functioning. Conclusion: The findings highlight the importance of establishing a stronger temporal congruence of Im-TSD ratings between therapists and clients to further improve clients’ experiences in treatment. The findings’ implications are discussed as well as situations in which temporal congruence may not be beneficial.

Reflections on (in)visibility and (in)audibility in music therapy: Who? How? To whom?

This article grew from a consideration of perceived visibility; specifically how this might play a role in experiences of minoritisation. In this article, I reflect on the concepts of (in)visibility and (in)audibility, together with critical theories of bodymind literacy and Barthes’s theory of the grain of the voice to consider what fresh perspectives these might offer to music therapy. Examples are drawn from clinical work and my personal lived experience as a nonbinary, trans, White, disabled person, to demonstrate how these concepts can be applied together in the context of music therapy work. Links are made with contemporary politics and popular culture to situate the implications for music therapy within a broader context, and to acknowledge some of the experiences nonbinary, trans and disabled people might carry to therapy sessions with them. I conclude with reflections questioning who Music Therapists are willing to listen to, suggesting the use of different conceptual lenses to support inclusive practice relating to music therapy process and experience, and noting the potential relevance to discussions around therapist self-disclosure, especially implicit disclosure.

The Dilemma of Therapist Self-Disclosure in Transgender Group Therapy

ABSTRACT Therapist self-disclosure can be a powerful yet highly personal tool in clinical work. Specifically for LGBTQ+ patients, the therapist’s self-disclosure of LGBTQ+ identity may foster empowerment and build the alliance. It may also risk misattunement and erasure. The therapist remaining silent may center the patient’s experience; it may also model the therapist’s internalized oppression. This is further complicated by the group setting and format, as well as the therapist’s own stage of identity development in both professional and personal spheres. This dilemma is considered through a case presentation of a trans student support group I led as a queer therapist during my doctoral training. The case and subsequent reflection question the need for a binary, fixed perspective on therapist-self disclosure, as identity and relationship are not static but ever-changing.

(TSD)2: THERAPIST SELF-DISCLOSURE THROUGH STAGES (OF) DEVELOPMENT

This Clinical Perspectives session is designed to explore the important considerations around therapist self-disclosure (TSD) when working with patients across development. The focus will be on TSD as it pertains to working with young children and their caretakers, school-aged children, adolescents, and those with ASD. Participants will gain an understanding of the unique developmental aspects that inform TSD occurrences and guide decision making when working with children and adolescents across development.

52.1 Therapist Self-Disclosure With Young Children and Caregivers

The goal of this session is to educate participants on the topic of therapist self-disclosure (TSD) with young children and their caregivers. The various ways in which TSD occurs and the important developmental considerations informing TSD decision making will be discussed. Clinical material will highlight different ways in which therapists self-disclose with young children and caregivers and the potential impact on clinical care.

70.2 Therapist Self-Disclosure and Personal Trauma Experiences

This Clinical Perspectives presentation explores therapist self-disclosure (TSD) with youth and families related to the therapist’s personal trauma experiences. It explores dilemmas of disclosure vs nondisclosure regarding a therapist’s personal trauma experiences, particularly as these intersect with sexual orientation and/or gender identity (SOGI). Participants will gain an understanding of factors to consider when making decisions around TSD, personal trauma experiences, and the intersection of these with SOGI.

70.1 Out in Therapy: Considerations Around Therapist Self-Disclosure and LGBTQIA+ Identity

This Clinical Perspectives is designed to examine the risks and benefits of disclosure or nondisclosure of sexual orientation and/or gender identity (SOGI) and frameworks for navigating disclosure with youth and families. The role of social media and public disclosure will also be explored.

52.3 Therapist Self-Disclosure With Adolescents

The goal of this session is to educate participants on the topic of therapist self-disclosure (TSD) with adolescents. The pivotal developmental and other considerations that impact TSD occurrences and decision making will be addressed. Review of the evidence base and clinical material will address the different ways in which therapists self-disclose as well as the indications, benefits, and risks of such disclosures with adolescents.

BEING OUT AND PROUD: THERAPIST SELF-DISCLOSURE OF SEXUAL ORIENTATION AND GENDER IDENTITY

This Clinical Perspectives explores the complexities around therapist self-disclosure (TSD) of sexual orientation and/or gender identity (SOGI). Theories, frameworks, and studies of TSD as it relates to SOGI will be explored with a focus on disclosure of SOGI in supervision, considerations around a transgender therapist’s self-disclosure when working with transgender and nonbinary youth and their families, and disclosure of a therapist’s personal traumatic experiences related to SOGI. Participants will gain an understanding of the risks and benefits of disclosure or nondisclosure of SOGI and approaches to navigating this space with youth and families.

52.4 Therapist Self-Disclosure With Children and Adolescents With ASD

The goal of this session is to educate participants on the topic of therapist self-disclosure (TSD) in working with neurodivergent children and adolescents and their families. The use of TSD in varying types of appointments and the intentions, benefits, and limitations of TSD when working clinically with this population, will be discussed. Clinical material will highlight different ways in which therapists self-disclose with individuals with neurodivergence and how these disclosures may impact assessment, clinical care and rapport.

70.3 Therapist Self-Disclosure and the Transgender and Nonbinary Community

This Clinical Perspectives is designed to explore the important considerations around a transgender therapist’s self-disclosure (TSD) when working with transgender and nonbinary youth and their families. The focus will be on how TSD can be used to benefit a patient, what and what not to self-disclose during sessions, and the importance of using TSD for a positive patient outcome. Participants will gain an understanding of the different ways in which TSD is defined. This will also include the various ways in which disclosing occurs with gender-diverse youth and why TSD guidelines can be different with trans/nonbinary patients vs cis normative patients.

52.2 Therapist Self-Disclosure With School-Aged Children

The goal of this session is to educate participants on the topic of therapist self-disclosure (TSD) with school-aged children. The pivotal developmental and other considerations that impact TSD decision-making will be addressed. A review of the evidence base and clinical material will highlight the different ways in which therapists self-disclose as well as the indications, benefits, and risks of such disclosures.

Covert therapeutic micro-processes in non-recovered eating disorders with childhood trauma: an interpersonal process recall study

MethodTo uncover therapeutic micro-processes from the perspectives of eating disorder (ED) treatment non-responders with childhood trauma (CT) late effects, we explored in-session experiences of poor long-term outcome patients. Female inpatients aged 28–59 (M = 40.2, SD = 5.0) from a randomised trial comparing Compassion Focused Therapy for EDs (n = 3) with Cognitive Behavioural Therapy for EDs (n = 3) were interviewed with video-assisted recall about a self-selected session. Data were analysed through Interpretative Phenomenological Analysis (IPA) with Grounded Theory (GT) elements.ResultsCovert patient strategies included self-effacement, regulating therapeutic distance to open up, and engaging with reflective rather than experiential interventions. First, self-effacement included submissive, passive or pretend responses to perceived criticising or violating therapist behaviours as well as other orientation and submission for approval. Second, some preferred a close patient–therapist alliance with therapist self-disclosure and reciprocity was a requirement for opening up; others required distance. Third, informants detached from experiential trauma work while engaging in joint reflection on post-trauma responses.ConclusionInformants were preoccupied with calibrating the emotional–relational landscape in session; we hypothesized that psychological insecurity and affective intolerance from CT limit their freedom to explore own in-session experiences.