This article advances an integrative conceptualization of therapist self-disclosure. The first section reviews various theoretical positions regarding self-disclosure and then proceeds to examine research and theory concerning the impact of self-disclosure on patients' perception of the therapist, its efficacy as evaluated by both patient and therapist, and its impact on the therapeutic outcome. It is proposed that the power of therapist self-disclosure derives from its integration of various therapeutic dimensions, enabling it to simultaneously strengthen the therapeutic relationship and advance diverse dimensions of therapeutic change. Illustrating this claim clinically, it is suggested that an integrative conceptualization of self-disclosure supplements previously discussed approaches to psychotherapy integration.
Therapist self-disclosure, particularly of the immediate type, might enhance the effect of brief integrative treatment on psychiatric symptoms of high symptomatic patients and contribute to favorable perception of therapists.
Our findings suggest that moderate levels of psychotherapy integraion were most beneficial in the face of alliance ruptures during psychodynamic psychotherapy. As such, our results highlight the importance of incorporating integrative treatment models into clinical training and of clinicians' flexibility and use of a moderately varied set of techniques.
Patients' crying in psychotherapy can, at times, be an indicator of a healing process and reflect patients' engagement. This study explored the relationships between Israeli patients' crying in therapy, the working alliance, therapeutic change and attachment styles, using similar procedures to the ones used by Genova et al. (2020; Psychotherapy, 58, 160) in a recent investigation of Italian patients. One hundred and thirteen patients completed an online survey in Hebrew about crying in therapy and self-report measures assessing the working alliance, therapeutic change and attachment styles. Our findings revealed that self-reported working alliance was related to the patients' perceptions of their therapist responding to their most recent crying episode with support and compassion. Therapeutic change was associated with a tendency to cry in therapy and higher instances of crying in therapy during the last year. Patients with anxious-preoccupied attachment styles had more faith that crying would lead to being understood by their therapist. Dismissive-avoidant attachment style was related to higher likelihood of feeling like the most recent crying episode helped the patient understand things that they did not understand before and feel like their tears expressed things that words could not. Further, fearful-avoidant, anxious-preoccupied and dismissive-avoidant attachment styles were all related to stronger faith in the therapy relationship strengthening after crying. These findings are in line with, and expand on, Genova et al.'s (2020; Psychotherapy, 58, 160) findings regarding the therapy alliance, crying in therapy and attachment styles. Implications for the relationships between patient attachment style, therapy alliance, therapeutic change and crying in therapy are discussed.
Ascending to prominence in virtually all forms of psychotherapy, therapist self-disclosure (TSD) has recently been identified as a primarily integrative intervention (Ziv-Beiman, 2013). In the present article, we discuss various instances in which using TSD in integrative psychotherapy might constitute a clinical error. First, we briefly review extant theory and empirical research on TSD, followed by our preferred version of integrative psychotherapy (i.e., a version of Wachtel's Cyclical Psychodynamics [Wachtel, 1977, 1997, 2014]), which we title cognitive existential psychodynamics. Next, we provide and discuss three examples in which implementing TSD constitutes a clinical error. In essence, we submit that using TSD constitutes an error when patients, constrained by their representational structures (object relations), experience the subjectivity of the other as impinging, and thus propels them to "react" instead of "emerge." (PsycINFO Database Record
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.