Psychotherapist self-disclosure: Ethical and clinical considerations.

Abstract

Self-disclosure is an ever present and unavoidable aspect of psychotherapy. But, why, how, and when it is done requires careful forethought. The use of self-disclosure is discussed in the context of boundaries, highlighting its ethical and appropriate use in psychotherapy. Rather than avoiding self-disclosure out of a fear of violating ethical and professional standards, a thoughtful approach to addressing self-disclosure is presented. Recommendations for the ethical and effective use of self-disclosure are provided to include the use of ethical decision-making models and thoughtful consideration of contextual factors that include the psychotherapist's motivations, the client's treatment needs and personal history, the psychotherapist's theoretical orientation, and individual differences to include each aspect of the client's and psychotherapist's diversity. Recommendations for psychotherapists considering the use of self-disclosure with clients are made along with specific recommendations for the profession of psychology to provide greater guidance on the ethical, effective, and clinically appropriate use of self-disclosure.

Attitudes to professional boundaries among therapists with and without substance abuse history

“…The topic of self-disclosure is widely discussed in therapeutic literature, elaborating on rules delineating what information therapists can share with their clients and under what conditions (Barnett, 2011). Some authors limit the notion of self-disclosure to verbal acts and differentiate types, such as facts, feelings, insight, strategy, reassurance/ support, challenge and immediacy (Knox & Hill, 2003).…”

Crossing the Boundaries of Privacy in Accidental Encounters: Interpretative Phenomenological Analysis of Therapists' Experiences

“…Discovering shared relationships was perceived as a potential threat to confidentiality and the therapeutic alliance itself, which could lead to patient's drop-out or to the therapist finding providing therapy too challenging. As Barnett (2011) observes, being in a fiduciary role results in co-owning private information about the patient and his or her social group and being entrusted with many secrets. Petronio (2002) notes that people not only need to protect their own privacy but also to manage collective boundaries.…”

“…We believe the same applies to counsellors, psychotherapists and many other professions associated with high status and entrusted public confidence. Barnett (2011) notes that, being fiduciaries, psychotherapists accept trust and confidence of their patients and agree to act in their entrustor's best interest. By the fiduciary status, they also have the power and opportunity to exert influence over patients.…”

“…Privacy boundaries regulation in a clinical setting is thoroughly informed by ethical standards of professional organizations, which determine what can be disclosed, to whom, when, where and under what conditions (Barnett, 2011). A revelation by the therapist of his or her personal (private) information to a client (or patient) is referred to as self-disclosure.…”

“…This metaphorically expresses cultural ideals associated with parenting, where giving up one's own pleasures or benefits for the sake of a child is perceived as a virtue. Such values are also expressed expressis verbis by the Ethics Code (Barnett, 2011) and apply to all therapists irrespective of their modality. Protecting the boundaries of one's privacy can thus be rationalized not only in terms of modality-specific norms but also as deliberate attempts to separate occupational and private domains, to protect one's own interests and needs.…”