The relationship between trainee therapist traits with the use of self-disclosure and immediacy in psychotherapy.

Abstract

The goal of the present study was to explore how self-disclosure (SD) and immediacy relate to trainee therapists' personal characteristics. A prospective multitrait multimethod assessment approach was utilized to assess a wide range of trainee characteristics at the beginning of graduate school. Results showed a significant, positive relationship between trainee interpersonal problems and SD for trainees (n ϭ 33) in their third psychotherapy session with their first patient. Moreover, greater use of SD correlated with less session depth, as rated by the trainee. Greater use of immediacy was positively related to trainee undergraduate grade point average and trainee-reported post-session arousal. Notably, all statistically significant findings had a moderate magnitude of effect. Finally, qualitative analyses of the SDs and immediacy statements were included to aid the discussion of potential reasons for the results. Overall, our findings provide preliminary conclusions about which trainees utilize SD and immediacy, what types of SDs and immediacy interventions they tend to use, and how trainees and patients perceived the session in which SD and immediacy were implemented. Implications for supervision and training are discussed. Clinical Impact StatementQuestion: This study explores the association between trainee therapist personality and the use of self-disclosure (SD) and immediacy. Findings: The strongest finding suggests that more problematic trainee interpersonal characteristics are associated with greater use of SDs, and many of the SDs were indicative of the trainee sharing his or her anxiety. Meaning: These results highlight the need for supervisors and trainees to be mindful of using SD in this way, and supervisors may want to caution trainees about keeping the focus on the patient or therapeutic relationship (i.e., use immediacy) if feeling anxious. Next Steps: Future work may explore how SD and immediacy relate to the interaction of patient and trainee characteristics over the course of psychotherapy.

Development and validation of the Barriers to Using Immediacy Scale (BUIS).

“…For instance, trainees with an anxious attachment may fear criticism or rejection if they use immediacy, whereas avoidant trainees may undervalue and avoid such direct communication, patterns consistent with adult attachment theory (Mikulincer & Shaver, 2016). Relatedly, Jowers et al (2019) found that therapist arousal was heightened after sessions with immediacy, and Berg et al (2016) found that therapists felt confused and struggled to stay attuned to emotions when using immediacy. As well, Joo et al (2019) found that Korean therapists were concerned that clients may be resistant, avoidant, or not return if immediacy were used, especially early in therapy.…”