Therapist self-disclosure and immediacy: A qualitative meta-analysis.

Abstract

Therapist self-disclosure (TSD) and immediacy (Im; see next section for operational definitions) have long been controversial. Psychoanalytic theorists (Curtis, 1981(Curtis, , 1982Greenson, 1967) traditionally urged analysts to be blank screens, allowing clients to project their feelings and perceptions onto the clinician. More recent relational psychoanalysts (Eagle, 2011;Levenson, 2010;McWilliams, 2004), by contrast, have suggested that therapists can facilitate the therapeutic process by disclosing and talking about the relationship. Humanistic theorists (Bugental, 1965;Farber, 2006;Jourard, 1971), having long advocated therapist transparency and genuineness, have viewed TSD and Im as curative elements of psychotherapy.

Therapist self‐disclosure and the problem of shared‐decision making

“…This conceptualization makes topics such as the therapist's personal history and emotional reactions relevant to the psychotherapy process . Many humanistic‐existential psychotherapists argue that TSD has great therapeutic potential . In fact, congruence, an open and transparent therapist attitude, is a core principle in Rogerian humanistic psychotherapy .…”

“…In cognitive‐behavioural therapy, TSDs are typically used to facilitate emotionally intense interventions like exposure for feared objects . Because of the current emphasis on evidence‐based practice in psychology, the contemporary focus is chiefly the efficacy and effectiveness of TSDs …”

“…There are numerous issues worth addressing before summarizing the empirical TSD literature. First, the existing research on TSD is relatively scarce . Second, there are significant methodological and ethical constraints associated with TSD research.…”

“…With regard to the effects of TSD, the empirical findings are mixed . However, the overall effect for both self‐disclosure and immediacy are more positive than negative . In a recent qualitative meta‐analysis, the authors created a list with practical advice for therapists considering self‐disclosure:

we offer the following recommendations for using TSD (i.e.

…”

“…immediate self‐disclosures] [the authors] recommend the following: Be aware that Im often involves lengthy processing if therapists want clients to be immediate, they should be immediate with their own feelings be attentive to how the client responds to Im given that many clients are not comfortable with it, and it is sometimes associated with negative effect examine countertransference (i.e. the therapist's thoughts and feelings about the patient) and seek consultation to ensure that therapists are acting in the best interests of clients when using Im …”