When in doubt, sit quietly: A qualitative investigation of experienced therapists’ perceptions of self-disclosure.

Abstract

Using consensual qualitative research (CQR), we analyzed 13 interviews of experienced psychotherapists about general intentions for therapist self-disclosure (TSD), experiences with successful TSDs, experiences with unsuccessful TSDs, and instances of unmanifested urges to disclose. For TSD generally (i.e., not about a specific instance), typical intentions were to facilitate exploration and build and maintain the therapeutic relationship. Therapists typically reported becoming more comfortable using TSD over time. In successful TSDs, the typical content was accurate, relevant similarities between therapist and client; typical consequences were positive. In unsuccessful TSDs, the typical antecedent was countertransference reactions; the typical intention was to provide support; typical content involved therapists mistakenly perceiving similarities with clients; and the general consequences were negative. In instances when therapists repressed the urge to disclose, the typical antecedent was countertransference and the content typically seemed relevant to the client's issues. We conclude that effective use of TSD requires general attunement to the client's dynamics, attunement to the client's readiness in the moment, ability to manage countertransference, and ability to use a specific TSD appropriately. Implications for practice, training, and research are discussed. (PsycINFO Database Record

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

“…Integrating the findings of the QMA with those in the broader TSD and Im literature (Audet, 2011; Audet & Everall, 2003, 2010; Hanson, 2005; Henretty & Levitt, 2010; Hill, 2014; Hill et al, 1989, 2014; Pinto-Coelho et al, 2016, 2018; Safran & Muran, 1996), we offer the following recommendations for using TSD: (a) Be cautious, thoughtful, and strategic about using TSD, (b) have a client-focused intention for using TSD, (c) evaluate how clients might respond and whether TSD is likely to help clients, (d) make sure the therapeutic relationship is strong before using TSD, (e) use TSD sparingly, (f) keep the disclosure brief with few details, (g) disclose resolved rather than unresolved material, (h) make the TSD relevant to client material, (i) focus on similarities between therapist and client, (j) focus on the client’s rather than on the therapist’s needs, (k) turn the focus back to the client after delivering the TSD, (l) observe the client’s reaction to the TSD, and (m) assess the effectiveness and decide whether it will be appropriate to use TSD again. For Im, we recommend the following: (a) Be aware that Im often involves lengthy processing; (b) if therapists want clients to be immediate, they should be immediate with their own feelings; (c) 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 effects; and (d) examine countertransference and seek consultation to ensure that therapists are acting in the best interests of clients when using Im.…”

Therapist self-disclosure: Let’s tackle the elephant in the room

“…TSD should neither burden the client nor create a situation in which the client must care for the therapist. In addition, effective use of TSD requires that the therapist be attuned to client readiness, the health of the therapeutic alliance and therapeutic dynamics (Pinto-Coelho et al, 2018). If working within a particular modality, the therapist should consider the specific treatment goals and parameters set by that modality to appreciate the kinds of disclosures that are consistent with it.…”

Telehealth Therapy for Therapists: Barriers and Benefits

“…Treating trauma survivors can contribute to the therapist’s experience of “I’ve got you under my skin,” requiring careful management of vulnerabilities (Bimont & Werbart, 2018). Prematurely or excessively disclosing personal information in a client session may slow or block progress (Pinto-Coelho et al, 2018). In personal therapy, the therapist learns how to use self and experiences as therapeutic instruments without bringing specific stories into the room and misusing the client’s “time and experience.”…”