Therapist disclosure

Image: Mike Lewinski

Therapist Disclosure Revisited: By Mamood Ahmad

Disclosure

Self-disclosure is the intentional or unintentional disclosure to the client of aspects of the therapist’s personal biography, such as identity, positionality, values, beliefs, or lived experience. Disclosure may occur while in therapy or outside of it. Self-disclosure may be deliberate, unavoidable, accidental, or client-initiated (Zur et al., 2009). Deliberate disclosure is voluntarily shared, such as disclosing a similar experience to the client. Unavoidable disclosure is information clients may pick up from appearance or the therapy space, such as indicators of race, gender, age, ethnicity, books, décor, books or artwork. Accidental disclosure is unintentional and unplanned, such as inappropriate spontaneous disclosure or running into a client in public. Client-initiated disclosure occurs when a client directly asks a personal question or searches for information in the public sphere, such as social media, public records, or even other people who may know the therapist.

Therapist’ deliberate self-disclosure in certain circumstances can help form and deepen the therapeutic relationship and promote therapeutic change (Audet and Everall, 2010). Disclosure is an enormously powerful tool, and there are many reasons given in the literature as to why self-disclosure could be of value. Disclosure can humanise the therapist to develop trust, foster hope, demonstrate humility and vulnerability, demonstrate allyship, attract underserved client groups, and position them as imperfect (humanise them) rather than ideal. It can also be a factor in reducing avoidable dropouts, remediating power dynamics, validating shared experience, alleviating societal alienation, correcting misconceptions, modelling relationships and enabling clients to feel their therapist is on their side (Danzer, Graham, 2018; Fisher and Shueman, 2013; Hill et al., 2018). Disclosure is thus an essential skill to discuss and practice.

It is also important to consider that there are risks to therapists’ disclosure that could have the opposite effect and even lead to avoidable endings. Overall, there are three main risks to disclosure. First, disclosure risks diverting from the client’s therapeutic process, for example if the therapist discloses a current crisis that is similar to a client’s, clients may feel they need to take care of the therapist’s feelings and may inhibit their own disclosures. Second, disclosure may lead to rupture, whether apparent or not, in the relationship if a therapist’s disclosure contradicts the clients’ experiences or beliefs, e.g., political, or religious beliefs. Third, the therapist may begin to feel unsafe following a disclosure, which in turn impacts the therapist’s ability to do their best work. For example, a therapist may disclose their experience of grief, only to find it brings up unresolved emotions, causing them to lose focus.

Although there are no specific rules regarding what to disclose and in what context to disclose it, experience and evidence (Danzer, Graham, 2018) provide overarching principles of good disclosure practice.

• Disclosure is intended to benefit the client, not the therapist.
• Before seeing clients explore your personal principles and limits of self-disclosure and whether you can flex these based on client context. Consider how your preferences might impact underserved and marginalised clients.
• Gain insight into the client’s experience and value system first through establishing the relationship before disclosing.
• Be cautious about the impact of disclosing current personal or crisis issues, as this could take the focus away from the client.
• Always explore the reasons for clients’ questions that require you to self-disclose (e.g., ethnicity or beliefs). If you decide not to disclose in response to client-initiated disclosure, it is recommended that you explain why and support clients to share their feelings around non-disclosure.
• Disclosure, including your own identity, beliefs, and background, can be used to demonstrate humility and allyship, which can be very important to some clients, such as marginalised communities, in ascertaining whether you are likely to be a ‘safe’ therapist for them.
• Disclosure typically needs to be brief and promptly return focus to the client.
• Where disclosure or non-disclosure elicits conflicts and disappointments, use core relational skills including rupture and repair if needed.

Discussion and reflection

Use these examples to explore the ways in which disclosure may or may not serve the client.

Case example 10.4: Amy and the idealisation of the therapist.

Self-disclosure can be used as a way of reducing power in the room, producing a calming effect on the client’s nervous system, and enabling the client to trust their own therapeutic journey. Discuss the risks and benefits of this example.

Amy was in therapy for over a year. She had chosen her therapist, Hyun, because he felt warm and inviting. Amy wanted to know more about the therapist; she knew nothing more than his professional credentials. During one session, she felt the anxiety of losing Hyun as her therapist. In exploring those feelings, Amy said that being in his presence felt like a joyful but scary experience. Deep down, she saw her therapist, in her own words, as a “gift from the universe” and “beyond human.” Hyun asked Amy what she wanted to know. He was happy to be interviewed by her but also explained transparently why personal disclosure limits were important. Amy asked about his birthplace, hobbies, books, educational experiences, and music. In retrospect, she could see how that moment had been extremely beneficial to her, as it made her feel valued for knowing what she needed and emphasised the importance of seeing Hyun as a human rather than a saviour archetype. She became relationally calmer and thus better able to focus on her process.

Case example 10.6: Disclosure in whose interest?

This example not only illustrates what can happen if we reveal, but also how a sudden change in the frame can cause role dissonance.

Carol was a qualified therapist in her first year of practice. They had recently received feedback during a training “fishbowl” experience about being distant in therapeutic relationships. Carol decided they wanted to be more genuine and present. Their client Jane asked them how they were today, to which they responded, “Not the best day; it’s been a bit of a struggle.” The client listened, was taken aback, and didn’t know what to do with that considering she had become accustomed to their therapist being okay. The situation brought up guilt about loading them with more issues and thinking they must be sick of hearing people’s problems. Something Jane was used to from caring for her siblings as a child. She asked Carol at the end whether she was okay.

Case example 10.7: Accidental disclosure

In this example, differences of political belief create tension in the relationship.

Anika lived in a country where the political climate meant there would be fewer freedoms than previously. They had recently migrated based on political reasons and in for hope for improved conditions. However, once they settled more in, they realised the politics and discrimination experiences were not what they expected. Anika found it difficult to criticise the country and its policies in therapy, and she became hyperaware of the therapist’s body language and silence on the subject. Anika was also on social media, and while scrolling through their feeds, they realised their therapist held an anti-migration stance as they believed it had a negative impact on the economy. Here, the public and personal spaces were invaded by disclosure outside of therapy. Therapy could not continue.

Case example 10.8:

Another risk to disclosure is overidentification. Rather than staying with the client’s unique experience, the therapist identifies closely with it, revealing a shared experience and threatening the client’s autonomy through over identification.

Thema had a busy practice. She had developed a rapport with her client Janine, who after many months had begun disclosing their sexual abuse experiences, which had become more vivid and, in her words, “real.” Prior to this, the therapist had decided to selectively disclose that they had experienced sexual abuse too — justified based on developing a more trusting relationship and knowledge by experience. When the client began to disclose specific details of the abuse, Thema sat back as she felt her body react and expressed that this was hard for her to hear, displaying signs of ‘disgust’ on her face. This interrupted the client’s deeply individual process as Janine was recalling their experiences of sexual violence. On reflection, the therapist had not worked enough on her own trauma to be able to contain her own needs and focus on the clients’ unique experiences. This caused the client to withdraw and feel ashamed for disclosing her problems, believing that their therapists’ problems were more important.

Flexible disclosure

There are no hard and fast rules for personal disclosure, except that it must be beneficial to the client and take risks into account. Ethics of putting the client first, non-maleficence, building an appropriate relationship, client confidentiality, and not bringing the profession into disrepute are key principles. Therapists who actively use the client to unburden themselves, gain validation, boast, seduce, or exploit are examples of inappropriate personal disclosure where therapists are unable to contain their own needs.

What can be helpful is for the therapist to ask, “What am I disclosing?” “Why am I disclosing?” and “What is my plan in response to disclosure?” Preparation for questions can go far, as therapy is a real-time process where disclosure is revealed through intuition and in the here and now.

Personal boundaries and approach: Constraints or opportunities

The therapist’s overall approach to disclosure will be guided by personal preferences, attitudes, limits, and theoretical approach. Each theory may have an active or neutral view of personal self-disclosure. Marginalisation theories and CBT-based theories actively incorporate disclosure into skill practice. Psychoanalytical theories require more neutrality, which may discourage disclosure. Although Carl Rogers’ person-centered theory did not formalise self-disclosure and used little disclosure (Myers, 2020), there is nothing that negates it. Each theory may have a differing rationale for disclosure.

Advocates for greater disclosure believe that disclosing one’s worldview and identity is a form of congruence in which clients learn about the type of therapist they are working with and recognise that a therapist cannot be right for everyone. Advocates for less disclosure want clients to project information on the therapist, reveal personal attitudes, and reduce the risk of negative consequences. Both recognise the need for ethical principles. A spectrum view of personal disclosure is a useful way for the therapist to consider their limits, what they would feel comfortable with, and whether they would disclose generally or situationally. The spectrum could include worldviews and beliefs, childhood experiences, mental and physical health issues, general life issues and events, identity, strengths, and experiences of othering and discrimination.

Disclosure is culture-bound (Zur et al., 2009), meaning disclosure can be influenced not only by theory but also by socio-cultural trends and movements. For example, as more therapists and the public talk more openly about therapy and personal life experiences, that will influence our views on disclosure. Books and media such as the film Stutz and the book “Maybe you should talk to someone” are indicators of the trend towards humanising therapists. Many workplaces are now recognising the need to nurture the individual’s self-improvement and are looking towards initiatives for mental health and wellbeing.

Exploring risks of disclosure

Overall, there are three non-exclusive risks to disclosure: it takes away from the client’s therapeutic process, it impinges on or avoidably ends the therapeutic relationship, or it creates a negative impact on the therapist, which in turn impacts the therapist’s ability to do their best work. It is the first two that I consider here.

A significant risk of self-disclosure is if it takes the client away from their own therapeutic process, needs, and goals. This example not only illustrates what can happen if we reveal, but also how a sudden change in the frame can cause role dissonance.

Carol was a qualified therapist in her first year of practice. They had recently received feedback during a training “fishbowl” experience about being distant in therapeutic relationships. Carol decided they wanted to be more genuine and present. Their client Jane asked them how they were today, to which they responded, “Not the best day; it’s been a bit of a struggle.” The client listened, was taken aback, and didn’t know what to do with that considering she had become accustomed to their therapist being okay. The situation brought up guilt about loading them with more issues and thinking they must be sick of hearing people’s problems. Something Jane was used to from caring for her siblings as a child. She asked Carol at the end whether she was okay.

Another risk to disclosure is overidentification. Rather than staying with the client’s unique experience, the therapist identifies closely with it, revealing a shared experience and threatening the client’s autonomy through over identification.

Thema had a busy practice. She had developed a rapport with her client Janine, who after many months had begun disclosing their sexual abuse experiences, which had become more vivid and, in her words, “real.” Prior to this, the therapist had decided to selectively disclose that they had experienced sexual abuse too — justified based on developing a more trusting relationship and demonstrating experience. When the client began to disclose specific details of the abuse, Thema sat back as she felt her body react and expressed that this was hard for her to hear, displaying an ickiness on her face. This interrupted the client’s deeply individual process as Janine was recalling their experiences of sexual violence. On reflection, the therapist had not worked enough on her own trauma to be able to contain her own needs and focus on the clients’ unique experiences. This caused the client to withdraw and feel ashamed for disclosing her problems, believing that their therapists’ problems were more important.

Personal disclosure that contradicts the worldviews of clients can also be problematic, so the therapist needs to be mindful of the effects of judgments, beliefs, and values that contradict the clients’ own.

Sadiq is a therapist working with couples. As they both entered, they told Sadiq he had been suggested to them by their previous therapist, to which Sadiq quickly responded, “Oh, yes, he is such a great therapist and friend.” As they sat and described their issues, it became clearer that the couple did not regard Sadiq’s “friend” highly, stating that they had been overly directed by them to push through intimacy issues in the relationship, which they found shaming due to their own past experiences of child sexual abuse.

Another example of the negative impact of worldview mismatches could be political views.

Anika was in a country where the political climate meant there would be fewer freedoms than previously. They had fled to Britain based on political reasons and the future. However, once they settled more in Britain, they realised the politics and discrimination they faced were not what they expected. Anika found it difficult to criticise Britain and its migration policies, and she became hyperaware of the therapist’s body language and silence on the subject. Anika was also on social media, and while scrolling through their feeds, they realised their therapist wanted less migration as they believed it had a negative impact on the economy. Here, the public and personal spaces were invaded by disclosure outside of therapy. Therapy could not continue.

Benefits of disclosure

There are many reasons given in the literature as to why self-disclosure could be of value: in humanising the therapist, developing trust, hope-giving, authenticity, demonstrating humility and vulnerability, attracting client groups, mitigating unavoidable dropouts, remediating power dynamics, validating shared experience, alleviating societal alienation, correcting misconceptions, modelling, and enabling clients to feel their therapist is on their side.

Therapist advocacy experiences can be a way of demonstrating real-life support for particular social problems.

Matie had, through his childhood, experienced poor living conditions in social housing. During that time, he developed a community around the issues, a collective voice, as their needs were being neglected while they lived in unhealthy conditions with mould, dampness, and dilapidated conditions. He used this example when working with a client who felt they wanted to do something to change the neighbourhood and the harassment many were feeling due to unsocial behaviours. On reflection, the client said it felt like you were on my side and understood where I might be coming from. It’s so hard to know whether you are being judged. The therapist’s advocacy work in this case is seen as part of being empathic in action.

This example also shows that different experiences that are generalisable can be helpful if they resonate and affirm the client’s autonomy. Self-disclosure can be used as a way of reducing power in the room, producing a calming effect on the client’s nervous system, and enabling the client to trust their own therapeutic journey. Therapists need to be aware of using self-disclosure in a trauma informed approach.

Amy was in therapy for over a year. She had chosen his therapist, Sharjeel, because he felt warm and inviting. Amy wanted to know more about the therapist; she knew nothing more than his professional credentials. During one session, she felt the anxiety of losing Sharjeel as a therapist. In exploring those feelings, Amy said being in his presence felt like a joyful but scary experience. Deep down, she saw her therapist, in her own words, as a “gift from the universe” and “beyond human.” Sharjeel asked Amy what she wanted to know. He was happy to be interviewed by her but also explained transparently why personal disclosure limits were important. Amy asked about his birthplace, hobbies, books, educational experiences, and music. In retrospect, she could see how that moment had been extremely beneficial to her, being valued for knowing what she needed and emphasising the importance of seeing Sharjeel as a human rather than a saviour archetype. She became relationally calmer and thus better able to focus on her process.

Sharing identity information can create hope.

Natasha was seeing a long-term client, Stephen. They had for a while thought Stephen may have undiagnosed neurodivergence and sought advice from a neuro-divergent affirming supervisor on whether to broach the subject with the client. One theme they discussed was how the client perceived social life to be a game in which she had to choose the right option to feel “included. They would often be targeted during school as a “weirdo”. While the therapist made no assumptions, they decided to share their thoughts in an open way. The client felt a sense of panic, not knowing what to make of it, to which the therapist responded that they considered themselves neurodivergent. The client responded that regardless of whether they were neurodivergent, it could be okay and that they saw the therapist as a positive role model.

Shared and/or different therapist identities can be used to open conversations about how the clients experience their lives in juxtaposition to the therapist, retaining separation.

As a neurodivergent individual, I often had to hide who I truly was to fit in. When I was in my bedroom, that’s when I could unmask. What was it like for you?

In the following, racial-cultural identity disclosure was used as an early way of creating rapport with the client. Noting that the disclosure and acknowledgement of differences may also be a valid way of developing trust.

Sunam met her therapist for the first time. It was visibly clear that they were both from the Global Majority. The client asked Sunam what her family background was, and they exchanged as part of contracting their commonality of south Asian heritage, Punjabi, and details of family township. When Sunam met with her supervisor, who was also of British Yorkshire heritage, they questioned her, stating it was too much disclosure and too friendly, very quickly. The therapist explained this was a standard part of cultural group relations and it helps them feel relief, especially as he was tired of explaining their lives to a therapist who had no cultural competency. The supervisor wasn’t fully convinced, which created an underlying fracture in their supervisee-supervisor relationship.

Disclosure can be a form of learning that allows for reflection on dominant cultural values.In this example, there are expectations of what it means to be a man in his family and the world.

Adam talked about his feelings toward his mother. How he would often not be allowed to cry but instead be ridiculed for being a “baby,” unlike his brother, who just got on with it. Every time he would be on the verge of showing emotion, he would distract himself with a smile or a “That’s just how it is, isn’t it?” statement. He would get to the point of feeling like he could cry, then shut down. His therapist responded by telling him that he does cry and has done it many times in the past. It’s difficult when cultural expectations of men are set—we are not robots. He found it comforting to know that he wasn’t alone in his feelings and that there was still hope that he could explore them and express his emotions.

Humility can be demonstrated as a form of disclosure that allows the client to share and model mistakes, learnings, and the possibility of change. For example, if the client has had a relapse in overcoming alcohol addiction, the therapist could share that they too have had many relapses. Furthermore, mistakes in therapy provide opportunities for the therapist to demonstrate humility by accepting accountability and being willing to be seen as fallible.

Unavoidable disclosure

Therapists need to be aware of the myriad of unavoidable disclosures: name, gender, age indicators, flu symptoms, visible impairments, appearance, skin tone, accent, religious clothing, jewellery, marriage rings, non-verbal language, body type, communication style, gender expression, and socio-economic indicators. Books, pride flags, paintings, certificates, plants, decor, smell, work, or home location are examples of unavoidables within the shared therapeutic environment. Knowing what individuals may assume, often built upon societal stereotypes, can help therapists prepare for therapy practice. For example, voice inflection and mannerism leading to assumptions of LGBTQ identity or skin tone determining cultural heritage can be used as part of the process.

There is always the possibility that a therapist’s identity and environment create meaning in the client’s world. Fear of a visible disability, for example, or hope in someone with a shared identity or lived experience.

Disclosure process

Any disclosure is likely to have an effect, even if benign. In the examples provided, some effects are disclosed to the therapist while others remain out of view, perhaps even to the client. Seeing disclosure as a process could help the client therapeutically, help build the relationship, or even prevent rupture or jarring in the relationship.

Where there is an overt negative effect, then the principles of acceptance, empathy, and relationship repair are valid, and there is another chance to model good communication and vulnerability to make mistakes. Much has been documented about the potential for repair to strengthen the relationship.

Through checking in based on intuition, observation, or client feedback, the process’ effects could even be therapeutic. In the previous example of the therapist disclosing having a bad day at the beginning of therapy:

Carol observed something different in the client—more hesitant to speak or focus too much on difficult experiences—for which she sought clarification. The client responded that they were concerned about them not loading them up with too much as they had a bad day, and they must be sick of hearing people’s problems. Carol was able to notice and broach this, which led to engaging in a process regarding her role in the family as a child caretaker. In this way, what could have taken considerably away from the process was utilised.

Sometimes a disclosure may produce anger, upset, envy, or disappointment. For example, a client who sees the therapist’s wealth indicators and the relative ease with which they are living may verbalise this envy as “it’s okay for some.” The consequences of this process, if allowed into the room, could be a helpful part of the disclosure process, which, subject to beneficence, would lead to further disclosure of the reality of earnings in the therapeutic profession.

Disclosure in the environment – Hope and comfort

Therapists can also positively leverage unavoidable but changeable disclosure in the environment by creating an atmosphere of safety, inclusion, and representation. Furniture positions, lighting, art, plants, and privacy are typical considerations. A practise that wished to become inclusive would consider adjustability of lighting, fidget toys, disabled access, colours, adjustability of room furniture, and representative images of different demographics as part of disclosing the therapists’ values and the clients they serve. For example, a black, neurodivergent client may already feel a sense of hope that their needs are being met because of certain environmental “touches.”

Good practice (Again!)

Although no specific rules of disclosure are provided, experience and research can lead us to make some general statements about good disclosure practice.

• Know what you put out there, including the unavoidable, and how you will respond when asked by clients.
• Keep disclosure statements brief and move the focus back to the client.
• Keep in mind the nature of client problems and relational impact in whether you decide to disclose.
• Be very cautious of disclosing current personal or crisis issues as it could lose focus on the client. New, unavoidable disclosures such as illness or visible markers may need to be broached.
• Make sure that statements are marked as your own and, therefore, different, no matter how similar they may seem to the client. statements may help.
• If you decide not to disclose in response to client-initiated disclosure, it is recommended that you explain why and help clients share their feelings around non-disclosure.
• Be cautious of disclosing worldviews or judgments until you are more aware of your clients’ value system.
• Consideration of early disclosure may be necessary to reduce avoidable endings.
• Consider the power dynamics and discussing the difference in the room, especially if there is societal pre-transference. Further ways of using disclosure to reduce the impact of power dynamics include examples of advocacy, lived experience, competency, values, and beliefs that demonstrate empathy with clients’ positionality.
• A blank slate therapeutic approach with no-disclosure policy may perpetuate pre-ruptured identity processes. Does your client know what they are getting?
• Work with a supervisor to work through decisions about disclosure and impact. The supervisor needs to be aware of how difference, diversity, and marginalisation impact disclosure processes.

Reflective questions

What are your personal limits of disclosure? Where have you learned that from?

Reflect on all areas of disclosure, including the unavoidable and the public sphere. How will you address these if clients raise them positively or negatively?

What marginalised, stigmatized, or othered parts of you would you be prepared to disclose? How will non-disclosure impact clients from majority-marginalised communities?

Can stories and metaphors be a “proxy” or indirect way of de-risking disclosure, e.g., “I had a friend once”?

How does disclosure support client confidence, hope, and expectations? How can it be used to display competence?