To Zip or Not To Zip (One’s Lips), Therapist Self-Disclosure: Ethical and Clinical Considerations
This intermediate level course explores the subject of therapist self-disclosure with clients and its clinical efficacy. While analytic tradition and risk management approaches have frowned upon therapist self-disclosure, it has been highly valued and widely used by humanistic, feminist, behavioral, cognitive behavioral and group therapists. It has been viewed as essential in therapy with Latino, African American, American Indian, gays and lesbians and clients with certain religious beliefs. Self-disclosure has been found to be commonly practiced among most non-analytically oriented therapists, to increase clients’ trust and enhance clients’ reciprocal self-disclosure. Most importantly, therapist self-disclosure has been shown to enhance therapeutic alliance, the best predictor of therapeutic outcome. More specifically, this course reviews the theoretical rationale, extent, timing, content, context and other relevant factors determining the efficacy of therapist self-disclosure. Inappropriate and excessive self-disclosure, and when not done for the benefit of the client, can be unethical and even harming. This course also discusses the issues of Therapists’ Disclosure online.
The course consists of five articles. The first is titled “To Cross or Not to Cross: Do Boundaries in Therapy Protect or Harm?” It identifies therapist self-disclosure as a form of boundary crossing and differentiates it from boundary violation and dual relationships. It articulates that, like gifts or home visit, when applied appropriately and strategically, self-disclosure is not only ethical but also, in fact, can be highly effective. The second article defines and explains therapists’ self disclosure, identifies the different types and discusses its clinical utility and ethical considerations. It also uses popular movies (e.g., What About Bob, Good Will Hunting) to discuss the clinical and ethical issues involved in self-disclosure. The third article, “Coming Out: Therapist Self-Disclosure as a Therapeutic Technique, with Specific Application to Sexual Minority Populations,” explains how therapist self-disclosure, like any other therapeutic technique, can be used skillfully or unskillfully, appropriately or inappropriately. It also emphasizes that when working with a stigmatized population, such as gays and lesbians, rigid non-disclosure by therapists can be detrimental to therapy. The fourth article, “The Ideal of the Anonymous Analyst and the Problem of Self-Disclosure,” provides a refreshing and inspiring critique of the traditional analytic negative view of therapist self-disclosure and looks at how it can effectively be utilized in psychoanalytic oriented psychotherapy. The fifth article introduces the emerging complexities around Internet disclosures about therapists. Additional resources and references are provided for further study, but they are not part of the course.
- Define the nature and clinical use of therapist self-disclosure.
- Describe the relationships between therapist self-disclosure and the theoretical orientation used.
- Summarize the importance of context and population in determining whether to disclose or not to disclose.
- Explain how rigid, non-disclosure can be counter-clinical.
- Detect the pitfalls of some ethical dilemmas.
- What are Boundary Crossings and Boundary Violations
- The Ethics of Boundaries.
- Boundary Crossings and the Standard of Care.
- The Slippery Slope Argument.
- Sexualizing Boundaries.
- Therapist Self-Disclosure as a Therapeutic Technique
- Self-Disclosure and the Therapist's Theoretical Orientation.
- Scrupulous and Skillful Use of Self-Disclosure.
- Use of Self-Disclosure with Sexual Minority Clients.
- Therapists' Self-Disclosure in the Movies
- Self-disclosure in Analysis - A Misleading Ideal: The Anonymous Analyst.
- Anonymity, Idealization and Projective Identification.
- Fantasy, Reality and Anonymity.
- Decision-Making about Self-Disclosure.
- Therapist Self-Disclosure on the Internet.
- What Clients May Find Out About Their Therapists on the Web.
- An Ethic of Self-Disclosure.
- Self-Disclosure as a Positive Clinical Tool.