DSC8883 - THERAPIST SELF-DISCLOSURE: USES & MISUSES - AN OVERVIEW FOR MENTAL HEALTH CLINICIANS
THERAPIST SELF-DISCLOSURE: USES & MISUSES -
AN OVERVIEW FOR MENTAL HEALTH CLINICIANS
by Dorothy Carrillo, PhD
Dr. Carrillo is an Associate Professor Emerita at the Georgia State University School of Social Work, as well as the Executive Chairperson for Continuing Education with the Georgia Chapter of NASW. In addition to her academic experience, she has over three decades of experience providing clinical services in school, agency, hospital and private practice settings.
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OBJECTIVES FOR THIS TRAINING
This course is designed to provide the mental health clinician with a comprehensive overview of the topic of self-disclosure in clinical practice. To increase the trainee’s understanding of the topic area, a number of scenarios will be presented to highlight some of the complexities of the use of self-disclosure.
Upon completing this course, the trainee will understand the following:
-The benefits of the use of self-disclosure
-The risks of the use of self-disclosure
-Appropriate uses of self-disclosure in terms of timing, intensity and content
-Important contraindications related to the use of self-disclosure in clinical practice.
Section I: Therapist Self-disclosure: Introduction
Section Two: Case Examples
Section Three: Content, Intensity and Timing
Section Four: Therapist Self-disclosure: Benefits and Contraindications
Section Five: Evaluating the Effects of Self-disclosure in Treatment
Section Six: Review of Guidelines for Self-disclosure
Section Seven: Personal Questions Directed to the Clinician
Section Eight: Self-disclosure as a Group Leader
Section Nine: Analysis of the Scenarios
References and Test
Section I: Therapist Self-disclosure: Introduction
To disclose or not to disclose? That is not the question. Clinicians cannot help but self-disclose by their manner of dress, the decor of their office, or even casual conversation meant to relax a client (7).The question is what, how much, and when to self-disclose?
Appropriate use of clinician self-disclosure to clients is a complex issue. Considerable research indicates that self-disclosure can enhance the therapeutic relationship and engender client disclosure (10).
However, too much, too soon can make a client feel that the clinician is more interested in him- or herself. Clients need to feel heard and understood before clinicians share their personal experiences, or the client may perceive the clinician as unable to help.
Therefore the choice of content, intensity, and timing of the self-disclosure are critical.
Two stories about Sigmund Freud are correspondent to the liberal and conservative schools of thinking about therapist self-disclosure. One maintains that in the early years of his practice, Freud “is reputed to have used self-disclosure with patients even to the point of showing photographs of himself and discussing personal interests and activities” (5).
Another story is that in the later years of his practice he was “unable to speak because of the prosthetic devise that had replaced the part of his jaw that was removed because it was cancerous....he could merely nod and murmur ‘uh huhs’.....this was interpreted by some of his followers to mean that therapists should say as little possible” (2).
Freud (1912) did caution analysts to avoid self-disclosure because of his conclusion that it risks overstepping the boundaries of therapist-client relations and therefore jeopardizing the therapy. Despite this warning, self-disclosure has proven to be a widely employed and useful intervention.
SELF-DISCLOSURE VS SELF-INVOLVING STATEMENTS
Self-disclosure should be distinguished from self-involving behaviors. In self-disclosure, the clinician makes statements that reveal their past history or personal experience similar or germane to the client’s (1; 9).
Examples would be statements like “I remember feeling the same way when my oldest child left home…I think that is a common reaction, I know that is how I reacted in a similar situation when…I would like to share an experience I had once that may be useful."
While the intent is to enhance the therapeutic relationship and increase client disclosure, these statements invite the client to pause, to relate to the clinician as a separate person, and to perceive their experience as similar to others.
Self-involving behaviors are meant to further the therapeutic relationship and may include providing information about yourself as a professional, or expressing your reaction to the client’s statements or behavior.
The latter may include facial expressions, gestures, or statements such as “That must have been very difficult…I can imagine how surprised you were…I am impressed by the way you thought that through before acting.”
These are conscious and appropriate professional responses that express understanding and invite the client to continue.
This course deals only with the use of clinician self-disclosure in individual and group counseling. At the conclusion of the course it is hoped that the trainee will:
Be able to define and explain the concept of clinician self-disclosure
Be able to make informed choices about the content, timing, and intensity of self-disclosure
Understand the effects of appropriate self-disclosure
Understand the contraindications to self-disclosure
Be able to apply self-disclosure in group counseling