Self-Disclosure as Clinical Tool

Last week we began our discussion of the value of equality within the client/therapist relationship. The primary way to behaviorally demonstrate therapist = client equality is with thoughtful self-disclosure, that is, the sharing of personal experiences, including thoughts and feelings going on in the moment, as a means to further the therapy.

Darrah Westrup, PhD, author of Advanced Acceptance and Commitment Therapy: The Experienced Practitioner’s Guide to Optimizing Delivery and consultant to acceptance and commitment therapy (ACT) providers, observed two primary barriers to using self-disclosure in session.

The first barrier is previous training that dictates that therapists refrain from self-disclosure due to concerns around “maintaining appropriate boundaries.” The idea here is that if the therapist steps too far out of the therapist role by sharing personal information, the therapeutic relationship would somehow deteriorate. There have been ethical concerns regarding dual roles (for example that the therapist would somehow become not just therapist but also a friend, or more) and that the client would subsequently be exploited or otherwise injured.

But Westrup says we can honor these concerns without needing to rigidly hold on to global rules about therapist behavior. “Over time it has seemed to me that many providers hold this line more because it is a rule than because it is the most effective stance to take at a given clinical moment. Operating behind a clearly defined, black-and-white line is simply easier than working within the grayer area of self-disclosure,” she comments.  The important thing to remember is that once you step out from behind that line you must think about such things as what to disclose, how much to disclose, the potential impact of that disclosure, and so on.

In ACT, self-disclosure is an important means to move the client forward in some way. Westrup suggests asking yourself the following questions:

1. Is what I’m thinking about sharing for me or for the client? If it’s purely or even mostly to fulfill my own needs, time to pass.

2. Is what I’m thinking about saying going to further things? Will it clarify an idea, or model a certain skill, or directly demonstrate that I am in the same boat as the client? If not, time to pass.

3. Is there a potential drawback to sharing this? For example, might this disclosure shift the focus to me or bring up other content that will stand in the way of what I am hoping to highlight? If so, it may be best to pass.

The second barrier that might be even more at the heart of things concerns vulnerability.

Missed opportunity for authentic connection with the client often comes down to a comfort issue. As long as the focus remains firmly on the client, the therapist’s own experience remains private and out of reach. It is important to note that various definitions of the word “vulnerable” stress being open, such as “open to censure or criticism, assailable” or “capable of being wounded or hurt.”

When you put yourself in the room, authentically sharing your experience, you have opened yourself; you are assailable because you can be impacted by the client’s response to what you shared. Even in situations in which the thing to be shared seems perfectly harmless, the discomfort of being vulnerable in this way can be intense. But Westrup emphasizes the importance of thoughtful sharing of your experience to enhance the work. Sharing allows us the opportunity to actively demonstrate our awareness of being in the same soup as our clients.

“There is an inherent vulnerability in the client role—just coming to therapy is an acknowledgment of wanting or needing another’s help. By claiming our own vulnerability in this process, we demonstrate willingness and join our clients in the most powerful of ways,” says Westrup.

For more from Darrah Westrup, check out her new book Advanced Acceptance and Commitment Therapy: The Experienced Practitioner’s Guide to Optimizing Delivery.