Exploring Decision Making Around Therapist Self-Disclosure in Cognitive Behavioural Therapy

BackgroundTherapist self-disclosure (TSD) usage varies greatly among different psychotherapy orientations. Anecdotal evidence seems to suggest that there are reasons for its judicious use, and a small number of researchers have proposed guidelines for how TSD should be used to help therapists across psychotherapy models make decisions around disclosure. However, there is almost no literature specifically exploring how cognitive behaviour therapy (CBT) practitioners make decisions around employing TSD within the CBT framework. ObjectiveThis study aimed to explore how experienced CBT practitioners make decisions around TSD. MethodIn-depth qualitative interviews were conducted with six clinical psychologists who were trained and experienced in CBT, and the interviews were analysed thematically. ResultsThere were two overarching themes in terms of how they made decisions to self-disclose: (A) the rules for TSD use, which included sub-themes (a) it must have a clear purpose, (b) it must fit, (c) the therapist must maintain boundaries, and (d) the therapist must always reflect on his/her use of TSD; and (B) how they use TSD, which included subthemes of (a) using it as a tool for change and (b) using it to manage the therapeutic relationship. ConclusionParticipants' decisions on whether or not to self-disclose were strongly influenced by the CBT model, and this process went beyond what is suggested in the transtheoretical literature. Understanding this process may lead to the development of CBT-specific guidelines for making TSD-related decisions.