Guidelines for Self Disclosure - To Tell or Not to Tell

By | Dec 21 2012       0 Comments      Print


This guide was developed in 2012 in response to the Trauma Informed Care - Trauma Advisory Committee's desire to create a safe and secure environment where all staff, whether they choose to self disclose or not, feel comfortable doing so. Below is the culmination of a review of the literature and conversations with committee members. It is our hope that this guide will be practical and meaningful to those who serve the clients of Genesee County. 

There is very little research on the topic of self disclosure. However, after a review of the literature and code of ethics for the various helping disciplines, National Council Trauma-Informed Learning Community leaders and members, and much lively discussion with Trauma-Informed Care Steering committee members -- especially with the consumers we serve in our system of care -- self disclosure can be summed up in one statement: Timing and motive are everything. Even with all the widely varying opinions, after all was said and done the Steering Committee came to the consensus contained in this document. The content (intentionally general in nature) will attempt to summarize important aspects to consider when self disclosing. 

Who Should Self Disclose?

That depends. If you are a peer or recovery coach in Michigan, it is expected that you self disclose by sharing your recovery story. A peer/recovery coach is someone who is legitimate because of their experiential knowledge of substance abuse and mental health. The very basis of peer support is the experiential journey that is shared between the peer/recovery coach and the client. The peer/recovery coach's experience enhances the client's sense of mutual identification, trust, and confidence.  “Hi. I’m Johnny and I’m a person in recovery” is a great place to start.    

If you are a professional, there is a commonly held view that self disclosure is to be discouraged. That view is now being reexamined. The current focus is on the benefits of self disclosure and whether or not it is helpful to the client. For example, if a counselor is asked “Are you in recovery?”, a good reseponse is “That is a very good question. What made you decide to ask that?” This exchange may provide a good opportunity for the client and counselor to mutually clarify and define the counseling process. Based on the outcome of that conversation, the counselor can decide “to tell or not to tell." However, the counselor needs to examine whether or not the client is attempting to divert attention from him/herself in a way that is not helpful. 

Although many of the clients believed strongly that their counselor needs to be someone in recovery, there were others who said it did not matter. What ultimately did matter, however, was whether he or she believed their counselor could help them.  

 How Much Should You Self Disclose?   

Proceed with caution. Whether you relate to a client from a peer or professional role, it is important that you maintain boundaries and decide what information you are willing to share to ensure that a sense of safety is created in the relationship. Self disclosure is a very personal event and should always be based on one’s own timetable. Everyone has a story to tell, and there has to be overall value and benefit to self disclosure. You have to ask yourself whether self disclosure is for personal gratification, or to inspire hope in the client. 

Clients will talk in waiting areas and other common areas. Consider that whatever is self disclosed will be repeated, and some clients will be left wondering why they were not given that same information. 

There are different levels of self disclosure. Are you disclosing your sexual orientation, your financial situation, pervious jail time, information about your children or pets, or what you had for breakfast that morning?  You need to find ways to self disclose without spilling everything.   

What is the Impact of Self Disclosure?

It varies. Clients were quite clear that counselor self disclosure stories were at times irrelevant to their treatment, feeling that the treatment they were receiving was not really for them, but for the counselor. In other words, the focus was on the counselor, not the client. Situations such as these are not of any benefit to clients. In other cases, self disclosure may build a therapeutic alliance and provide identification, hope, and inspiration to the client; research indicates it can be very useful if done skillfully.  

For both the peer and professional, the key to effective self disclosure is ongoing supervision. Clinical supervision will assist the practitioner to learn from his or her experience and ensure good service to the client. 

A Self Disclosure Story

In a recent training, Cheryl Sharp, Special Advisor for Trauma Informed Service, National Council for Community Behavioral Healthcare, heard this story: 

“I have been a social worker for  40 years and no one that I have ever worked with knows that I was hospitalized several times dues to depression. It wasn’t safe to talk about personal struggles. I am looking forward to retirement so I can finally be the person I have always been; a very good social worker who has always struggled.” 

If we know that 51% of the general population has been exposed to at least one adverse childhood experience/trauma (Felitti and Anda, 1998); that 90% of public mental health clients have been exposed to trauma (Mueser et al., 2004, Mueser et al., 1998); and that most have multiple experiences of trauma (Mueser et al., 2004, Mueser et al., 1998), why are we still trying to cover it up and pretend it didn’t happen? This causes separation, stigmatization, and a perpetuation of blame, shame, and secrecy.  

It is the hope of the committee that the providers, peers, and professionals in our system of care find the balance necessary to create a safe and secure environment in which everyone is able to bring their humanity to the table in a way that is comfortable and supportive to all staff, whether they choose to self disclose or not. Hopefully this guide will be another step in reducing shame for those who have experienced trauma, and for all those we serve. 

Many many thanks go to the Trauma Steering Committee members who contributed to the Self Disclosure guide.  Without them this guide would not have been developed. 

Contributors:

Stacey Dettloff-Jones, Clinical Director, Training and Treatment Innovations

Michael Hunt, Clinical Director, Catholic Charities

Kristen Kenny, Trauma Coordinator, Training and Treatment Innovations

Sheila Lopez, Recovery Coach, New Paths

Zoe Lynch, Peer Support Specialist, Genesee County Community Mental Health

Jean Nemenzik, Director of Clinical Services, Hope Network

Nancy Rodda, Senior Clinical Director, Genesee County Community Mental Health

Gisela Schwartz, Peer Support Specialist, Genesee County Community Mental Health

Charlene Stier, Clinical Director, Sacred Heart Rehabilitation Center

Jamie Tharp, Clinical Director, Consumer Services Inc.

Clients:  Diana, Janet, Shelley, Jeffrey, Alex, Sheila, Shannon, Ambie, Stevie, Montellle, Wesley, Barry, Joe, Lindsey, Kenneth, Jennara, and Curtis.

Resources:

http://www.nytimes.com/2011/06/23/health/23lives.html?pagewanted=all

http://www.clinicalpsychiatrynews.com/views/commentaries/single-article/editorial-thoughts-on-self-disclosure-for-psychiatrists/36388f6a86.html

http://www.ap.psychiatryonline.org/article.aspx?articleid=86695

http://www.counselormagazine.com/componenet/content/article/65-professional-development

 

 

 





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