Therapist self-disclosure in therapeutic interventions

Abstract

Section A.
herapist self-disclosure (TSD) remains a controversial therapeutic technique in psychotherapy. Although evidence suggests several benefits, practitioners remain concerned that TSD may blur client–therapist boundaries and compromise professionalism. Research in this area has predominantly prioritised clinician perspectives, in part due to methodological challenges associated with accessing and capturing client experiences. This narrative review synthesised 14 empirical studies to explore client perspectives of therapists who use self-disclosure. A structured search strategy and narrative synthesis approach were used to integrate findings across qualitative, quantitative, and mixed methods designs. Findings indicated that client perceptions appeared to depend on how skilfully TSD was used. The contextual conditions found to determine skilful execution included timing, frequency, level of detail, content, client characteristics, cultural context, and dyadic congruence. These were broadly consistent across the studies. Skilful disclosures were associated with increased client perceptions of therapist qualities, including authenticity, credibility, and trustworthiness, while poorly executed TSD reduced perceptions of these same qualities. Methodological weaknesses included small sample sizes and homogeneous samples limited the generalisability of the findings. Moreover, design choices across the studies made it difficult to establish clear relationships between TSD and perceptions of the therapists. This review highlights the need for more experimental research with actual therapy client participants, and more clearly addresses the definitional complexity of TSD to establish causal links.

Section B.
Introduction: Boundary management and therapist self-disclosure (TSD) are ethically complex aspects of psychotherapy; however, little is known about how practitioners make these decisions within family intervention for psychosis (FIp). This study aimed to develop a theoretically grounded account of practitioner decision-making in this context. Method: A critical realist modified grounded theory design was employed. Semi-structured interviews were conducted with 12 multidisciplinary practitioners across the United Kingdom who were formally trained and experienced in delivering FIp. Data were analysed using constant comparison, memo writing, and iterative category development to generate a model grounded in practitioners’ accounts. Results: Analysis produced a process-oriented model centred on practitioners’ calibration of boundaries and TSD under conditions of uncertainty, where guidance was ambiguous and relational consequences difficult to anticipate. Five interconnected categories emerged: contextual conditions, emotional and ethical appraisal, boundary enactment, relational feedback, and the development over time. Calibration was characterised as a dynamic, reflexive process where practitioners balanced professional responsibility with relational responsiveness, drawing on experience and reflection to inform future decisions. Discussion: Findings conceptualise decision-making as a context-sensitive clinical process, highlighting the emotional–ethical demands of relational work and positioning competence as an emergent form of clinical wisdom. Implications underscore the importance of training, reflective supervision, and organisational cultures that support practitioner judgement.

Date of Award	2026
Original language	English
Awarding Institution	Canterbury Christ Church University