Therapist Self-Disclosure and Immediacy: A Qualitative Meta-Analysis

• Published in: Psychotherapy (Chicago, Ill.) Vol. 55; no. 4; pp. 445 - 460
• Main Authors: Hill, Clara E, Knox, Sarah, Pinto-Coelho, Kristen G
• Format: Journal Article
• Language: English
• Published: United States Educational Publishing Foundation 01-12-2018
• Subjects: Attitude of Health Personnel; Clients; Evaluation Studies as Topic; Female; Human; Humans; Insight; Mental Disorders - therapy; Mental Health; Professional-Patient Relations; Psychotherapeutic Outcomes; Psychotherapeutic Processes; Psychotherapy; Psychotherapy - methods; Self Disclosure; Therapist Characteristics; therapist self-disclosure; therapist immediacy; psychotherapy relationship; psychotherapy process and outcome
• ISBN: 1433892081; 9781433892080
• ISSN: 0033-3204; 1939-1536
• DOI: 10.1037/pst0000182

We review definitions and provide case examples of therapist self-disclosure (TSD) and immediacy (Im). We then present a qualitative meta-analysis of 21 studies that examined the subsequent process following TSD and Im in psychotherapy (excluding analogue and correlational studies). Across the 21 studies, the most frequent subsequent processes were enhanced therapy relationship, improved client mental health functioning, gains in insight, and overall helpfulness, suggesting that most often TSD and Im were followed by positive and beneficial therapeutic processes. In additional analyses, TSD was associated more often with improved mental health functioning, overall helpfulness, and enhanced therapy relationships, whereas Im was associated more often with clients opening up and being immediate. We also consider possible moderating variables, including client contributions and diversity issues. The article concludes with research-informed recommendations for judiciously using TSD and Im in practice.
Clinical Impact Statement
Although therapist self-disclosure and immediacy are often used in psychotherapy, there have been no meta-analyses examining the subsequent processes associated with them. Question: We sought to examine the evidence for whether therapists should disclose information about themselves and talk directly about the therapeutic relationship with clients. Findings: Therapist self-disclosure and immediacy were both associated primarily with positive subsequent process. Therapist self-disclosure was more often helpful in terms of providing support, whereas therapist immediacy was more often helpful in terms of facilitating clients in talking openly about the therapeutic relationship. Meaning: Clinicians can use these results to decide about whether and when to use these interventions. Next Steps: More research is needed about therapist and client variables that influence the use and effectiveness of these interventions.