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The February 2010 issue of Counselor contained an article by William A. Rule titled “Self-Disclosure in Addictions Counseling: To Tell or Not to Tell.” We are grateful to Rule for addressing the therapeutic advantages and disadvantages of counselor self-disclosure and for his contribution to the continued discussion of counselor boundaries. However, we disagree with Rule’s statement in the final paragraph of his article, “Therapists and counselors who are also recovering addicts and alcoholics and who wish to be considered professional and effective should not, under any circumstances, self-disclose to his or her client that they are in recovery.” We believe that a recovering counselor’s selective self-disclosure of their recovery can be an effective tool in promoting client recovery. We share our observations with the goal of promoting much-needed dialogue of this important subject.
Further, an interesting question that may be asked is why we are singling out the question around recovery when other questions might also be asked, such as “Are you married? Do you have any children? Have you ever experienced depression ______________________ (fill in the blank)?” Granted, the issue of recovery is unique in the addiction field. One would not likely ask an OB/GYN if she had a baby. But, the question of recovery may typically arise. However, we need to be careful not to focus just on the question of recovery as self-disclosure. This article we will offer information about (1) Counselor Self-Disclosure in General; (2) The Question Behind the Question; and (3) Guidelines for Effective Self-Disclosure. Counselor self-disclosure in general
Discussions of whether recovering addiction counselors should “Tell or Not to Tell” are not new. Dr. Shelia Bloom’s article on the “Role of the
Recovering Alcoholic in the Treatment of Alcoholism” is testament to such concerns 33 years ago. The 1978 “Counseling Alcoholic Clients: A Microcounseling Approach to Basic Communication Skills” training module developed by the National Center for Alcohol Education, includes a section with strategies for training addiction counselors in the use of counselor self-disclosure. Today, most effective entry-level addiction counselor training courses contain structured opportunities to explore the subject, often resulting in lively debates on the “pros” and “cons” of self-disclosure.
Unfortunately, there is not consensus on the subject. It is regrettable that the 2006 publication, TAP 21: Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice, does not even mention the skill of counselor self-disclosure. When estimates of the number of recovering counselors working in this field range from 45 to 60 percent (by self report), we believe more clarity on this subject is essential to effective client care. A good entry point to our discussions is Gutheil’s (2008) suggestion that referring to the issue as one of self-disclosure is simplistic since there are inescapable revelations by clinicians, spontaneous self-disclosures, shared affiliations, non-verbal communications and implicit communications (such as marital status indicated by a ring on the finger or pregnancy of a counselor). Gutheil concludes it is an over-simplification to merely flatly assert, “no-self-disclosure,” and states that “decisions about the therapeutic use of self-disclosure need to be made on a case-by-case basis in the content of the type of therapy offered.” We agree with his statement. The question behind the question
The decision by a recovering counselor “not to tell under any circumstances” when asked if they are in recovery ignores the nature of what often prompts the client to ask the question. The question behind the question is the issue of counselor competency. When a client asks a counselor if they are in recovery, the inquiry is often an attempt by the client to establish trust in the relationship, and confirm that his counselor is able to help. If the counselor responds appropriately, the ensuing dialogue can encourage the client to explore the nature of the therapeutic client/counselor relationship, fundamental boundaries and counseling expectations. For instance, if the counselor responds to the question, “Are you in recovery?” with “That’s a very good question. Thanks for asking. I wonder what prompted you to ask that?” the client could perceive the counselor response as an invitation to explore deeper their motivation for asking the question. This could be an occasion for the client to clarify their assumptions and expectations about the counseling process. Then, based on the work done by the client in the session, the counselor can decide “to tell or not tell” based on an informed judgment as to what’s best for the client. A study by Barrett and Berman (2001) found “that clients in the increased disclosure condition reported less symptom distress, and like their therapist more than clients in the limited disclosure condition.” The study found that “self-disclosure by therapists can in fact strengthen the therapeutic alliance and improve treatment outcomes.” Guidelines for effective self-disclosure
Decisions about the therapeutic use of self-disclosure are appropriate and need to be made on a situation-by-situation basis, based on what’s best for the client. It is beneficial for clients to explore the “question behind the question.” Here are suggested guidelines for therapeutic self-disclosure (Gutheil & Brodsky, 2008):
1. More is Less; Less Is More. Limit your self-disclosure to information that you believe will be helpful to the client by sharing the “mountain tops” of your experience, not the “valleys.” You do not want to shift the focus to yourself for too long, but rather, keep the focus on the client.
2. Maintain Appropriate Boundaries. ecide for yourself what information you will not share with the client. This information might include your financial condition, sexual preference, past legal problems, conflict with employers, etc. Firm boundaries will create safety in the relationship for the client.
3. Remember Which “Hat You Are Wearing.” If you are in recovery and thereby are subject to a “dual relationship,” always be aware of which relationship you are in. For instance if you see a client at a 12 Step meeting, remember that you are not acting as a professional counselor in
that setting.
4. There are Different Levels of Self-Disclosure. Remember, there are different levels of self-disclosure which are often associated with differing results. For instance, sharing you once received a traffic ticket for speeding might have a far lesser impact upon your relationship with a client than sharing you were once incarcerated for DUI.
5. Remember the principle of “cui bono,” which benefits from this disclosure. Is dis-closure serving the needs of the counselor or the client? Is it
being done for the sake of the client, to build the therapeutic alliance, to enhance the therapy process? Does it work?
In conclusion, we encourage continued debate and discussion on this issue, and we thank Rule for raising the important question of appropriate self-disclosure.
References
Barrett, M.S., Berman, J.J. (2001). Evidence Based Mental Health. Is Psychotherapy More Effective When Therapists Disclose Information About Themselves? Journal of Consulting Clinical Psychology. August; 69: 597–603.
Blume, S. (1977) Role of the recovering alcoholic in the treatment of alcoholism. In B. Issin & H. Begliester (Eds.) Biology of Alcoholism, Volume 5: Treatment and Rehabilitation of the Chronic Alcoholic. New York: Plenum Press 545–565.
Gutheil, T. & Brodsky, A. (2008). Preventing Boundary Violations. Guilford Press.
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (2006). Addiction Counseling Competencies, The Knowledge, Skills, and Attitudes of Professional Practice, TAP 21.
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