Professional Documents
Culture Documents
Social Workers Attitudes
Social Workers Attitudes
DOI 10.1007/s10615-012-0408-z
ORIGINAL PAPER
Abstract This article reports on a study of social workers engagement in self-disclosure. Consistent with theory
and research, participants limited their use of personal selfdisclosure but were more willing to be transparent with
clients. Yet, the social workers in this study did not always
feel prepared by their education to appropriately engage in
self-disclosure nor did they believe their use of this skill
was grounded in theory or research. Many of the participants also didnt feel comfortable talking about self-disclosure in supervision or with colleagues. Findings suggest
that more attention should be devoted to teaching social
work students about appropriate use of self-disclosure,
particularly its different manifestations and its indications
and contraindications. The findings also underscore the
need for more open and direct discussion of this set of
skills in supervision and consultation.
Keywords Use of self Therapist transparency
Self-disclosure
Introduction
Self-disclosure with adult clients remains one of the more
controversial and misunderstood aspects of social work
practice. Authors generally concur that the self of the
therapist is always present in the working relationship
(Reupert 2007, 2008). Yet, others caution that the professionals intentional use of self through behaviors such as
C. Knight (&)
School of Social Work, University of Maryland Baltimore
County, 1000 Hilltop Circle, Baltimore, MD 21250, USA
e-mail: knight@umbc.edu
123
298
123
change. Shulman acknowledges the potential for countertransference and the disruption this can create in the
working relationship. Like Rogers, he cautions that
appropriate use of his skill requires a high level of selfawareness.
Attachment and relational theories are an even more
recent set of constructs that provide support for self disclosure (Arnd-Caddigan and Pozzuto 2008). From a relational perspective, the workers disclosures promote the
working alliance and a positive attachment between the
client and worker (Dewane 2006; Smolar 2003; Tantillo
2004). Relational theorists place greatest emphasis on
therapist transparency though they do not rule out the
therapeutic benefit of self-involving disclosures.
One can be authentic, that is trying to represent
oneself more fully in the relationshipwithout selfdisclosing. For example, authenticity can occur
through verbal meansand through non-verbal
means (e.g., being attentive and emotionally present
in the moment to moment interplay of therapy).
[W]hen self-disclosure is used, it does not equal full
therapist self-revelationit is used to help the patient
recognize that the therapist has been moved in
response to his or her experience or behavior (Tantillo 2004, p. 58).
Relational theorists also observe that the clinicians
transparency can be utilized deliberately to foster client
transference. This provides both client and clinician with a
valuable opportunity to examine the clients interpersonal
relationships through the immediate relationship with the
therapist (Ganzer 2007; Smolar 2003; Tantillo 2004).
In a related vein, intersubjective theorists emphasize
empathy and therapists capacity to understand and appreciate the perspective of the client, as distinct from their own
subjective reality (Renik 1993; Smith 1999). While this
theoretical orientation does not distinguish between the two
types of disclosure, the focus is on transparency, which is
presumed to affirm the clients reality and the therapists
honesty and humanness (Gediman 2006; Gorkin in Maroda
1999). Self-disclosure also helps the client see the impact
that she or he has on the therapist and can be used when
there is a therapeutic impasse. Intersubjective theorists also
recognize the importance of transparency for modeling
healthier, more functional behavior for clients and note that
efforts to remain neutral actually have a negative impact
this process.
It appears that we may have been misguided in our
attempts to appear cool, calm and in control at all times.
Not only because we present an unrealistic model for
our patients or because we may inadvertently squash
their personal disclosures, but also because, over time,
298
123
change. Shulman acknowledges the potential for countertransference and the disruption this can create in the
working relationship. Like Rogers, he cautions that
appropriate use of his skill requires a high level of selfawareness.
Attachment and relational theories are an even more
recent set of constructs that provide support for self disclosure (Arnd-Caddigan and Pozzuto 2008). From a relational perspective, the workers disclosures promote the
working alliance and a positive attachment between the
client and worker (Dewane 2006; Smolar 2003; Tantillo
2004). Relational theorists place greatest emphasis on
therapist transparency though they do not rule out the
therapeutic benefit of self-involving disclosures.
One can be authentic, that is trying to represent
oneself more fully in the relationshipwithout selfdisclosing. For example, authenticity can occur
through verbal meansand through non-verbal
means (e.g., being attentive and emotionally present
in the moment to moment interplay of therapy).
[W]hen self-disclosure is used, it does not equal full
therapist self-revelationit is used to help the patient
recognize that the therapist has been moved in
response to his or her experience or behavior (Tantillo 2004, p. 58).
Relational theorists also observe that the clinicians
transparency can be utilized deliberately to foster client
transference. This provides both client and clinician with a
valuable opportunity to examine the clients interpersonal
relationships through the immediate relationship with the
therapist (Ganzer 2007; Smolar 2003; Tantillo 2004).
In a related vein, intersubjective theorists emphasize
empathy and therapists capacity to understand and appreciate the perspective of the client, as distinct from their own
subjective reality (Renik 1993; Smith 1999). While this
theoretical orientation does not distinguish between the two
types of disclosure, the focus is on transparency, which is
presumed to affirm the clients reality and the therapists
honesty and humanness (Gediman 2006; Gorkin in Maroda
1999). Self-disclosure also helps the client see the impact
that she or he has on the therapist and can be used when
there is a therapeutic impasse. Intersubjective theorists also
recognize the importance of transparency for modeling
healthier, more functional behavior for clients and note that
efforts to remain neutral actually have a negative impact
this process.
It appears that we may have been misguided in our
attempts to appear cool, calm and in control at all times.
Not only because we present an unrealistic model for
our patients or because we may inadvertently squash
their personal disclosures, but also because, over time,
299
Evidence-Based Foundation
A significant limitation of most of the research on selfdisclosure with adult clients is that it has focused only on
self-involving disclosure. Given this limitation, it is not
surprising that findings reveal that while the majority of
clinicians report self-disclosing, they do so infrequently
and express confusion over this behavior (Henretty and
Levitt 2009; Kelly and Rodriguez 2007).
Clinicians, including social workers, are more likely to
engage in self-involving disclosure if the need for it is
unambiguous. Yet, the need for such disclosure is rarely
clear-cut (Heydt and Sherman 2005; Reupert 2007).
Research also indicates that clinicians are particularly
likely to self-disclose to clients similarities and parallel
experiences to convey empathy and understanding and to
disclose their qualifications and credentials to convey
reassurance (Edwards and Murdock 1994; Hanson 2005).
Some evidence suggests that inexperienced clinicians may
disclose less about themselves than their more experienced
counterparts but few other differences based upon therapist
demographics have as yet been observed (Barrett and
Berman 2001). One study did find that when compared to
therapists from another discipline, social workers were less
likely to engage in self-involving disclosure, citing
boundary and ethical issues (Jeffrey and Austin 2007).
Studies of the impact that self-disclosure has on clinical
outcomes have produced contradictory findings, in part due
to the narrow definitions of self-disclosure that typically
have been employed. Most noteworthy is the finding that
there and then, self-involving disclosures generally are less
helpful than here and now transparency (Henretty and
Levitt 2009; Knox and Hill 2003). Findings do reveal that
in the early phase of work, disclosure about professional
background and transparency contribute to the establishment of the working relationship (Hanson 2005; Hendrick
1988; Heydt and Sherman 2005; Reupert 2007). Transparency also has been found to enhance the clients feelings of trust in the clinician, convey normalization,
validation, and understanding of client feelings, and result
in a lessening of symptom distress (Barrett and Berman
2001; Knox et al. 1997).
Self-involving disclosure may encourage client selfdisclosure, but evidence suggests that if too much attention
is devoted to such disclosures, clients willingness to disclose actually can be lessened (Kelly and Rodriguez 2007;
Knox and Hill 2003). On the other hand, evidence also
reveals that non-disclosure also can have a disruptive
influence on the working relationship. When the client asks
for information about the clinician and this information is
not provided, this undermines the clients trust in the clinician (Hanson 2005). Finally, disclosures about sexual
issues, particularly the clinicians feelings about the client,
123
300
2.
3.
Rationale for Study and Research Questions
4.
Given the confusion and controversy that surrounds selfdisclosure with adult clients, it is important to ascertain
clinicians understanding of and engagement in this most
basic of social work skills. There is evidence that this topic
does not receive the attention it deserves in the social work
classroom (Chapman et al. 2003; Heydt and Sherman 2005;
Reupert 2007). During many practitioners training,
therapist self-disclosure is either taboo or portrayed as a
mistake (Henretty and Levitt 2010, p. 70).
Further, evidence suggests that clinicians remain confused and anxious about their engagement in self-disclosing behaviors (Knox and Hill 2003). This may impact their
willingness and ability to discuss self-disclosure with colleagues and supervisors since the findings of several studies
indicate that clinicians typically avoid discussing sensitive
topics in supervision (Ladany et al. 1996; Pisani 2005;
Rosenberger and Hayes 2002; Webb and Wheeler 1998;
Yourman 2003).
The present study focuses on professional social workers understanding of, preparation for, and engagement in
the two sets of self-disclosing behaviors, transparency and
self-involving. The investigation was guided by the following questions:
1.
What are social workers attitudes towards selfdisclosure with adult clients?
To what extent do social workers feel prepared by their
social work education to engage in self-disclosure with
adult clients?
To what extent do social workers feel comfortable
talking to their supervisor, if relevant, and/or colleagues about self-disclosure with adult clients?
Research Method
Research Instrument
The researcher constructed an instrument to measure social
workers attitudes towards and engagement in self-disclosure with adults, incorporating elements of two instruments
which have been used in the past to measure this phenomenon. Respondents were asked to indicate the extent to
which they engaged in behaviors identified in Hendricks
Counselor Disclosure Scale (1988, 1990). Participants were
asked how often they engaged in eight different types of
self-involving disclosures on a four-point Likert-type scale
ranging from very frequently to never (see Table 1).
The author added three questions to this part of the
questionnaire to measure transparency. These included
how often respondents: allowed clients to see their affective responses to what clients share; discussed their
thoughts and discussed their feelings about the things the
client shares. These questions employed the same fourpoint Likert-type scale (see Table 1).
Never
n
Infrequently
Frequently
Very frequently
Total
Self-involving disclosures
Disclose personal relationships
36
19.1
124
66.0
26
13.8
1.1
188
100
51
27.1
109
58.0
27
14.4
.5
188
100
15
8.0
72
38.3
75
39.9
26
13.8
188
100
67
35.6
102
54.3
17
9.0
1.1
188
100
76
40.6
94
50.3
15
8.0
1.1
187
100
100
43
22.9
125
66.5
17
9.0
1.6
188
131
69.3
51
27.0
2.6
1.1
189
100
78
41.7
96
51.3
13
7.0
187
100
15
8.2
90
48.9
76
41.3
1.6
184
100
4.8
48
25.7
110
58.8
20
10.7
187
100
15
8.1
60
32.4
102
55.1
4.3
185
100
123
301
Sample
Five hundred members of the Maryland chapter of the
National Association of Social Workers (NASW) were
randomly selected to serve as subjects in this study.
Chapter members were considered for inclusion if they
reported on their membership form that they were engaged
in some form of direct practice and were currently
employed full- or part-time in social work practice. The
national NASW provided the researcher with the randomly
selected names. In no case was an individual who participated in the pre-test randomly selected to participate in the
actual study.
Strongly
disagree
Disagree
Agree
Strongly
agree
Total
10
5.4
13
7.0
112
60.5
50
20.7
185
100
4.9
26
14.1
108
58.7
41
22.3
184
100
2.2
24
12.9
134
72.0
24
12.9
186
100
12
6.6
76
41.8
81
44.5
13
7.1
182
100
3.2
52
28.1
109
58.9
18
9.7
185
100
1.1
12
6.3
101
53.2
75
39.5
190
100
.5
10
5.3
120
63.5
58
30.7
189
100
SD conveys expertness
27
14.1
118
61.5
31
16.7
10
5.4
186
100
70
36.8
106
55.8
13
6.8
.5
190
100
27
14.2
91
47.9
69
36.3
1.6
190
100
27
43
14.2
22.9
105
112
55.3
59.6
56
30
29.5
16.0
2
3
1.1
1.6
190
188
100
100
Variable
Strongly
disagree
Disagree
Agree
Strongly
agree
Total
%
5
2.6
90
47.4
38
20.0
57
30.0
190
100
14
7.4
108
56.3
67
34.9
0.0
189
100
123
302
Results
Characteristics of Respondents
Respondents Attitudes Towards Self-Disclosure
A total of 192 social workers completed and returned the
research instrument. Twenty-one instruments were
returned with incorrect addresses. Thus, the response rate
among the social workers who received the survey was
40.08 %. Almost 80 % of the respondents were female
(79.2 %, n = 152). Slightly more than 90 % of the social
workers characterized themselves as white (91.0 %,
n = 162), while fifteen (8.4 %) described themselves as
African-American. The average age of the social workers
who participated in this study was 48.9, and their ages
ranged from 23 to 75.
More than 90 % of the respondents had an MSW
(93.2 %, n = 177). The average year in which respondents
graduated with their highest degree was 1985; the year in
which the highest degree was achieved ranged from 1967
to 2006. The average number of years of practice experience among the respondents was 22.3 and ranged from 2 to
39 years. Almost all of the social workers in this study held
a license to practice (95.3 %, n = 183), and the majority of
these social workers held the highest level of license,
licensed certified social worker-clinical (93.7 %, n = 149).
Slightly more than half of the social workers indicated
they worked in private practice (52.4 %, n = 88) while
almost 30 % reported they worked in agency-based practice (29.8 %, n = 50); thirty respondents stated they were
engaged in both agency-based and private practice
(17.9 %). More than one-half of the social workers who
participated in this study indicated they typically saw
123
Discussion
Social Workers Attitudes Towards and Engagement
in Self-Disclosure
Participants generally expressed positive attitudes towards
self-disclosure. However, more than one-third of the participants indicated there were times when they disclosed too
much to clients and 30 % reported they disclosed too little.
Participants reasons for engaging in this skill set mirror
what have been found in previous studies to be its
303
4.
Rather than being a spontaneous from the gut intervention, self-disclosure should result from a thoughtful
assessment of client need and worker intention. As discussed in the section that follows, both education and
supervision have a role to play in this regard.
Previous research has not adequately addressed the
impact that personal characteristics have on clinicians
engagement in self-disclosure even though there is wide
agreement that the self of the clinician is always present
in the working relationship (Reupert 2007, 2008). In the
present study, women were more likely to engage in
123
304
self-involving disclosure and transparency, and AfricanAmerican workers were more likely to use self-involving
disclosure. These findings suggest that decisions regarding
self-disclosure reflect more than just professional judgment. Socialization and culture also may play a role in
determining when and how clinicians use themselves in
professional ways with their clients.
Not surprisingly, self-disclosure also was associated
with the number of sessions clinicians reported having with
clients. Specifically, the more sessions the social workers
in this study reported having with clients, the more likely
they were to engage in self-involving disclosure and be
transparent. As workers gain more experience with the
client, they may feel more confident self-disclosing, perhaps because they have a better sense of the clients needs
and worker-client boundaries are more clearly established.
Role of Education
Approximately one-half of the social workers in this study
did not believe that their social work education prepared
them to engage in self-disclosure. Further, almost one-half
disagreed or strongly disagreed that their use of self-disclosure was grounded in theory and research. These findings
certainly are cause for concern and suggest that social
workers are not receiving adequate preparation for self-disclosure. While the reasons for this are not altogether clear,
findings of previous research suggest that self-disclosure
does not receive the attention it deserves in the social work
curriculum, perhaps because of educators own lack of
understanding of and/or comfort with this skill set (Chapman
et al. 2003; Heydt and Sherman 2005; Reupert 2007).
It is important for educators to create an environment in
the classroom in which students are able and encouraged to
talk openly and honestly about their self-disclosures with
clients. Unfortunately, it can be difficult to create this sort
of environment given curricular demands, class sizes, and
the like (Chapman et al. 2003; Reupert 2009). Yet, it is
necessary if students are to learn to identify and manage
personal feelings and manifestations of countertransference, each of which has the potential to undermine students ability to engage in appropriate self-disclosure with
their clients. Such an environment requires that the
instructor reach for students feelings and deliberately
ask students to discuss their use of self-disclosing behaviors and reflect on their personal reactions to their clients.
The instructor also can serve as a model, engaging in
self-disclosing behaviors in the classroom. For example, in
a study previously conducted by the author that examined
teaching skills in the practice/methods sequence, one of the
most helpful was the instructors willingness to share
mistakes and missteps in her or his own work with clients
(Knight 2002). This sort of intentional self-disclosure also
123
Role of Supervision
More than one-half of the respondents indicated they were
uncomfortable talking with colleagues and/or a supervisor
about self-disclosure. This finding suggests that social
workers are not availing themselves of the guidance of
others when it comes to self-disclosure. This actually is
consistent with research that indicates that in general, clinicians avoid discussing sensitive topics in supervision
(Ladany et al. 1996; Pisani 2005; Rosenberger and Hayes
2002; Webb and Wheeler 1998; Yourman 2003).
Given the controversy that surrounds self-disclosure and
the lack of attention it receives in the academic classroom,
it is possible that the participants viewed it as taboo and
therefore off-limits for discussion with colleagues and
supervisors. Like the classroom instructor, the supervisor
will need to be proactive and ask supervisees to discuss
their use of self-disclosure. This discussion can be guided
by the same five learning objectives that were identified
previously. The supervisor also must reach for supervisees
personal feelings and reactions to their work. This discussion enhances supervisees self-awareness, thereby minimizing the risks of countertransference. This, in turn,
increases the likelihood that supervisees self-disclosures
will be appropriate and helpful to clients.
Analogous to the classroom instructor, the supervisor
also can model the appropriate use of self-disclosure by
engaging in this behavior in the supervisory relationship
(Ganzer and Ornstein 1999). In fact, the supervisors
transparency has been found to foster the supervisory
alliance and encourage supervisee honesty (Nelson et al.
2008). Research also suggests that when the supervisor
reveals therapeutic mistakes and challenges, this facilitates
honest discussion and supervisee openness (Ladany and
Conclusion
Two different types of self-disclosing behaviors have been
identified in the literature: self-involving and transparency.
Consistent with what both theory and research suggest, the
participants in this study limited their use of self-involving
disclosure and were more willing to be transparent. Future
research, using larger, more diverse samples of social
workers, should be devoted to replicating and extending the
findings of the present study. As noted earlier, a noteworthy limitation of the present study was the lack of diversity
of the sample. Thus, future research should focus particular
attention on ascertaining the role that culture and personal
characteristics play in therapists use and clients experience of self-disclosure. In a related vein, future research
305
References
Arnd-Caddigan, M., & Pozzuto, R. (2008). Use of self in relational
clinical social work. Clinical Social Work Journal, 36, 235243.
Barrett, M., & Berman, J. (2001). Is psychotherapy more effective
when therapists disclose information about themselves? Journal
of Consulting and Clinical Psychology, 69, 597603.
Baum, N. (2012). Trap of conflicting needs: Helping professionals in
the wake of a shared traumatic reality. Clinical Social Work
Journal, 40(1), 3745.
Brown, L., & Walker, L. (1990). Feminist therapy perspectives on
self-disclosure. In G. Stricker & M. Fisher (Eds.), Self-disclosure
in the therapeutic relationship. New York: Plenum Press.
Burkard, A., Knox, S., Green, M., Perez, M., & Hess, S. (2006).
European American therapist self-disclosure in cross-cultural
counseling. Journal of Counseling Psychology, 53, 1525.
Chapman, M., Oppenheim, S., Shibusawa, T., & Jackson, H. (2003).
What we bring to practice: Teaching students about professional
use of self. Journal of Teaching in Social Work, 23, 314.
Dewane, C. (2006). Use of self: A primer revisited. Clinical Social
Work Journal, 34, 543558.
Domenici, T. (2006). Reflections on infecting the treatment. Journal
of Gay & Lesbian Psychotherapy, 10, 3956.
Edwards, C., & Murdock, N. (1994). Characteristics of therapist selfdisclosure in the counseling process. Journal of Counseling and
Development, 72, 384389.
Farber, B. (2006). Self-disclosure in psychotherapy. New York:
Guilford Press.
Fisher, C. (2004). Ethical issues in therapy: Therapist self-disclosure
of sexual feelings. Ethics and Behavior, 14, 105121.
123
306
Gabbard, G., & Lester, E. (1995). Boundaries and boundary
violations in psychoanalysis. Washington, DC: American Psychiatric Publishing.
Ganzer, C. (2007). The use of self from a relational perspective.
Clinical Social Work Journal, 35, 117123.
Ganzer, C., & Ornstein, E. (1999). Beyond parallel process:
Relational perspectives on field supervision. Clinical Social
Work Journal, 27, 231247.
Gediman, H. (2006). Facilitating analysis with implicit and explicit
self-disclosures. Psychoanalytic Dialogues, 16, 241262.
Goldfried, M., Burckell, L., & Eubanks-Carter, C. (2003). Therapist
self-disclosure in cognitive-behavior therapy. Journal of Clinical
Psychology, 59, 555568.
Gray, L., Ladany, N., Walker, J., & Ancis, J. (2001). Psychotherapy
trainees experience of counterproductive events in supervision.
Journal of Counseling Psychology, 48, 371383.
Gutheil, T. (2010). Ethical aspects of self-disclosure. Psychiatric
Times, 27, 3941.
Hanson, J. (2005). Should your lips be zipped? How therapist selfdisclosure and non-disclosure affects clients. Counseling and
Psychotherapy Research, 5, 96104.
Hendrick, S. (1988). Counselor self-disclosure. Journal of Counseling
and Development, 66, 419424.
Hendrick, S. (1990). A client perspective on counselor self-disclosure.
Journal of Counseling and Development, 69, 184185.
Henretty, J., & Levitt, H. (2009). The role of therapist self-disclosure
in psychotherapy: A qualitative review. Clinical Psychology
Review, 30, 6377.
Henretty, J. R., & Levitt, H. M. (2010). The role of therapist selfdisclosure in psychotherapy: A qualitative review. Clinical
Psychology Review, 30(1), 6377.
Heydt, M., & Sherman, N. (2005). Conscious use of self: Tuning the
instrument of social work practice with cultural competence.
Journal of Baccalaureate Social Work, 10, 2540.
Ivey, G. (2009). The problems of intentional therapist self-disclosure
in psychoanalytic therapy: A critical response to Zelda Knight.
South African Journal of Psychology, 39, 8692.
Jeffrey, A., & Austin, T. (2007). Perspectives and practices of clinician
self-disclosure to clients: A pilot comparison study of two
disciplines. The American Journal of Family Therapy, 35, 95108.
Jouard, S. (1971). Self-disclosure: An experimental analysis of the
transparent self. New York: Wiley.
Kelly, A., & Rodriguez, R. (2007). Do therapists self-disclose more to
clients with greater symptomology? Psychotherapy: Theory,
Research, Practice, Training, 44, 470475.
Knight, C. (2002). Teaching generalist social work practice: Students
perceptions of the importance of the instructors own practice
experience. Journal of Baccalaureate Social Work, 7, 93112.
Knox, S., Hess, S., Petersen, D., & Hill, C. (1997). A qualitative
analysis of client perceptions of the effects of helpful therapist
self-disclosure in long-term therapy. Journal of Counseling
Psychology, 44, 274283.
Knox, S., & Hill, C. (2003). Therapist self-disclosure: Research-based
suggestions for practitioners. Journal of Clinical Psychology, 59,
529539.
Ladany, N., Hill, C., Corbett, M., & Nutt, E. (1996). The nature, extent,
and importance of what psychotherapy trainees do not disclose to
their supervisors. Journal of Counseling Psychology, 43, 1024.
Ladany, N., & Lehrman-Waterman, D. (1999). The content and
frequency of supervisor self-disclosures and their relationship to
supervisor style and the supervisory working alliance. Counselor
Education and Supervision, 38, 143161.
Mahalik, J., Van Ormer, E., & Simi, N. (2000). Ethical issues in using
self-disclosure in feminist therapy. In M. M. Brabeck (Ed.),
Practicing feminist ethics in psychology (pp. 189201). Washington, DC: American Psychological Association.
123
Author Biography
Carolyn Knight is a Professor in the School of Social Work,
University of Maryland Baltimore County, where she teaches social
work methods courses. Dr. Knight is a licensed social worker with
more than 25 years of experience working individually and in groups
with adult survivors of childhood trauma.