Clinician Self-Disclosure or Clinician Self-Concealment? Lesbian, Gay and Bisexual Mental Health Practitioners’ Experiences of Therapeutic Relationships

Previous research exploring therapist self disclosure (TSD) indicates that when therapeutically relevant and used sparingly it can have a beneficial effect for the client, particularly when the client is a member of a stigmatised population. There are several limitations to the current literature including the failure to consider contextual variables that may influence the decision making process behind TSD and its impact. The quantitative methodology has mostly utilised analogue designs which may fail to capture the complexity of the topic when applied to clinical practice. There is a dearth of literature exploring the experience of disclosing from the perspective of the clinician. The current study sought to bridge this gap by utilising a qualitative methodology, Interpretative Phenomenological Analysis (IPA), to explore the experiences of lesbian, gay and bisexual (LGB) mental health practitioners disclosing sexual orientation to clients. Eight self identifying LGB clinicians within Leicester Partnership Trust with experiences of disclosing sexual orientation to clients were interviewed for this study. Analysis revealed five super-ordinate themes; a) not just another disclosure b) reaching a make or break disclosure decision c) the experience of disclosing d) the enhancing effects of disclosure and e) the cost of concealment. Each super-ordinate theme contained three sub-ordinate themes. Overall the analysis revealed that disclosing sexuality is a complex, risky and meaning laden experience that requires careful consideration of the potential costs and benefits to the client, clinician and relationship. When a considered disclosure was made the participants experienced enhancing effects. A negative impact was experienced when they felt the need to conceal their sexual orientation. Clearly a complex process, disclosures of this nature were usually infrequent and done with the best interests of the clients and relationship in mind. Strengths and weaknesses of the study and suggestions for further research are discussed.