Significant client disclosures in therapy : context, process and effects

Aims: The aims of this research were to explore significant client-identified disclosures that occurred in therapy; specifically, (a) to understand the context, or the factors that contributed to the disclosures, (b) to investigate the process of the disclosure event itself and (c) to track the effe...

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Bibliographic Details
Main Author: Balmforth, Jane
Published: University of Strathclyde 2012
Subjects:
150
Online Access:http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.576424
Description
Summary:Aims: The aims of this research were to explore significant client-identified disclosures that occurred in therapy; specifically, (a) to understand the context, or the factors that contributed to the disclosures, (b) to investigate the process of the disclosure event itself and (c) to track the effects of the disclosure to the end of therapy and beyond. Method: This investigation consisted of a pilot study and a principal study, consisting of six clients who were each interviewed about one significant disclosure that they identified in a session of therapy. The data from both studies were analysed using Comprehensive Process Analysis (CPA), a discoveryoriented, interpretive method. A cross-analysis was then carried out to identify themes, followed by a frequency analysis; finally, an expectancy analysis was carried out to investigate the possible effects of researcher bias. Results: All the clients in the principal study planned to disclose in advance. Although the allian ce was a factor, significant disclosures were not necessarily associated with the presence of a warm, close bond with the therapist. Female clients, older than the therapist, disclosed despite doubts. Important disclosures were generally marked by the client's hesitant, tentative speech and a deepening of experience at one minute after the event. Clients experienced disclosing as helpful, especially when this was recognised by the therapist, as it was the first step to assimilating puzzling and painful material; discussion of the significance of the disclosed material helped progress in therapy. The significance and helpfulness of the disclosures appeared to last over time. Implications for practice: This study provides initial evidence that clients are active in planning disclosures in therapy; therapists may facilitate such disclosures by an awareness of discourse markers, such as hesitant speech, and by attending to covert processes, as well as recognising and acknowledging when a client makes a significant disclosure.