Wednesday, October 20, 2010

Disclosure in the therapy process

How to talk about therapy without talking about therapy.

In other discussions, I emphasized the importance of full disclosure. I recognize the importance, however, of full disclosure occurring in a meaningful way usually near the end of the therapy process. It is also important for some type of ongoing disclosure to occur along the way that fosters healing and trust in the relationship. Below are a few ideas on how to talk about the therapy process without getting bogged down in the details of the history. Eventually the history will be shared.

1) Both individuals in the relationship have to agree to this process. I typically meet with the client and partner near the beginning of therapy to talk the process through, and clarify the guidelines.

2) Clients are encouraged to talk about their internal process, without necessarily disclosing the content. This is where the client can share feeling statements from therapy. As an example, “I realized I fell sad which is a trigger in my acting out cycle…”

3) Clients are encouraged to talk about the “lessons learned” from therapy. For example, “Today’s topic was on intimacy, and I realize I need to develop my skills in emotional intimacy.”

4) Clients are encouraged to develop assertive communication skills to express needs, desires and requests. All behavior is goal focused, including sexual compulsivity. Identifying healthy ways to get needs meet reduces the future risk of acting out.

My experience is when the client learns how to engage in these smaller disclosures, the relationship experiences healing. Occasional intermediate sessions with the partner can foster this process. It is this healing that allows the full disclosure to occur. Yes, couples therapy will still be necessary but much of that work is helped by the ongoing disclosure.

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