Abstract

Background: Research indicates that it is the non-therapeutic factors such as warmth, empathy, understanding and therapeutic alliance that are most effective at creating change. The use of the therapists’ own identities has been highlighted as a means of enhancing such non-specific factors. The literature suggests that 90% of therapists disclose something about themselves to clients; however therapist disclosure is a contentious issue. Furthermore, literature suggests that for therapists working with stigmatised or minority groups (e.g. sexual minorities) disclosure can be beneficial. Guidelines suggest that therapist disclosure of sexual orientation (TDSO) should be used judiciously, while others suggest that TDSO could be classed as the therapist displaying sexualised behaviours towards the client.
Aim: This study aimed to understand the purpose of lesbian, gay, bisexual and trans (LGBT) therapists’ disclosing sexual orientation to clients, while exploring their perceptions and experiences of disclosure.
Method: This study employed a mixed methods design. Purposeful sampling was used to recruit 53 participants from an international sample of LGBT therapists, through professional body listservs and an LGBT therapist directory, to complete an online survey. From this survey 17 participants were purposively sampled to take part in a semi-structured interview. Quantitative and qualitative analysis methods were utilised.
Results: The findings highlighted that 81.1% of the online survey sample reported that they had disclosed their sexuality to a client, with the majority stating that they mainly disclosed to non-heterosexual clients and 73.6% of participants stating that they were not aware of any guidelines related to using TDSO. Chi-square test of independence found that there was no significant association between therapists’ awareness of guidelines and TDSO. A Mann-Whitney U analysis revealed that there was no significant difference between participants post qualification experience (years) and making a disclosure. Three main themes were derived from the qualitative analysis: 1) Function of
1415, RPV, UoN: 4194596, UoL: 12353909, Research Portfolio & Viva Page 10 of 202
disclosure; 2) Function of non-disclosure; 3) How disclosure happens, each of these themes have between two and five subthemes.
Conclusions and recommendations: TDSO was shown to occur mainly with non-heterosexual clients. Disclosure was highlighted to facilitate the enhancement of the therapeutic alliance and create a safe, non-judgemental space for sexual minority clients. However, therapists expressed that concealing their sexuality was common when working with heterosexual clients because of fear of judgement and personal safety. Psychological effects were also noted due to therapists’ concealment. Disclosure was found to happen in various contexts, with direct verbal disclosures being one of many ways that sexuality was disclosed.
It is suggested that supervisors and training courses need to acknowledge the psychological impacts of therapists concealing their sexual identity by showing an understanding of how concealment can lead to increased stress for professionals who are trying to maintain focus on the clients. Sexuality is seen as a key characteristic of being human and concealing it is like trying to conceal your gender or ethnicity. Future guidelines need to reflect the experience of non-heterosexuals working within a heteronormative society and understand the importance of therapists’ rationales for making disclosures.