A temporal model of patient disclosure in psychotherapy

The primary aim of this study was to identify the temporal elements of patient self-disclosure in psychotherapy. Twenty-one patients in individual psychotherapy participated in a semistructured interview that explored issues related to the intrinsic decision-making process and the emotional experiences involved in disclosing intimate concerns and secrets in therapy; they also completed several Likert-type questions focused on feelings experienced after disclosures. Results indicate a general sequence of events within the disclosure process: (a) a generally positive attitude toward disclosure; (b) ambivalence before disclosure; (c) vulnerability during disclosure; (d) primarily positive emotional experiences immediately after disclosure; (e) a search for and receipt of therapist approval after disclosure; and (f) increased likelihood of future disclosures to therapists and others. The data suggest that, whereas distressful feelings (e.g., shame) often precede and accompany self-disclosure, positive feelings (e.g., relief and pride) tend to predominate during and after disclosure.