Clients' secret keeping in outpatient therapy

This research investigated the relation between clients' self-reported secret keeping in therapy and symptomatology. Therapy outpatients at a community hospital (N = 42) completed surveys that asked them to list relevant secrets that they were keeping from their therapists and their reasons for doing so. Over 40% of the clients reported keeping a relevant secret in therapy, and the most frequently listed reason was that they were afraid to express feelings. After adjusting for clients' initial symptomatology, tendency to keep secrets in general, and social desirability scores, the analyses showed that keeping secrets in therapy was a significant predictor of having fewer symptoms. The results support a self-presentational perspective on secret keeping in counseling and suggest that clients may benefit from hiding some undesirable aspects of themselves from their therapists.