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White Therapist Self-Disclosure in Multicultural Contexts:

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Danzer, G. (2017). White therapist self-disclosure in multicultural contexts: A critical discussion of research, boundaries, and bridges. Psychotherapy Bulletin, 52(3), 5-9.

Graham Danzer, Psy.D.

Within the conceptual literature, multicultural therapeutic approaches have long recognized therapist self-disclosure as a skill or even competency (Bitar, Kimball, Bermúdez, & Drew, 2014; Henretty & Levitt, 2010). Self-disclosure has been discussed as an intervention that may build trust and credibility in cross-cultural contexts (Constantine & Kwan, 2003; Henretty & Levitt, 2010). Disclosure may suggest a White therapist’s willingness to take risks, may be experienced as a gesture of openness, and may encourage reciprocal client disclosure (Constantine & Kwan, 2003). These potential benefits are particularly important to consider in light of the high early drop-out rates among clients of color whom are paired with White therapists (Chang & Berk, 2009).

Also within the conceptual literature are cautions against promoting self-disclosure as a more scripted technique rather than as an expression of genuine interest. Cultural factors and the racial composition of therapist and client dyads strongly influence client perceptions of whether therapeutic self-disclosure may be appropriate and under what circumstances (Simonds & Spokes, 2017). White therapists are cautioned against insincere or even patronizing self-disclosures such as random mentions of having friends of color or over-emphasizing perceived similarities (Constantine & Kwan, 2003; LaPorte, Sweifach, & Linzer, 2010). Moreover, it may be considered particularly challenging for White therapists to self-disclose ethically and effectively to clients of color in light of research suggesting that problematic cross-racial counter transference is common and that an exceptional level of self-awareness is necessary to self-disclose effectively, in general (Chang & Berk, 2009; Henretty & Levitt, 2010; LaPorte et al., 2010). These perspectives combine to suggest that both the potential ethical risks and benefits of self-disclosure may be magnified in cross-cultural contexts.

This article will explore the research on White therapist self-disclosure in multicultural contexts and discuss implications for culturally sensitive practice. Research on White therapist self-disclosure to Mexican American/Latino, African American, Asian American, and Native American populations will be reviewed. Areas of convergence within the conceptual and empirical literature, as well as from one client population to another, will be identified and discussed.

Research on White Therapist Self-Disclosure in Multicultural Contexts

Earlier research on cross-cultural experiences with therapist self-disclosure was based on interviews with college students. Cherbosque (1987) surveyed 100 Mexican/Mexican American and 100 White college students in an effort to explore how cultural norms and expectations may relate to perceived self-disclosure impacts. Consistent with aspects of cultural norms, Mexican/Mexican American students expressed stronger preferences for counselor formality and lower levels of disclosure.

Cashwell, Scherbakova, and Cashwell (2003) conducted a prospective interview study of 444 undergraduate students, 294 (or 66.2%) of whom were African American. Cashwell et al. (2003) sought to determine whether racial matching/mismatching might predict a significantly higher level of client desire for therapeutic self-disclosure. African American students in the study reported a significantly stronger preference for therapeutic self-disclosure in instances where they might be paired with a White therapist. Consistent with aspects of the conceptual literature noted previously, Cashwell et al. (2003) hypothesized that the desire for greater amounts of self-disclosure may arise from historical trust barriers associated with ethnic differences.

Also consistent with other perspectives within the cultural literature, studies of real therapy clients of color have consistently found that White therapist self-disclosure had positive impacts on the therapeutic relationship and outcomes when the disclosures were commensurate with the client’s cultural values. Kim et al. (2003) studied the relationship between adherence to traditional values and level of self-disclosure in a single therapy session for a sample of 62 Asian American clients paired with White therapists. Kim et al. (2003) sought to determine the extent to which client adherence to traditional Asian cultural values would predict self-disclosure efficacy. One hypothesis was that therapist disclosure might model and encourage reciprocal disclosure and also help to address client beliefs and experiences of the therapist as an agent of an oppressive system. Commensurate with cultural norms (and therefore also consistent with prior findings on Mexican American college students), Asian American clients in Kim et al.’s (2003) study reported more positive responses to therapist disclosures of problem solving strategies rather than those related to emotionally-focused reassurance, therapist credentials, and feelings.

Lokken and Twohey (2004) conducted a retrospective interview study of 17 Native Americans paired with White therapists. The researchers sought to identify common factors in cross-cultural relationships experienced by clients as meaningful and helpful. In addition to a respectful and caring attitude, casual demeanor, and empathic listening, six of the 13 Native American participants identified that self-disclosure helped to build trust and enhance the therapist’s credibility. Participants endorsing the benefits of self-disclosure noted that it helped to establish a sense of mutuality and common ground akin to nation/tribal values for communalism and interconnection, which further supports the position on self-disclosure tending to be beneficial when it is put forth in a manner consistent with cultural values and expectations.

Qualitative interview studies of both White therapist perspectives (Burkard, Knox, Groen, Perez, & Shirley, 2006) and cultural minority client perspectives (Bitar et al., 2014; Chang & Berk, 2009) consistently identified positive therapeutic outcomes associated with White therapist self-disclosures in general. Chang and Berk (2009) conducted a qualitative interview study of 16 ethnic minority clients paired with White therapists, identifying a significant positive association between White therapist self-disclosure and minority client satisfaction with treatment.

Bitar et al. (2014) conducted a study of 10 court-mandated Mexican American male clients. In keeping with the results from other studies of multicultural populations, clients in Bitar et al.’s (2014) study consistently reported that White therapist self-disclosure encouraged their participation in treatment, lessened the negative effects of hierarchy, modeled appropriate male vulnerability, and normalized their feelings and experiences. Consistent with prior positions on cultural congruence, Bitar et al. (2014) hypothesized that White self-disclosures were well-received because the timing, content, and context were consistent with Mexican American cultural values for respect, dignity, and equality. Carlton’s (1993) dissertation study of 60 male and female adolescents indicated that Latino youth tended to disclose more to therapists who disclosed general and limited information to them. Carlton’s (1993) findings on self-disclosure to Latino youth are more consistent with Cherbosque’s (1987) findings on disclosure to male and female Latino college students and less consistent with Bitar et al.’s (2014) finding on disclosure to court-mandated Latino male adults. Thus, in research studies, younger male and female Latinos were found to prefer less self-disclosure and a more formal therapist approach than did older and court-referred Latino males. Smaller sample sizes prevent full generalizability of findings, though may cautiously suggest that self-disclosures may impact Latino clients differently, depending on generational issues, gender, and whether psychotherapy is of a voluntary or involuntary nature.

Studies make particular mention of the benefits of tactful, provocative, and reciprocal dialogue about the White therapists’ experiences with racism. White therapists in Burkard et al.’s (2006) study frequently indicated that sharing sincere outrage at multicultural client stories of victimization and transparently acknowledging that the therapist too had held racist beliefs appeared to deepen therapeutic relationships with African American, Latino, and Asian American clients. Therapists also reported that these disclosures helped multicultural clients to subsequently address/progress into other important personal issues in therapy. Implications from Chang and Berk’s (2009) study included that self-disclosure, particularly White therapist admissions and reflections concerning racism, might begin to bridge social and power imbalances between White therapists and cultural minority clients as a foundation for change-inspiring relationships.

Conclusions

From the research flows a thought-provoking discussion about the possibility of utilizing self-disclosure to improve engagement and outcomes among therapeutic dyads of White therapists and multicultural clients—not as a scripted technique, but as a genuine and professional form of risk-taking intended to establish a more authentic form of connection. Cautions against disingenuous or inappropriate disclosures are noted, albeit with indication (within the research) that what makes certain disclosures less helpful and more problematic is not unlike what makes any other intervention less helpful and more problematic. To be effective, it is necessary for the therapist to be mindfully aware of what is occurring within the therapeutic relationship and with a conceptualization of relationship dynamics that is equally, openly, and even courageously considerate of both between group and individual differences. For therapists who are members of racially privileged groups, this will likely involve a substantial amount of personal work and self-reflection. Without the necessary awareness and intentionality, self-disclosure is unlikely to be any more helpful than traditional therapeutic techniques that have yet to bridge longstanding gaps in engagement and retention. If flowing from sincerity, trust, and genuine interest, it is possible that self-disclosure may become a better understood and more integral component of clinical psychology’s larger efforts to help members of disenfranchised populations, all within a context where the symbolic oppressor meets the oppressed. In such cases, self-disclosure may be less of a boundary crossing, in a traditional sense, and more of a bridge whereby the therapist crosses over, transcends the racism underneath, and attempts to restore a fuller form of connection to multi-cultural humanity.

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References

Bitar, G. W., Kimball, T., Bermúdez, J. M., & Drew, C. (2014). Therapist self-disclosure and culturally competent care with Mexican-American court mandated clients: A phenomenological study. Contemporary Family Therapy, 36(3), 417-425.

Burkard, A. W., Knox, S., Goren, M., Maria, P., & Hess, S. A. (2006). European American therapist self-disclosure in cross-cultural counseling. Journal of Counseling Psychology, 53(1), 15-25. doi:10.1037/0022-0167.53.1.15

Carlton, C. J. (1993). Effects of therapist self-disclosure and explanation of confidentiality on adolescent client willingness to self-disclose and therapist preference (Doctoral dissertation). Retrieved from ProQuest Dissertations and Theses database. (No UMI No.).

Cashwell C. S., Scherbakova, J., & Cashwell, T. H. (2003). Effect of client and counselor ethnicity on preference for counselor disclosure. Journal of Counseling and Development, 81(2), 196-201. doi: 10.1002/j.1556-6678.2003.tb00242.x

Chang, D., & Berk, A. (2009). Making cross-racial therapy work: A phenomenological study of clients’ experiences of cross-racial therapy. Journal of Counseling Psychology, 56(4), 521-536. doi: 10.1037/a0016905

Cherbosque, J. (1987). Differences between Mexican and American clients in expectations about psychological counseling. Journal of Multicultural Counseling and Development, 15(3), 110-114. doi: 10.1002/j.2161-1912.1987.tb00385.x

Constantine, M. G., & Kwan, K.-L. K. (2003). Cross-cultural considerations of therapist self-disclosure. Journal of Clinical Psychology, 59(5), 581-588. doi: 10.1002/jclp.10160

Henretty, J. R., & Levitt, H. M. (2010). The role of therapist self-disclosure in psychotherapy: Aqualitative review. Clinical Psychology Review, 30(1), 63-77. doi: 10.1016/j.cpr.2009.09.004

Kim, B. S. K., Hill, C. E., Gelso, C. J., Goates, M. K., Asay, P. A., & Harbin, J. M. (2003). Counselor self-disclosure, East Asian American client adherence to Asian cultural values, and counseling process. Journal of Counseling Psychology, 50(3), 324-332. doi: 10.1037/0022-0167.50.3.324

LaPorte, H. H., Sweifach, J., & Linzer, N. (2010). Sharing the trauma: Guidelines for therapist self-disclosure following a catastrophic event. Best Practices in Mental Health, 6(2), 39-56.

Lokken, J. M., & Twohey, D. (2004). American Indian perspectives of Euro-American counseling behavior. Journal of Multicultural Counseling and Development, 32, 320-331.

Simonds, L. M., & Spokes, N. (2017). Therapist self-disclosure and the therapeutic alliance in the treatment of eating problems. Eating Disorders, 25(2), 151-164. doi: 10.1080/10640266.2016.1269557

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