Eye on Ethics

The Boundaries of Self-Disclosure in Clinical Social Work
By Frederic G. Reamer, PhD
January 11, 2011

Amanda, a clinical social worker at a mental health center, counseled people struggling with major mental health and substance abuse issues. One of Amanda’s clients, Craig, was referred to Amanda by an employer concerned about Craig’s job performance. The psychiatrist at Amanda’s mental health center diagnosed Craig with bipolar disorder and cocaine addiction. Amanda worked with Craig on ways to manage and cope with his co-occurring disorders.

Toward the end of a counseling session, Craig asked Amanda whether she was in recovery. “You seem to know so much about this process,” Craig said. “Have you had personal experience with addiction? Are you in recovery, too?” In fact, Amanda was a recovering alcoholic, but she was unsure about how to respond to Craig’s direct question.

Self-Disclosure in Social Work
Every seasoned clinical social worker has been asked by clients for personal information at one time or another. Common questions include “Are you married?” “Do you have children?” “How old are you?” “Where do you live?” “Are you in recovery?”

Professional life would be much simpler if there were clear-cut guidelines regarding social workers’ self-disclosure to clients. Not surprisingly, however, the issue of self-disclosure in clinical social work is remarkably complex. Many social workers are reluctant to disclose personal information to clients because doing so may stir up complicated transference and countertransference issues that may be counterproductive clinically. A social worker who reveals information about her own recent divorce while counseling a client who is struggling with marital issues may undermine the therapeutic process. A clinical social worker who shares information about his family, recent travels, and daunting health issues may communicate to a client that their relationship is more like a friendship than a professional-client relationship. And in extreme cases, a social worker who shares details about his intimate relationships may do so as a prelude to engaging in a sexual relationship with the client. Clinician self-disclosure can blur boundaries, damage a client’s trust, shift the focus of the relationship away from the client, and undermine the therapy.

However, handled skillfully, judicious self-disclosure can enhance clients’ sense of reciprocity in the clinical relationship, strengthen the therapeutic alliance, facilitate client trust, contribute to a more collaborative worker-client relationship, provide the client with a powerful role model, demonstrate the universality of human frailty, and normalize the client’s challenges. Many social workers believe that carefully considered self-disclosure can be therapeutically useful and a key element in clients’ clinical journey. A client who is mourning his wife's death may feel especially helped by a social worker who discloses that he, too, experienced the loss of a spouse years earlier. A client like Craig may find the therapeutic process more meaningful if he knows that his clinician has experienced recovery-related challenges firsthand.

Ethical Considerations
In addition to the clinical sequelae, social workers must also be mindful of the ethical implications of self-disclosure. Self-disclosure can introduce complex boundary issues that may lead to questionable dual relationships. A clinical social worker who discloses details about her birthday may have to deal with uncomfortable boundary issues if her client brings the social worker an expensive or intimate birthday gift. A social worker who shares personal information about his religion may have to deal with a client’s invitation to attend a local worship service.

Social workers’ management of self-disclosure should take into consideration three key issues: the content of self-disclosure, the degree of intimacy of the self-disclosure, and the duration of the self-disclosure.

The Content of Self-Disclosure
Many social workers believe that disclosure of personal information about a narrow range of topics is appropriate. Examples include disclosure of relatively superficial information about whether the social work has children or where he or she went to college. However, disclosure about other topics is much riskier, for example, information about the social worker’s health struggles or career frustrations. Some topics are clearly inappropriate, such as social workers’ marital or relationship difficulties.

Self-disclosure that may be considered ethically appropriate in one work setting may be considered inappropriate in another. For example, staffers’ self-disclosure about being in recovery may be considered appropriate in a program that treats addictions but inappropriate in a traditional mental health or healthcare agency.

The Intimacy of Self-Disclosure
Disclosure of personal information can be more or less intimate. The more intimate the disclosure, the greater the risk of problematic boundaries. Some social workers argue that the potential risks of any disclosure outweigh the potential benefits. Yet many experienced social workers recognize that modest, judicious self-disclosure of intimate information may be useful therapeutically and is ethically acceptable. For example, a clinician might appropriately mention to a client who is grappling with her teenage daughter's moodiness, "Oh, yes, I remember those years with my own teenage daughter" but would not elaborate further so as to keep the focus on the client.

The Duration of Self-Disclosure
Social workers who engage in a steady stream of self-disclosure run a higher risk of ethics violations. Such a pattern typically demonstrates a social worker's questionable judgment about proper practitioner-client boundaries. Of course, even isolated or brief self-disclosure can violate ethical standards, especially when the content and the intimacy of the disclosure are inappropriate.

To Disclose or Not to Disclose: Questions to Ask
Social workers who contemplate any form of self-disclosure to clients would do well to consider several questions:

• Why is the social worker sharing this information with the client? Whose needs are being met by the self-disclosure? Social workers should carefully examine their motives when sharing personal information with clients. They should consider whether they are disclosing personal information to meet their own needs or their client’s needs. Is it purely for the client or is it a subtle, self-serving expression of the social worker's need to share?

• What are the potential benefits to the client?In what ways does the social worker expect that the self-disclosure will benefit the client?

• What are the potential risks to the client?What is the potential harm to the client if the social worker shares this personal information?

• How would a panel of the social worker's peers view the self-disclosure? Suppose a client files an ethics complaint or lawsuit alleging unethical self-disclosure and related boundary violations. How would members of a state licensing board, a NASW ethics committee, or employment-related colleagues interpret the self-disclosure?

• If the social worker shares personal information, how much information should be shared?Social workers who decide to share personal information with clients should consider sharing relatively superficial, general information that would apply to virtually everyone.

• Should the social worker process the self-disclosure with the client?If social workers decide to share personal information with clients judiciously, they should consider explaining their rationale and acknowledging directly with the client that the self-disclosure is a deliberate decision. Such discussion can provide clients with a valuable message about maintaining clear boundaries.

In recent years, social workers’ grasp of complex boundary issues in the profession has matured. Self-disclosure is among the most challenging boundary issues in social work. It is incumbent on social workers to think carefully about the purposes and nature of self-disclosure and prevailing ethical and risk management guidelines. Most important, skillful management of self-disclosure requires skillful use of self.

— Frederic G. Reamer, PhD, is a professor in the graduate program of the School of Social Work, Rhode Island College. He is the author of many books and articles, and his research has addressed mental health, healthcare, criminal justice, and professional ethics.