Eye on Ethics
The Boundaries of Self-Disclosure in Clinical Social Work
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
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.
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
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
The Duration of Self-Disclosure
To Disclose or Not to Disclose: Questions to Ask
• 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.