Earlier this year as my partner and I were going through the challenging adoption application process, it occurred to me that as a therapist with a busy private practice, I now faced an ethical dilemma 鈥� when the time comes, should I self-disclose to clients that a required month off is for adoption leave? My instinctive response is that I鈥檇 need to give the context for taking several weeks off, to reassure my clients that there was a 鈥榮erious鈥� reason for not being there for them, but to my surprise my supervisor disagreed, in part due to our different therapeutic training and approaches. She urged me to consider the potential adverse effects on clients of such a self-disclosure. I found myself at odds with her stance, meaning we started to bump heads 鈥� our first rift.
As I pondered the dilemma further, I embarked on a journey of enquiry and research. Exploring my emotions and perceptions in personal therapy revealed the complexity of the issue 鈥� why did my gut advocate so strongly for careful selfdisclosure? What caused my frustration with my supervisor鈥檚 response? These explorations propelled me into a reflective process that led me to the conclusion that there is an additional dimension to self-disclosure for LGBTQ+ therapists and clients.聽
The student perspective聽
I started by seeking insights from the students who I work with as a counselling tutor, aware that involving them offered an opportunity for trainees to learn something about therapy in practice but also for us all 鈥� including me 鈥� to learn from each other. In my experience those at the start of their career journey are often not as weighed down by the fear of 鈥榬ule-breaking鈥� as more experienced therapists.聽
The responses to the question 鈥業s it OK for a therapist to self-disclose that the reason for their upcoming break is adoption leave?鈥� were as follows:聽
- There were broadly three groups, with the majority falling into the 鈥榠t depends鈥� camp, and the rest responding with 鈥榳hy not?鈥�, and some with a definite 鈥榥o鈥�.
- Students were able to imagine what it would be like if their therapist disclosed this news to them and were concerned about how such a disclosure could impact clients, depending on their attachment styles.
- The overall consensus was that the self-disclosure could be therapeutically important but that careful consideration on a client-by-client basis was needed.聽
We discussed how for some clients it could enhance the therapeutic relationship, deepening the work, but for some it might initially be triggering and could cause a rift, one that the therapist would ideally aim to repair.
The ethics adviser鈥檚 view
Seeking an 鈥榦fficial鈥� view, I then had a consultation with an adviser from the 香港六合彩精准资料 Ethics hub. The overall conclusion from the ethics adviser was that any self-disclosure is down to the practitioner and their modality, but they also raised several questions I had not considered:聽
- As this situation represented a long-term change for the therapist, what would it mean for my clients to have to sit with the knowledge that I was to become a father, with all the usual demands on time and attention that brings?
- As well as considering how the selfdisclosure might impact clients depending on their attachment styles, a bigger question was raised 鈥� are we still 鈥榙oing therapy鈥� if we are sharing aspects of our lives with clients?
- How would I deal with a professional complaint 鈥� if my self-disclosure about adoption leave negatively affected a client and they complained, would I be able to justify the self-disclosure?聽
I鈥檒l be honest 鈥� the idea that this self-disclosure may result in a professional complaint never even entered my mind as a possibility, and it has given me food for thought. I know that self-disclosure can have an adverse impact on clients, and clients have every right to complain. But it also left me wondering whether operating from a fear-based 鈥榳hat if鈥� position is ever helpful.聽
The social media response聽
To expand the conversation, I sought input from a larger audience through social media, and posed the question, 鈥業s it OK for a therapist to self-disclose that they are taking a month off for adoption leave?鈥� to the 6,000+ followers of a fellow therapist鈥檚 Instagram account @tipsfortherapists):
- As expected, some responded with a clear 鈥榥o鈥�: 鈥榊ou would then be bringing in your own frame of reference rather than staying in the client鈥檚鈥�; 鈥業 think it is very personal information to be disclosing so absolutely not.鈥� Others, however, were in the 鈥榶es鈥� camp: 鈥榃e are human! And it gives context.鈥�; 鈥業t鈥檚 OK but up to the therapist whether they want to share that much information.鈥�
- Overall the consensus leaned towards doing what feels right for the therapist, the client and the relationship. For example, other responses included: 鈥楲ike with most dilemmas, it鈥檚 case-by-case dependent. If there is a strong rapport with the client and it feels comfortable to do so, then yes. If it may disrupt any dynamics and if the themes are too close to home, then no.鈥�; 鈥極K, but being mindful of certain triggers for certain clients is important.鈥櫬�
The parent鈥檚 perspective
To include the views of a therapist who was already a parent, I spoke to Ali Xavier (), a private practitioner who contracts with clients to work on a school termtime basis only. Although she doesn鈥檛 explicitly state that she has children, the term-time-only disclosure through the contract makes this fairly obvious. She raised the following points:聽
- Breaks can offer a therapeutic intervention, an opportunity for the client to be able to explore their responses and also find their own resources to cope when there is a break in the therapy. 鈥楥lients can be asked questions like, how did you cope? What techniques did you use to get through this time? What might you need if we were to have another break like this in the future?鈥� she says.
- Being in private practice makes taking such breaks possible, and those working for a service may not have the autonomy to make this decision.聽
Ali and I agree that the way we practise therapy is evolving, and the profession needs to keep up with the changing culture in general in relation to working parents. When Ali spoke about her work-life balance as a parent, she reflected that ways in which women make their careers work for them have evolved, particularly over the past 30 years. She speculates that her way of working wouldn鈥檛 have been possible as a therapist 30 years ago. Private practice has enabled Ali to make that work, and she doesn鈥檛 think working at an agency would really invite the same autonomy, which is perhaps a reflection of the further catching up needed by the profession.聽
Ali鈥檚 reflection on times changing for her and women led me to the realisation that my planned way of working wouldn鈥檛 have even be discussed 20 years ago as same-sex adoption wasn鈥檛 legal until 2002. Therefore I am left wondering how much the profession has adapted to consider laws changing, to consider the intersectionality of a queer therapist.聽
The queer perspective聽
With that in mind I had an informal conversation with a former supervisor, who is very much queer- informed, to consider the disclosure in more detail from the queer perspective. He gave me some important food for thought:聽
- While the self-disclosure might open a rift in the work, any impact on the client could become an important theme to work through 鈥� for example, if a client didn鈥檛 believe two men should adopt then we could explore those views (if the client wanted to). The question then was whether I鈥檇 be able to depersonalise the situation enough to hold in mind that such a response is not about me adopting but about the client鈥檚 beliefs, process and how it is affecting them.
- It is important for me 鈥� and for all therapists 鈥� to be aware of our own narcissism, which as humans we all have. Do I want to share this part of my life because it is about me and it makes me feel special? If so, how might that impact the client work?
- We need to take time to consider in advance what reactions might come up for each client before any self-disclosure, while leaving room for surprises.
- We need to consider the difference between offering unsolicited information about the reason for my leave versus responding to being asked for more details by clients. It reminded me of the importance of tuning in to what I know about clients and how long we have been working together. I gave some thought to whether my leave announcement should also come with the question, 鈥榃ould you like to know more?鈥� I also needed to bear in mind that some might not need or want to know anything about the reasons for my time off.
- As with any self-disclosure, it might change the way the client sees the therapist, and that might mean the work changes, so we must be ready for that.聽
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Ethical Framework
My final consideration was to consult the principles by which we agree to work under the 香港六合彩精准资料 Ethical Framework, using them as a tool to help structure my thoughts:聽
- Being trustworthy: As therapists we are expecting our clients to trust us. Part of that trust for clients is knowing the focus of their sessions are about them and them alone. One of the skills of a therapist is being able to build that trust 鈥� and intimacy and understanding 鈥� through the way we are with a client in the room, rather than through self-disclosing any specific information or details. But are there situations and contexts where holding back some elements of ourselves becomes a barrier to that trust and to our congruence?
- Autonomy: If a self-disclosure was made and the client chose to leave therapy, or even make a professional complaint, is that not OK? It is not ideal, and a relational therapist would do their utmost to repair any rifts, but autonomy means allowing the client to do what they feel is right. We would of course hope that the therapeutic relationship would allow a client to share why they might have struggled with the news, and provide an opportunity for repair and for deeper work.
- Beneficence: Any self-disclosure can have an impact on a client鈥檚 wellbeing, but there is perhaps particular potential for harm with issues that involve parenthood. I have no doubt that, as already discussed, a disclosure such as this does need to be done on a caseby- case basis. We must protect our clients and ask, 鈥楳ight this self-disclosure affect the client鈥檚 wellbeing?鈥� However, another consideration is challenge. For example, if a client is being explicitly homophobic, unaware that their therapist is gay, will the therapist bring this into the room and challenge the client? Doing so might have an impact on the client鈥檚 wellbeing for a moment, but what healing work could come from that? With this, I think back to something my former supervisor said: 鈥楾herapy isn鈥檛 solely a 鈥渟afe space鈥�, therapy is a 鈥渟afe space鈥� to feel unsafe.鈥�
- Non-maleficence: Much like beneficence, the question goes back to 鈥榃ill this self-disclosure actually harm my client?鈥� This question will ideally provide us with a very quick and easy answer. If it is 鈥榶es鈥�, then the way forward is simple 鈥� if, for example, I was working with a client struggling with childlessness there is a good chance this self-disclosure would harm them. However, if it is a 鈥榥o鈥�, we must go back to considering all of the above.
- Justice: I wondered whether if I chose to disclose to some clients but not others I would be straying into potential 鈥檌njustice鈥� by withholding information, but feel that flexibility with self-disclosure is in the clients鈥� best interest. Some clients might get no information, some might get some, some might get a little more.
- Self-respect: This is an important one for me for several reasons. What damage will it do to me by not self-disclosing? How will I feel about my lack of congruence? As someone who spent the majority of his life (so far) hiding, how can I respect myself by hiding once again?
My decision
The question of whether a therapist should self-disclose about adoption leave proved to be a nuanced and multifaceted dilemma. I am very grateful to my supervisor for challenging my initial thoughts, as it enabled me to really delve deeper. While some staunchly advocated for or against self-disclosure, the majority acknowledged the complexity of the issue, endorsing a case-by-case evaluation.聽
As I went through the enquiry process, what was interesting was what showed through the cracks 鈥� none of the responses considered the intersectionality of my position as a gay man in posing the question. As a visually pregnant woman, of course, this would not be an issue, a point that evaded most respondents.聽
What has stayed with me is the response of my therapist who, when I shared my concerns with a wobble in my voice about the impact that not self-disclosing would have on me, kindly offered me the thought that in doing this perhaps I am modelling self-acceptance, something that takes a while especially for queer people, who make up a large part of my client base. With my self-disclosure I am saying to clients, 鈥業 am comfortable with my identity.鈥� Although there is clearly no 鈥榦fficial鈥� guidance about self-disclosing about adoption leave, why should therapists who, like me, are becoming a parent by adoption be sanctioned for sharing information that would be openly communicated by a visually pregnant therapist, queer or otherwise? Considering adoption is now open for everyone, this dilemma has the potential to impact all genders and sexualities.聽
As I prepare for the future and potential self-disclosure, I carry with me the lessons learned from this exploration 鈥� the need for thoughtful consideration, a client-centred approach, and the acceptance of the inevitable human aspect, which may include making mistakes and learning from them. What will happen in the future when this self-disclosure becomes necessary I will only know when it happens. But I now feel as ready as I can be.聽