Client concealment and disclosure of secrets in outpatient psychotherapy

Abstract

We investigated client motivations for concealing vs. disclosing secrets and how concealment and disclosure relate to therapeutic process and outcome. Of 115 participants who were currently in psychotherapy, most had revealed a secret and about half were concealing a secret in psychotherapy. Concealed secrets were most likely to be sexual in nature and were concealed due to shame or embarrassment. Disclosed secrets were most likely to be related to relationships and were disclosed because clients felt they could trust their therapists and because they thought they could benefit from sharing the secret. Clients were most likely to report that they would choose to share their concealed secret if keeping it prevented them from making progress in therapy, and about half of the clients keeping a secret thought they would eventually disclose it. Reflecting back, clients thought they experienced equal levels of negative and positive emotion when they first disclosed their secret, but currently felt more positive and less negative about disclosing. Concealment was negatively related to the real relationship. Implications for research and practice are discussed.

Keywords:

• secrets
• concealment
• disclosure
• psychotherapy process
• treatment progress
• real relationship

Disclosure statement

No potential conflict of interest was reported by the authors.