In this episode, Rachel LaFleur, PhD, Stephanie Davis, PhD, and Julie Brownley, MD, PhD unpack one of the most ethically complicated parts of clinical work: self-disclosure. They explore how disclosure can build rapport, deepen trust, and repair ruptures, but also create shame, blur boundaries, or shift emotional labor onto the client. Key TopicsStephanie opens with the central question: when is disclosure appropriate in therapy, and when does it cross the line? Julie describes training at Hopkins with an extremely strict "never disclose" stance, and how that approach felt limiting and unrealistic in practice. A powerful example: Julie tells a patient she is pregnant, and the patient is upset not because care was worse, but because the lack of disclosure felt strange and disconnected. Stephanie distinguishes between intratherapeutic disclosure—sharing what is happening in the relationship and room—and extratherapeutic disclosure, such as having a child or experiencing depression. Stephanie emphasizes that disclosure is not just biographical facts. It can mean naming what the clinician is experiencing with the client. Rachel highlights how context matters and explains how limited personal sharing can be useful with pediatric patients, especially when rapport is hard to build, such as inviting her dog into a first session. The conversation explores how lived experience can reduce shame and increase connection, while also carrying the risk that clients feel responsible for the clinician’s emotions. Political disclosure comes up as a difficult issue in a polarized climate, with clients sometimes wanting to know whether a therapist shares their views before feeling safe. The clinicians discuss how demographic differences, racism, sexism, religion, and bias can enter the room, and how some moments are clinically relevant while others should be set aside. The group describes the importance of contextualizing visible emotion, including tears or frustration, so clients do not feel they need to take care of the therapist. Stephanie shares a moment when her frustration slipped out, leading to an apology and reflection on how disclosure can be useful when handled honestly. The conversation closes with a research tangent on sexual attraction disclosures, which all three agree are high-risk, ethically fraught, and not something to normalize. 00:00 - Opening the disclosure debate in therapy 01:19 - Julie’s training: a strict no-disclosure culture 02:05 - The pregnancy example that changed Julie's perspective 05:23 - Why disclosure can be necessary in the therapeutic relationship 06:21 - Intratherapeutic vs extratherapeutic disclosure 08:19 - Training differences 10:08 - How clinicians weigh the utility of sharing 12:38 - Telehealth and keeping home life out of session 14:07 - Lived experience as a teaching tool, not a burden 17:11 - Expert power vs referent power in therapy 20:20 - When clients ask for personal disclosure directly 22:24 - Political affiliation and therapeutic safety 25:58 - Choosing a therapist who understands your lived experience 27:31 - The vulnerability of being the therapist 30:27 - Rachel on crying and contextualizing emotion 32:17 - Julie on joy, sadness, and not making it about her 35:20 - Reassurance seeking, shame, and therapeutic timing 36:15 - Being real in the room without becoming the focus 37:47 - Using disclosure to challenge distorted beliefs 39:32 - Building safe relational experiences 40:15 - When tears open the door to deeper work 41:50 - Apologizing after a disclosure misstep 43:10 - Stephanie’s indvertent disclosure and repair 46:08 - Calling out inadequate care without collapsing into blame 49:45 - The power of saying "I could be wrong" 52:27 - The discomfort of sexual attraction disclosures
