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When to disclose and to whom? examining within- and between-client moderators of therapist self disclosure-outcome associations in psychodynamic psychotherapy
Psychotherapy Research ( IF 4.117 ) Pub Date : 2020-12-30 , DOI: 10.1080/10503307.2020.1867774
Tal Alfi-Yogev 1 , Ilanit Hasson-Ohayon 1 , Gal Lazarus 1 , Sharon Ziv-Beiman 2 , Dana Atzil-Slonim 1
Affiliation  

Abstract

Objective: While previous studies have indicated that therapists’ self-disclosure (TSD) can have curative effects, the contextual variables that may moderate the link between TSD and treatment outcome have not been sufficiently explored. Using session-by-session psychotherapy data, we examined the extent to which within-client distress and between-clients emotion regulation difficulties moderated the associations between TSD and session outcomes.

Method: The sample comprised 68 clients treated according to the principles of psychodynamic psychotherapy by 47 therapists in a university clinic. Emotion regulation difficulties were assessed at the beginning of treatment, and functioning and distress levels as well as symptoms were assessed at the beginning of each session. After each session, therapists completed a measure of frequency and centrality of their immediate and non- immediate self-disclosure interventions during the session.

Results: At the within-client level, in sessions marked by high pre-session client distress, immediate TSD was associated with a better next session outcome. At the between-clients level, for clients who had low emotion regulation difficulties, immediate TSD was marginally associated with better outcomes.

Conclusion: These findings highlight the importance of considering within-client level as well as between-clients level variables when deciding upon self-disclosure.



中文翻译:

何时披露,向谁披露?检查心理动力学心理治疗中治疗师自我披露-结果关联的客户内部和客户之间的调解人

摘要

目标:虽然之前的研究表明治疗师的自我披露 (TSD) 可以产生疗效,但尚未充分探讨可能缓和 TSD 与治疗结果之间联系的背景变量。使用逐个会话的心理治疗数据,我们检查了客户内部的痛苦和客户之间的情绪调节困难在多大程度上调节了 TSD 和会话结果之间的关联。

方法:样本包括由大学诊所的 47 名治疗师根据心理动力学心理治疗原则治疗的 68 名来访者。在治疗开始时评估情绪调节困难,并在每次治疗开始时评估功能和痛苦水平以及症状。每次治疗后,治疗师都会在治疗期间完成对他们即时和非即时自我表露干预的频率和中心性的测量。

结果:在客户端内部级别,在会话前客户端压力高的会话中,立即 TSD 与更好的下一个会话结果相关联。在客户之间的层面上,对于情绪调节困难的客户,即时 TSD 与更好的结果略有关联。

结论:这些发现强调了在决定自我披露时考虑客户内部和客户之间级别变量的重要性。

更新日期:2020-12-30
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