ABSTRACT

Background: Client disclosure of emotionally salient information to a therapist may be an important factor in the effectiveness of Cognitive Behavioural Therapy for Psychosis (CBTp). The present study explores how people engaging with CBTp make sense of sharing emotionally salient information with a therapist and considers how mental health stigma may influence how participants decide whether to share information.

Methods: Eight participants were recruited for semi-structured interviews lasting 30–75 minutes. Interpretive Phenomenological Analysis was used.

Results: Two main themes were identified. I am responsible for controlling the negative impact of disclosure refers to participants’ awareness that sharing distressing experiences may have negative consequences. Participants worried about being judged, such as being seen as abnormal or having the potential to harm others. They also worried about feeling shamed or distressed. Non-disclosure may be a way of avoiding these fears. The second theme, Therapy makes me feel normal, describes how participants viewed themselves more positively from their therapist validating and understanding their experiences.

Conclusions: Internalized stigma-based beliefs may influence self-disclosure, and the therapeutic relationship may provide alternative, positive beliefs about the self as normal. Further research can explore beliefs about self-disclosure and consider micro-affirmations as a therapeutic process.

摘要

背景：客户向治疗师披露情绪显着信息可能是精神病认知行为疗法 (CBTp) 有效性的一个重要因素。本研究探讨了参与 CBTp 的人们如何与治疗师分享情感上的显着信息，并考虑心理健康耻辱如何影响参与者决定是否分享信息的方式。

方法：招募八名参与者进行持续 30-75 分钟的半结构化访谈。使用了解释性现象学分析。

结果：确定了两个主要主题。我负责控制披露的负面影响是指参与者意识到分享痛苦经历可能会产生负面影响。参与者担心被评判，例如被视为异常或有可能伤害他人。他们还担心感到羞耻或痛苦。不披露可能是避免这些恐惧的一种方式。第二个主题，治疗让我感觉正常，描述了参与者如何从他们的治疗师验证和理解他们的经历中更积极地看待自己。

结论：内化的基于污名的信念可能会影响自我表露，治疗关系可能会像正常一样提供关于自我的替代性、积极的信念。进一步的研究可以探索关于自我披露的信念，并将微观肯定视为一种治疗过程。