Self-Disclosing Commonalities Enhances Therapeutic Alliance

By Dr. Omer Liran | Published February 22^nd, 2010, 9:48 AM

Clients come from a wide variety of economical, cultural, racial, and religious backgrounds, and so do psychiatrists. How these variables interact to form and shape the therapeutic alliance is undoubtedly an important factor in treatment outcomes, and every therapist should tactfully employ alliance-building strategies to enhance the therapy and improve client compliance. Carefully selecting self-disclosing commonalities may trigger a positive transference that may improve medication compliance and foster comfort and enthusiasm towards the therapy.

Both the quality and the quantity of mutual commonalities may advance positive alliance. High-quality mutual commonalities refer to commonalities that create a great sense of personal bond, and include race, language, cultural background and religious beliefs. Some of these are self-evident even before the initiation of therapy, while others cannot be known by the client without self-disclosure by the therapist. Other mutual commonalities are more subtle and are of lower quality. For example, when a client reveals how much fun he had while visiting Paris, the therapist may share that he also liked his vacation in Paris. One needs to be careful not to over-disclose, thereby allowing the client’s fantasies to fill-in gaps and maintain the personal bond associated with shared experience. Statistically, the therapist’s experience is likely to deviate from those of the client’s with every additional disclosure, thus disbanding the shared comfort associated with the mutual experience.

Tactfully choosing which commonalities to share and which to withhold should be decided on a case-by-case basis, and the client’s individual beliefs and fantasies should be carefully considered before any self-disclosure. However, successful attempts to increase familiarity in the therapeutic setting by self-disclosing mutual commonalities may increase adherence to treatment, minimize discomfort and its consequential defenses, and result in greater overall satisfaction with treatment for the client.