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The primary aim of the present study was to identify those issues that patients do and don't discuss in therapy, as well as factors that affect disclosure. A total of 147 patients currently in therapy completed a battery of demographic and self-report measures, including the Disclosure to Therapist Inventory-Revised, an 80-item scale. Results indicated that patients most extensively discuss aspects of their personalities that they dislike or worry about, characteristics of their parents that they dislike, and feelings of depression or despair. Least discussed issues tend to be sexual in nature, including sexual feelings or fantasies about one's therapist and interest in pornography. The two factors that emerged as most strongly predictive of overall disclosure were length of time in therapy and strength of the therapeutic alliance. Findings confirm the importance of long-term therapy in allowing clients to access deep-seated concerns and fears.
“I suppose one never does tell anybody everything about oneself. Except one's analyst of course.”
Patient disclosure is a critical factor in the psychotherapeutic process. Beginning with Freud's (1913/1958) fundamental rule that the patient must disclose everything that comes to mind without censorship and extending through the numerous and diverse treatment modalities that have emerged in the last 100 years, most mental health treatments, especially those that are psychodynamically oriented, depend for success