Client experiences of therapist self-disclosure: a qualitative meta-synthesis, and “you would be able to relate to me if you let me talk. I promise, I’m not so different”. An interpretative phenomenological analysis of gay and lesbian women’s experiences of talking therapy

Dyson, Anna 2025. Client experiences of therapist self-disclosure: a qualitative meta-synthesis, and “you would be able to relate to me if you let me talk. I promise, I’m not so different”. An interpretative phenomenological analysis of gay and lesbian women’s experiences of talking therapy. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

This thesis is submitted in partial fulfilment of the requirements for the Doctorate of Clinical Psychology (DClinPsy) degree. It consists of two papers: a systematic review exploring client experiences of therapist self-disclosure, and an empirical report investigating the experiences of Lesbian/Gay women in therapy. The first paper presents a systematic review of client experiences of therapist self-disclosure (TSD). TSD refers to a therapist sharing personal information about themselves during therapy, typically to develop the therapeutic relationship and reduce power imbalances. While the use of TSD has long been debated within clinical practice, relatively little is known about how clients themselves experience and interpret such disclosures. This review aimed to understand how clients experience TSD and to assess the quality of the research in this area. Thirteen studies were analysed using thematic synthesis, and the quality of the research was judged using the Critical Appraisal Skills Programme (CASP) 2013 Qualitative Checklist. Findings revealed that the methodological quality of the research varied, with many studies lacking transparency around researcher reflexivity, ethical considerations and recruitment methods. There was variation in the way participants experienced TSD. Participants reported a positive experience if they felt the therapist was using it as a deliberate therapeutic tool intended to enhance their progress in therapy. In contrast, if the disclosure was perceived to be irrelevant or therapist-centred, it was experienced negatively. The review concludes by highlighting the need for increased training around the role of consent with TSD and the benefits of reflective practice for disclosing clinicians. The second paper presents an empirical study exploring the experiences of Gay and Lesbian women within therapy. Lesbian women experience higher rates of mental health difficulties in comparison to the general population. However, unlike other members of the Lesbian, Gay, Bisexual, Transgender, Queer plus (LGBTQ+) community, their experiences of therapy have not been explored, meaning little is known about the specific challenges Lesbian/Gay women may face when accessing therapy. This study aimed to address this gap in the literature by exploring the therapy experiences of self-identified lesbian women. Ten participants completed semi-structured online interviews, with their data being analysed using an approach called Interpretative Phenomenological Analysis (IPA). Results revealed the impact of past experiences of discrimination on participants’ interactions in therapy, with a fear of rejection or underlying shame leading participants to dilute or minimise their sexuality. Negative therapeutic experiences resulted from the silencing or pathologising of participants’ sexuality. In contrast, positive experiences resulted from the therapist displaying curiosity about the participants’ lived experiences and making space for discussions relating to sexuality within therapy. These findings demonstrate the need for additional training for therapists on LGBTQ+ competencies and increased awareness of how past experiences of discrimination may be contributing to a client’s current presentation. Together, these papers seek to centre client perspectives on two complex dimensions of therapy: the use of therapist self-disclosure and the lived experiences of lesbians navigating psychological therapy. It is hoped that this thesis contributes to ongoing conversations around equity, ethical practice, and the centrality of relational dynamics in psychological therapy. Comment on language: Throughout this thesis, the term LGBTQ+ (Lesbian, Gay, Transgender, Queer +) is used to refer to people who identify outside of the heteronormative and cis-normative sphere. Although different variations of this acronym exist (LGBT, LGBTQIA+, 2SLGBTQIA+) and the validity of these terms are recognised, the researcher has chosen to use LGBTQ+ for the following reasons: 1) The acronym is widely recognised both within and outside of the Queer community (Thelwall et al., 2022). 2) The + enables those not feeling represented by the previous letters to associate with or distance themselves from the community while retaining autonomy regarding how they wish to identify (Stonewall, 2023). While the participants in the empirical study were comfortable with the term lesbian, the phrase gay women is also used in the title and aims to reflect the diversity of identity preferences within the community.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	18 September 2025
Last Modified:	18 Sep 2025 15:57
URI:	https://orca.cardiff.ac.uk/id/eprint/181172

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