The Practice of Self-Disclosure Among Mental Health Professionals: The DÉVOILE Study

Background Self-disclosure, defined as professionals revealing personal information, is a recognized but variably practiced technique in mental health care. While evidence highlights its potential to strengthen therapeutic relationships, the diversity in practices across professions remains insufficiently documented. Aims The DÉVOILE study aimed to (1) examine the frequency of self-disclosure across 25 identified domains among various mental health professions and (2) analyze the contexts and perceptions surrounding its use. Method An online survey was conducted in France (May 2023–May 2024), gathering responses from 929 eligible professionals, including psychiatrists, psychologists, nurses, and peer workers. The participatory study design ensured diverse input in constructing the survey domains. Results A total of 94% of participants reported engaging in self-disclosure, with peer workers disclosing the widest range of content (mean: 18.3 domains), compared to psychiatrists (8.6) and psychologists (7.8). Commonly disclosed topics included work and coping strategies, while relational and personal themes (e.g., sexual or romantic relationships) were less frequently shared. Peer workers also reported the highest perceived mastery and utility of the technique, contrasting with cautious use by psychologists and psychiatrists. Conclusions This study provides an in-depth overview of self-disclosure practices, emphasizing the need for profession-specific guidelines and training. The distinct role of peer workers calls for tailored recommendations to address their unique relational dynamics. Further research is needed to refine the content categories and explore the timing and impact of self-disclosure in mental health care. The Practice of Self-Disclosure Among Mental Health Professionals: The DÉVOILE Study

Background Self-disclosure, defined as professionals revealing personal information, is a recognized but variably practiced technique in mental health care. While evidence highlights its potential to strengthen therapeutic relationships, the diversity in practices across professions remains insufficiently documented. Aims The DÉVOILE study aimed to (1) examine the frequency of self-disclosure across 25 identified domains among various mental health professions and (2) analyze the contexts and perceptions surrounding its use.

An online survey was conducted in France (May 2023–May 2024), gathering responses from 929 eligible professionals, including psychiatrists, psychologists, nurses, and peer workers. The participatory study design ensured diverse input in constructing the survey domains.

A total of 94% of participants reported engaging in self-disclosure, with peer workers disclosing the widest range of content (mean: 18.3 domains), compared to psychiatrists (8.6) and psychologists (7.8). Commonly disclosed topics included work and coping strategies, while relational and personal themes (e.g., sexual or romantic relationships) were less frequently shared. Peer workers also reported the highest perceived mastery and utility of the technique, contrasting with cautious use by psychologists and psychiatrists.

This study provides an in-depth overview of self-disclosure practices, emphasizing the need for profession-specific guidelines and training. The distinct role of peer workers calls for tailored recommendations to address their unique relational dynamics. Further research is needed to refine the content categories and explore the timing and impact of self-disclosure in mental health care.

Self-disclosure, mental health, peer workers, therapeutic relationship, professional practice.

The practice of self-disclosure is not uncommon among psychotherapists. Studies have reported that between 65 and 90 percent of these professionals admit to making intentional disclosures at least occasionally (Danzer, 2018). The objective of this technique is to establish a dynamic of symmetry in the relationship with the individual being supported (Danzer, 2018; Nguyen et al., 2021), to reinforce the therapeutic relationship (Hill et al., 2019), or to facilitate a therapeutic intervention (Danzer, 2018). These interventions are employed across various therapeutic approaches, including cognitive-behavioral, psychoanalytic, and humanistic (Danzer, 2018; Peterson, 2002). This highlights the cross-cutting nature of self-disclosure, demonstrating that it is not confined to a single theoretical framework but is instead integrated into diverse therapeutic practices. Despite the general discouragement of the absence of self-disclosure (Audet, 2011; Henretty et al., 2014) recent recommendations indicate that this promising technique still requires empirical proof (Hill et al., 2019; Norcross & Lambert, 2019). In light of these considerations, the American Psychological Association (APA) has established an evidence-based task force with the objective of identifying the fundamental elements of the therapeutic relationship ( i.e. the Interdivisional APA Task Force on Evidence-Based Relationships and Responsiveness, Norcross & Lambert, 2019)). Among other areas, the task force aims to cover the issue of therapist self-disclosure. The term ”self-disclosure” was defined as ”therapist statements that reveal something personal about the therapist” (Hill & Knox, 2001, p. 256). Nevertheless, there are several indications that self-disclosure is not a technique that is exclusive to therapists. Even outside the field of mental health, numerous professionals, including social workers, may find themselves questioning the most appropriate manner in which to engage in self-disclosure with the individuals with whom they work (Knight, 2012). Additionally, there is a profession in which self-disclosure is a central tool, yet the practitioners are not therapists: peer workers (Byrne et al., 2022). Consequently, for this study purpose, it was decided to define self-disclosure as verbal statements made by a professional, disclosing personal information about themselves or their life outside the context of support. There is a paucity of evidence describing the practice of self-disclosure among the diversity of mental health professionals. The majority of studies in this field focusing psychologists and psychiatrists (D’Aniello & Nguyen, 2017; Danzer, 2018; Hill et al., 2019). A more comprehensive examination of this practice may provide a foundation for empirically informed recommendations that extend beyond the current scope of inquiry. For instance, the question of the content of self-disclosure (i.e. ”What can be revealed?”) represents a pivotal issue in the existing literature (D’Aniello & Nguyen, 2017; Danzer, 2018; Hill et al., 2019). In the existing literature, the most widely used classification of disclosure content is that of Wells (1994). This classification identifies two categories of self-disclosure: the first category encompasses information regarding the professional’s training and practice, while the second category pertains to the professional’s personal life experiences. The limitation of this classification is that the first category is highly specific, while the second is too broad to be informative (Wells, 1994). In 2020, Warrender provided a list of the different contents mentioned in the literature, rather than a categorization. These included appearance, behaviors, beliefs, attitudes, values, thoughts, feelings, life experiences, similarities, family, interests, activities, identity, perspectives, dilemmas, personal strategies and motivations (Warrender, 2020). Knowing what can be revealed means being able to better prepare for the reveal. It is imperative that professionals are aware of the benchmarks that delineate the limits of what can be revealed. This awareness is necessary both to guide professionals in exploring their own boundaries regarding the content they are willing to divulge and to prepare them for self-disclosure in accordance with the recommendations set forth in the literature (Hill et al., 2019). The objective of this study was therefore to examine and describe the practice of self-disclosure among mental health professionals. Specifically, the first aim was to investigate the frequency with which different domains were disclosed by mental health professionals from various professions. The second aim was to examine the key aspects of the practice context and the perceptions associated with self-disclosure.

Construction of the DÉVOILE study A participatory methodology was employed to facilitate the involvement of mental health professionals in the development of the DÉVOILE study. In April 2023, a working group was convened, including 15 professionals from diverse roles—psychiatrists, psychologists, nurses, professional peer-workers, and health managers. The objective was to ensure a representative diversity of perspectives. The qualitative methodology employed was structured around three workshops, each lasting approximately one hour. During these sessions, the group pursued three specific goals: (i) identifying potential domains of self-disclosure through thematic brainstorming, (ii) collaboratively formulating survey items to capture these domains, and (iii) evaluating and refining the clarity and relevance of the items based on their professional expertise. Through iterative discussions, the group defined 25 distinct domains of self-disclosure, which were later operationalized for the survey. These domains are presented in the results section, with detailed formulations provided in the measurement section. Procedure The survey was conducted between May 2023 and May 2024 in France. An online survey was constructed using the free Limesurvey® software. The use of cookies was employed to prevent multiple entries. In order to safeguard the anonymity of participants, a number of parameters were excluded from the Limesurvey® data set, namely the IP address, the date and time of response to the survey. The participants were permitted to answer the questions at their own pace, but they were unable to save their responses in order to complete the questionnaire at a later date. Once informed consent had been obtained, the participants proceeded to complete the questionnaire, which took between 10 and 20 minutes to complete. The order of the scales was not randomized, nor was the order of the items on each scale. At the conclusion of the questionnaire, the participants were asked to answer a series of socio-demographic questions. No participants received any form of financial compensation for their involvement in the study. No participants received any form of financial compensation for their involvement in the study. Participants The online survey was conducted with the assistance of email broadcasts in numerous services supporting people with a diagnosis of mental illness, as well as on social networks ( i.e. LinkedIn). To be eligible for participation, respondents were required to meet two criteria: (i) they must be a professional, and (ii) they must be engaged in work that involves interacting with individuals who have a diagnosis of mental illness. MEASURES Disclosable content Three domains of disclosable content were investigated: psychic experience, relational experience, and the professional’s civil life. For each item, professionals were asked whether they had disclosed a similar content (’never’ or ’already’). With regard to the professional’s psychic experience, we explored disclosures of ‘my emotional feelings about past events ( e.g. mourning, anger, moments of joy, shame, regrets)’, ‘my thoughts or beliefs ( e.g. about myself, others, the world, the future/past)’, ‘metacognitive elements ( e.g. taking a step back, becoming aware)’, ‘my behaviors ( e.g. acts of help, violence, avoidance, clumsiness, approaches, gestures)’, ‘motivations of my behaviors or choices ( e.g. acting for pleasure, constraint, fear)’, ‘my cognitive functioning ( e.g. attentional skills, learning style, memory problems, planning)’, ‘strategies I used to cope ( e.g. solutions, problem-solving strategies)’, ‘information on my mental health ( e.g. serious events, symptoms, diagnoses, care and organization of care)’, ‘memories of my childhood/adolescence ( e.g. relationship with peers or parents, health, school performance)’. In terms of relationships, we explored disclosures of information about ‘my romantic relationships ( e.g. encounters, break-ups, communication within the couple, meeting needs)’, ‘my sexual relationships ( e.g. orientations, practices, risk-taking, screening, consent)’, ‘my parenting practices ( e.g. emotional demonstration, discipline, care, problem-solving, relationship with school)’, ‘my other family relationships ( e.g. (grand)parents, brothers/sisters, uncle/aunt, cousin)’, ‘my friendships ( e.g. close and less close friends)’, ‘my professional relationships ( e.g. colleagues, hierarchy, people under my responsibility)’, ’my relationships with the professionals who have supported me ( e.g. carers, social workers, administrative staff)’, ‘my relationships with the professionals who have supported a member of my family ( e.g. carers, social workers, administrative staff)’. In terms of civil life, we explored disclosures of information about ‘my physical health ( e.g. serious events, symptoms, diagnoses, care and organization of care)’, ‘my hobbies ( e.g. indoor, outdoor, group)’, ‘my spirituality ( e.g. beliefs, practices) ’, ‘my job ( e.g. study, profession, experience, pay)’, ‘my domestic life ( e.g. housework, shopping, budget)’, ‘my administrative procedures ( e.g. official recognition of a person’s status as a worker with a disability, taxes)’, ‘my rights and freedoms ( e.g. during my hospitalisations, my housing, my schooling, my work, my spirituality)’, ‘the stigmatization I have suffered ( e.g. stereotypes about me, discrimination)’. Context of practice and representations concerning unveilings In order to provide information on the context of practice and representations regarding disclosures, participants were required to respond to a series of supplementary questions. One item inquired as to the primary setting in which disclosures are made: during formal exchanges (interviews, therapy, groups) or during informal exchanges (in the corridors, outside, cigarette breaks). One item inquired as to the objective most frequently pursued through the use of self-disclosure: to reinforce the position of the supported individuals, validating and normalizing their perspective or to propose an alternative viewpoint, thereby challenging the position of the supported individual. With regard to representation, one item inquired as to the perceived utility of self-disclosure. Participants were asked to indicate their level of agreement with the statement, ”In my practice, I consider self-disclosure to be:”, with responses ranging from 0 (indicating ”Totally useless”) to 4 (indicating ”Essential”). Another item inquired about the participants’ sense of mastery of the technique, asking them to rate their comfort level with self-disclosure on a scale of 0 (“not at all comfortable”) to 4 (“totally comfortable”). Two additional questions asked whether the participants felt they needed training in self-disclosure (yes/no) or whether they had already received training in this domain (yes/no). Analysis The data were subjected to analysis using the Jamovi software. The analyses were conducted at two levels: an examination of the categorical variables and an examination of the continuous variables. Chi-square tests of independence were employed to ascertain whether there were significant differences between the various mental health professions with regard to the categorical variables. To compare the scores of the different professions on the continuous variables, non-parametric analyses of variance (Kruskal-Wallis ANOVA) were employed, as the data did not follow a normal distribution. In light of the considerable number of statistical tests conducted in this article and on the data from the DÉVOILE study in general, an alpha value of .001 was deemed appropriate as a significance threshold.

Characteristics of participants A total of 1,542 professionals initiated the questionnaire, and 929 participants completed the questionnaire and met the inclusion criteria (students were excluded). Table 1 presents a summary of the characteristics of the participants. | Variables | Professional peer-workers | Psychologists | Psychiatrists | Nurses | Management professionals | Other professions * | | N | 68 | 404 | 95 | 182 | 57 | 123 | | Gender %(N) woman | 57%(39) | 87%(351) | 59%(56) | 77%(140) | 74%(42) | 83%(102) | | Age %(N) 55 y-o | 3%(2) 24%(16) 29%(20) 31%(21) 13%(9) | 11%(43) 45%(182) 25%(99) 15%(60) 5%(20) | 0%(0) 23%(22) 38%(36) 22%(21) 17%(16) | 5%(9) 21%(38) 33%(60) 34%(61 8%(14) | 0%(0) 7%(4) 56%(32) 28%(16) 9%(5) | 4%(5) 26%(32) 34%(42) 26%(32) 10%(12) | | Area of activity %(N) | |||||| | Health Medico-social Independent practice Mixed Other | 47%(32) 32%(22) 6%(4) 4%(3) 10%(7) | 43%(174) 11%(43) 31%(125) 7%(29) 8%(33) | 64%(61) 5%(5) 25%(24) 4%(4) 1%(1) | 84%(153) 4%(8) 4%(7) 1%(2) 7%(12) | 49%(57) 30%(17) 2%(1) 2%(3) 16%(9) | 42%(52) 37%(46) 5%(6) 2%(3) 13%(16) | | Accompanied public %(N) | |||||| | Adults Adolescents Children | 91%(62) 13%(9) 3%(2) | 85%(342) 44%(179) 32%(128) | 82%(78) 41%(40) 23%(22) | 85%(155) 22%(40) 8%(15) | 95%(54) 11%(6) 7%(4) | 90%(111) 17%(21) 12%(15) | | Theoretical framework | |||||| | Biomedical CBT** Psychoanalysis Systemic therapy Humanism Don’t know | 0%(0) 18%(12) 2%(1) 9%(6) 34%(23) 38%(26) | 1%(4) 54%(217) 13%(54) 9%(35) 17%(67) 7%(27) | 15%(14) 33%(31) 9%(8) 14%(13) 21%(20) 38%(26) | 5%(9) 30%(54) 8%(15) 10%(18) 30%(54) 18%(32) | 2%(1) 16%(9) 12%(7) 16%(9) 33%(19) 21%(12) | 0%(0) 15%(18) 6%(7) 20%(25) 30%(37) 29%(36) | | Note. * The other professions category includes social workers, care assistants, educators, workshop instructors, occupational therapists, speech therapists and nutritionists. **CBT: Cognitive behavioural and/or emotional therapy. | The groups of professionals differed significantly in gender (χ²(5,929)=59; p<.001), age (χ²(20,929)=129; p<.001), sector of activity (χ²(20,929)=245; p<.001), theoretical orientation (χ²(25,929)=321; p<.001), training received (χ²(5,929)=96; p<. 001), in training desired (χ²(5,929)=14.9; p<.001), in the accompanied child population (χ²(5,929)=73.8; p<.001), in the accompanied adolescent population (χ²(5,929)=76.9; p<.001) but not in the adult population (χ²(5,929)=8.9; p=.11). Content of self-disclosures by mental health professionals A total of 94% of professionals (N=895) reported having already disclosed at least one domain. Of the 25 available domains, peer-workers reported the widest range of content already disclosed, with 18.3 domains revealed on average (M), with a standard deviation (SD) of 5.02. They were followed by supervisory professionals (health managers, service directors, M=12.68, SD=6.18), and nurses (M=11.49, SD=6.88). Psychologists (M=7.84, EC=5.61) and psychiatrists (M=8.62, EC=6.35) reported the fewest domains revealed. The other unspecified professions reported an average of 12.67 domains revealed (EC=6.53). Professionals therefore differed in the number of domains disclosed according to their profession (χ²(5,929)=170; p<.001, post-hoc tests available in the supplementary material). Disclosure of the professional’s psychic experiences Table 2 describes the content that professionals disclose about their mental life, the domains least disclosed being mental health and childhood memories. A total of 92% of the professionals (N=856) reported that they had already disclosed at least one content of their mental life. Peer-helpers continue to be the professionals who reveal the most overall, particularly in the domains of mental health, metacognitive content, behavior and motivation. Psychologists and psychiatrists reported the fewest disclosures, particularly about their mental health and childhood memories. | Total | Professional peer-workers | Psychologists | Psychiatrists | Nurses | Management professionals | Other professions * | χ² p value | | | N | 929 | 68 | 404 | 95 | 182 | 57 | 123 | | | Domains | |||||||| | My emotional feelings | 64% 596 | 85%(58) | 52%(209) | 53%(52) | 75%(136) | 83%(47) | 76%(94) | 69.2 <.001 | | My beliefs | 61% 565 | 90%(61) | 50%(200) | 57%(54) | 67%(122) | 75%(43) | 70%(85) | 57.8 <.001 | | My metacognitive elements | 59% 549 | 94%(64) | 47%(188) | 55%(52) | 64%(116) | 74%(42) | 71%(87) | 75.1 <.001 | | My behaviors | 48% 448 | 87%(59) | 36%(144) | 45%(43) | 53%(97) | 61%(35) | 57%(70) | 76 <.001 | | Motivations of my behaviors or choices | 47% 439 | 88%(60) | 34%(136) | 43%(41) | 53%(96) | 54%(31) | 61%(75) | 89.1 <.001 | | My cognitive functioning | 68% 633 | 82%(68) | 65%(263) | 57%(54) | 70%(127) | 74%(42) | 74%(91) | 16.6 .005 | | Strategies I used to cope | 73% 675 | 99%(67) | 62%(250) | 63%(60) | 79%(143) | 88%(50) | 86%(105) | 70.6 <.001 | | Information on my mental health | 32% 295 | 97%(65) | 20%(82) | 27%(26) | 30%(55) | 37%(21) | 37%(46) | 156 <.001 | | Memories of my childhood/adolescence | 32% 295 | 66%(45) | 22%(89) | 23%(22) | 39%(71) | 37%(21) | 38%(47) | 65.5 <.001 | Disclosure of the professional’s relational life Table 3 describes what professionals reveal about their relationships. A total of 69% of professionals (N=643) reported having already disclosed at least one domain of their relationship life. Parenting practices and professional relationships were the domains most frequently disclosed, while sexual and romantic relationships were rarely disclosed. Peer-helpers continue to be the professionals who reveal the most overall, particularly in terms of sexual, romantic, parental, friendly and family relationships, and relationships with the professionals who accompany us or have accompanied us. Psychologists and psychiatrists report the least disclosure overall. | Total | Professional peer-workers | Psychologists | Psychiatrists | Nurses | Management professionals | Other professions * | χ² p value | | | N | 929 | 68 | 404 | 95 | 182 | 57 | 123 | | | Domains | |||||||| | My romantic relationships | 17% 153 | 53%(36) | 10%(40) | 7%(7) | 21%(38) | 11%(6) | 21%(26) | 90.1 <.001 | | My sexual relationships | 5% 49 | 25%(17) | 2%(6) | 2%(2) | 6%(10) | 4%(2) | 10%(12) | 71.8 <.001 | | My parenting practices * | 52% 276 | 92%(22) | 49%(90) | 44%(30) | 51%(65) | 52%(23) | 54%(46) | 18.1 .003 | | My other family relationships | 31% 287 | 71%(48) | 18%(74) | 27%(26) | 39%(71) | 35%(20) | 39%(48) | 91 <.001 | | My friendships | 34% 318 | 72%(49) | 24%(95) | 28%(27) | 42%(76) | 39%(22) | 40%(49) | 72 <.001 | | My professional relationships | 42% 388 | 52%(35) | 37%(149) | 39%(37) | 43%(79) | 54%(31) | 46%(57) | 11.9 .04 | | My relationships with the professionals who have supported me | 38% 348 | 82%(56) | 27%(109) | 27%(26) | 42%(76) | 51%(29) | 42%(52) | 88.6 <.001 | | My relationships with the professionals who have supported a member of my family | 27% 247 | 46%(31) | 20%(79) | 20%(19) | 29%(53) | 35%(20) | 37%(45) | 33.9 <.001 | | Note. *The scores for this item were only calculated for the 535 professionals who were parents (i.e. 24 peer helpers, 187 psychologists, 68 psychiatrists, 127 nurses, 44 managers and 85 other professions). | Disclosure of the professional’s civil life Table 4 describes the content that professionals reveal about their private lives. A total of 90% of professionals (N=837) reported having already disclosed at least one domain of their personal life. Work-related information was the most disclosed domain, while spirituality, administrative procedures and rights and freedoms were the least disclosed. Peer-workers continue to be the professionals who disclose the most overall, particularly with regard to stigma, physical health, administrative procedures and rights and freedoms. Psychologists and psychiatrists reported the least disclosure, specifically in terms of spirituality, stigma and rights/freedoms. | Total | Professional peer-workers | Psychologists | Psychiatrists | Nurses | Management professionals | Other professions * | χ² p value | | | N | 929 | 68 | 404 | 95 | 182 | 57 | 123 | | | Domains | |||||||| | My physical health | 40% 372 | 81%(55) | 29%(118) | 28%(27) | 44%(80) | 56%(32) | 49%(60) | 83.6 <.001 | | My hobbies | 66% 615 | 84%(57) | 52%(211) | 58%(55) | 78%(142) | 84%(48) | 83%(102) | 82.6 <.001 | | My spirituality | 20% 182 | 37%(25) | 13%(51) | 17%(16) | 19%(35) | 35%(20) | 29%(35) | 40.5 <.001 | | My job | 78% 721 | 85%(58) | 77%(312) | 74%(70) | 77%(139) | 70%(40) | 83%(102) | 7.16 .21 | | My domestic life | 37% 341 | 63%(43) | 21%(85) | 22%(21) | 47%(85) | 60%(34) | 59%(73) | 120 <.001 | | My administrative procedures | 25% 234 | 72%(49) | 12%(48) | 17%(16) | 30%(54) | 33%(19) | 39%(48) | 137 <.001 | | My rights and freedoms | 22% 200 | 63%(43) | 9%(37) | 14%(13) | 25%(46) | 39%(22) | 32%(39) | 129 <.001 | | The stigmatization I have suffered | 31% 291 | 93%(63) | 17%(69) | 20%(19) | 36%(65) | 35%(20) | 45%(55) | 175 <.001 | Context of practice and representations Table 5 describes the variables relating to the context of self-disclosure and the representations of this practice. With the exception of supervising professionals, most of the professionals involved in self-disclosure reported do so in a formal context. Just as many professionals used self-disclosure to confront the person’s point of view as to reinforce it. Although only 11% of professionals have received training in disclosure, peer-helpers were the most highly trained category (i.e. 44%). Nevertheless, a majority of professionals felt they needed training in this domain. In addition, the scores for perceived usefulness of this practice were around average overall, with the exception of the professional peer-workers, who expressed a greater perception of the usefulness of disclosure (see additional material for post-hoc analyses). Finally, the feeling of mastery of this technique was average overall among the professionals, except among the peer-helpers who reported the highest score for feeling of mastery (see supplementary material for post-hoc analyses). | Total | Professional peer-workers | Psychologists | Psychiatrists | Nurses | Management professionals | Other professions * | χ² p value | | | N | 929 | 68 | 404 | 95 | 182 | 57 | 123 | | | Variables | |||||||| | The main place where self-disclosure is practiced Formal Informal | 74% 690 26% 239 | 74%(50) 27%(18) | 83%(336) 17%(68) | 85%(81) 15%(14) | 65%(118) 35%(64) | 51%(29) 49%(28) | 62%(76) 38%(47) | 57.6 <.001 | | Main objective of self-disclosure confront the person reinforce the person | 56% 518 44% 411 | 54%(37) 46%(31) | 60%(241) 40%(163) | 55%(52) 45%(31) | 54%(182) 46%(84) | 46%(57) 54%(31) | 52%(64) 48%(59) | 5.91 .32 | | Trained in the self-disclosure | 11% 98 | 44%(30) | 10%(40) | 6%(6) | 5%(9) | 0%(0) | 11%(13) | 96 <.001 | | Need for self-disclosure training | 63% 583 | 57%(39) | 60%(244) | 61%(58) | 68%(123) | 49%(28) | 74%(91) | 14.1 .011 | | Perceived utility of this practice /4 | 2.59 (.94) | 3.57(.66) | 2.45(.88) | 2.21(.94) | 2.63(.95) | 2.67(.91) | 2.63(.88) | 98.8 <.001 | | The feeling of mastery of this technique /4 | 2.57 (1.09) | 3.37(0.86) | 2.48(1.09) | 2.45(1.17) | 2.54(1.06) | 2.61(1.05) | 2.55(1.05) | 45.4 <.001 |

The Dévoile study offers a comprehensive overview of the practice of self-disclosure among mental health professionals. The objective of this publication was to provide a descriptive analysis of the data, focusing on the content disclosed and the context of practice. In total, 25 domains of disclosable content were identified and formulated by the group of professionals who constructed the study, extending the previous findings of the scientific litterature on self-disclosure (Warrender, 2020). One of the principal findings of the study is the particularly illuminating profile of professional peer-workers. In our sample, this was the profession with the greatest diversity of content revealed. In particular, professional peer-helpers reportedly discussed topics that other professionals tended to avoid, including sexual relationships, love, stigma, rights and freedoms, and mental health. Furthermore, this is the profession that reports the greatest mastery of self-disclosure and the greatest perceived usefulness of self-disclosure. It can be concluded that self-disclosure represents an essential technique for establishing and maintaining relationships within the context of peer-help. This is particularly the case when compared to other professions. Nevertheless, the extant evidence-based recommendations on this technique are calibrated for psychotherapists (Hill et al., 2019). It would appear that some recommendations are not readily adaptable to the practice of professional peer-support. To illustrate, the meta-analysis conducted by Hill and colleagues (2019) suggests that it is essential to ensure the quality of the therapeutic relationship is optimal prior to utilizing self-disclosure. However, this recommendation is not readily applicable to a professional peer-helper, who, when introducing themselves to a supported person, immediately discloses that they have undergone mental health care, a piece of information that is far from trivial. There is therefore a need for a recommendation specific to this profession, as expressed by the majority of our peer-helper participants. While the majority of international literature concentrates on the topic of self-disclosure among psychotherapists, the results of our study indicate that psychiatrists and psychologists are the professionals who report the least self-disclosure. It is important to note that this does not necessarily indicate suboptimal practice in these professions. The meta-analysis conducted by Hill and colleagues (2019) suggests that self-disclosure should be employed judiciously. It may therefore be hypothesized that our results reflect a measured and restrained use of disclosure. Nevertheless, 10% of psychologists and 6% of psychiatrists indicate that they have received training in self-disclosure, and the majority of them express a desire for more in-depth training on the subject. It may therefore be hypothesized that the results reflect a form of precaution taken with regard to this technique, given the lack of training. In the comparative analysis of self-disclosure content, the results indicate that interpersonal relationships are the least disclosed theme. This result appears to be consistent with those of previous international studies (Danzer, 2018) and francophone studies (Nguyen et al., 2021). Similarly, and in accordance with the existing literature, information on work, leisure activities and coping strategies is the most disclosed content. The study also explores content that has not been previously investigated: rights and freedoms, relationships with professionals who have supported the participants, or with professionals who have supported a loved one. This is particularly the content revealed by the peer-workers participants, and it was possible to question this content thanks to the presence of professional peer-workers in the working group that set up the DÉVOILE study. It is important to acknowledge the limitations of this study. While the primary objective was to explore the practice of self-disclosure among mental health professionals, certain variables of potential interest were not addressed. For example, the study focused solely on the content of disclosures but did not explore the temporal aspect—specifically, when self-disclosure is most appropriate or effective during professional interactions. Additionally, the study does not investigate the level of intimacy or the quality of these disclosures. Another significant limitation concerns the statistical power inherent in a sample of nearly 1,000 participants. Although an adjusted alpha threshold of .001 was used, the large sample size increases the likelihood that even minor differences may emerge as statistically significant. With 31 Chi-square tests performed, the risk of inflated Type I errors is notable. To address this concern, reporting effect sizes for each test would provide a more nuanced interpretation of the findings and help reviewers better contextualize the results. Moreover, the composition of the sample raises questions about its representativeness. The predominance of psychologists with a cognitive-behavioral orientation and the underrepresentation of psychoanalytic practitioners poses a potential bias. While no robust data are available on the exact proportions of these orientations among mental health professionals in France, it is generally acknowledged that psychoanalytic practitioners are at least as numerous as cognitive-behavioral therapists. This imbalance limits the generalizability of the findings, particularly with regard to variations in self-disclosure practices across theoretical orientations. To address this limitation, future analyses could investigate differences in self-disclosure based on professional orientation. For instance, preliminary observations suggest that psychoanalytic practitioners disclose significantly less than cognitive-behavioral therapists. Confirming such trends would enrich the understanding of self-disclosure practices within specific therapeutic frameworks. Finally, the categorization of disclosure content may appear arbitrary and incomplete. For example, physical health is currently grouped within the ’civil life’ dimension, while a more comprehensive framework could include disclosures related to physical sensations, hygiene, and body maintenance within a distinct ’physical and bodily life’ category. Future research should aim to address these limitations by exploring the timing of disclosures, refining content categorizations, ensuring more balanced representation of theoretical orientations, and employing methodologies to mitigate the risks associated with statistical over-powering.

This study offers an unparalleled overview of the practice of self-disclosure among mental health professionals, identifying 25 domains of disclosable content. Professional peer-workers are distinguished by a diverse array of disclosable content and a high perception of the efficacy of self-disclosure, underscoring the necessity for tailored recommendations for this profession. Psychiatrists and psychologists disclosed less, which may reflect a cautious use of this technique. Our results also demonstrate that interpersonal relationships are the least disclosed theme, while work, leisure and coping strategies are the most frequently discussed. In light of these results, further research is required to explore the practice of self-disclosure and to provide empirical support for recommendations for good practice. DISCLOSURE STATEMENT No potential conflict of interest was reported by the author(s). FUNDING The author(s) reported there is no funding associated with the work featured in this article. ETHICS APPROVAL STATEMENT This study did not require formal ethics committee approval, as it adhered to French legislation on non-interventional research. All procedures were conducted in accordance with the ethical standards of the Declaration of Helsinki and relevant national guidelines.

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Authors Metrics & Citations Metrics Article Usage 616views 242downloads Citations Download citation Kevin-Marc Valery, Lee ANTOINE, Julien BONILLA-GUERRERO, et al. The Practice of Self-Disclosure Among Mental Health Professionals: The DÉVOILE Study. Authorea. 05 January 2025. DOI: https://doi.org/10.22541/au.173607111.16598877/v1 DOI: https://doi.org/10.22541/au.173607111.16598877/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu.