What are Debra’s options at this point and what might the consequences be for each?

Question

Debra Masters, a social worker in private practice, conducted an initial interview with Stephanie Railsback, a young woman also working in the helping professions, who was conflicted about her sexual orientation. Debra was a lesbian herself, open, but discreetly so. As the interview proceeded Debra was increasingly distracted by the question of whether she should disclose her sexual orientation to this client and, if so, when. Her anxiety intensified to such a degree that she had to leave the interview to compose herself and decide what to do to resolve this dilemma.

Answer 1

Debra might choose to return from the “time out” and return to the introductory aspects of engagement and disclose her sexual orientation. This may result in great relief for Stephanie (certainly for Debra), realizing that her therapist is one who can and will understand her conflict and likely has the skills to help her resolve it. Stephanie might also interpret such a disclosure as ill timed and wonder why Debra felt so anxious and compelled to make such a disclosure so early in their relationship. As such, Stephanie may now become distracted and anxious about the relationship and her potential therapist’s ability to focus on Stephanie’s issues rather than her own. The focus of the interview and the relationship for Stephanie now has the potential to shift to Debra, at least until she can fully interpret and assign meaning to the disclosure.
Another option is that Debra could elect to disclose her sexual orientation to Stephanie but choose to make this disclosure somewhat later in the engagement phase of their relationship. This would serve to allow Stephanie to continue to be the focus of the relationship at least until the history and assessment were largely completed. This would also give Debra the opportunity to gather more assessment information specifically for the purpose of trying to predict how Stephanie might respond to such a disclosure and to rule out the possibility that it might do more harm than good. A delay in self-disclosure involves the risk of Stephanie responding with the sense of “Why didn’t you tell me sooner?” and some possible resentment that she didn’t have the opportunity to learn this about Debra sooner.
Debra could elect to disclose her sexual orientation even later in the relationship, like the working or implementation phase of the generalist intervention model where such a disclosure might seem to more naturally complement her efforts to communicate empathy as Stephanie shares more intimate information and is working to go beyond the feelings and content presented. Again, this strategy risks the possibility of Stephanie feeling resentful or even manipulated by Debra’s withholding this information until later in their work.
Debra could decide not to decide and spend the time in the “time out” only to regain her composure and develop a “wait and see” approach to this dilemma. Avoiding a conscious strategic decision about the disclosure serves to increase the possibility that Debra will make the wrong decision for the wrong reason. In this decision she is failing to reflect on her decision making in practice in order to weigh the costs and benefits of each alternative. This approach involves making this practice decision more on intuition, which, in this case, may not be consistent with the best outcome or best interests of the client.
Finally, Debra could elect not to disclose her sexual orientation to Stephanie at all. This scenario ensures that the focus of the therapy remains on Stephanie at the content level. However, at the process level, Debra is likely to continue to wonder whether she is doing the right thing by not disclosing and whether Stephanie will find out about her sexual orientation from another source. This creates a constant tension in the relationship and fails to consider the possibility that that therapeutic progress may be hastened and enhanced through a well-timed, well-thought-out disclosure.