To Disclose or Not to Disclose?

Welcome to the second blog in my #OTalk series and the last blog of my placement for a few weeks whilst I’m on Easter break. I was debating just carrying on, but I have an assignment to get done and a few to start so I don’t want to overdo it!

I’ve talked about disclosure multiple times on my blog as it’s something that I often get confused about. As on one hand, it’s good to disclose as it brings in a bit of normality and can enhance the therapeutic relationship. But, on the other hand, it’s not all about me as the occupational therapist it’s all about the service user and needs to remain this way to maintain a client-centred approach. Therefore, finding the right balance can be hard.

At times with my disability being so visible, I almost have to disclose, for example, I have to make people aware of my speech impairment. I just struggle to know how much I can disclose. What’s appropriate? What’s not appropriate? Where do I draw the line?

But I don’t think I’m alone…

“Not yet qualified, but I’m anxious about this… I did disclose in my last non-clinical role with patients I worked with and it helped with rapport, but my experiences now more historic, so less relevant and worried if it’s professional or not? #OTalk“

Anya de Longh, @anyadei 

I agree with this, over time it may not be as relevant as occupational therapy is always changing due to evidence-based practice. From previous experience, I think it depends on what setting you are based in. For example, on my paediatric placement it was a lot more relevant for me to share my experiences than on my placement in assistive technology. But then in assistive technology, I was working with all ages and a range of different disabilities so, therefore, I found that I got asked just as many questions. It depends on the questions as well sometimes if I get a direct question about my experience of occupational therapy, I don’t want to be biased so, therefore I just give a more general answer than going into detail. This is because…

1. It’s not about me.

2. I also need to consider my ethical reasoning to make sure the situation doesn’t escalate.

3. Is it professional?

This takes us back to my original question… is it professional to disclose?

“As a student, I feel I have been taught to never discuss/disclose any of my own experiences. However, sometimes if it feels natural and appropriate to do, I have…if I feel it can offer support to service users. I think it *can* help establish rapport and show empathy #OTalk“

Annie Severn, @AnnieSevern_OT

As a student, I also feel that disclosure is frowned upon, and I remember having a big discussion in the first year about if you should show a service user your Kawa River journey or not (a model to reflect your life). We also came up with the same solution which is if it’s appropriate why not? It may even make someone feel a lot better and enhance the therapeutic relationship. Of course, you still must remain professional and non-judgemental. But I don’t think I’m alone in thinking that disclosure isn’t something to be ‘frowned upon’.

The question is… where and when is disclosure appropriate?

“I agree, I think we use our clinical judgement with whom we share any experience as. Sometimes, even saying “I’ve had a similar experience, I found it tough but this worked for me/ I got through it” can be enough, without going into too much detail! #OTalk“

Kayleigh Wain, @kayleighwainOT

This yet again brings us back to clinical reasoning and judging the situation.

Storytime- on my paediatric placement I visited a child who had just been given a diagnosis of CP and the child’s parents had no clue what CP was. I could have quite easily said ‘’I have CP.’’ But this wouldn’t have been fair as cerebral palsy is an umbrella term and individual needs are different. But, sometimes in other situations, people have directly asked me about my experiences and I’ve just gone into it and around it, in the vaguest way possible again making sure I don’t form any biases.

So, I agree with what has been said here. On my first placement for the first few weeks I didn’t really mention my disability as I didn’t want to make it about me but then in supervision my educator said “Your disability is your weapon, you need to use it”. Which made me think that disclosing to some extent is not actually a bad thing.

“#OTalk consider therapeutic use of self. Yes, whilst not making it all about me! Specifically when patients lead with justification for decisions they’ve made services they need. I can understand where that come from and the impact of occupational deprivation on their lives.“

Debbie Knowles, @debbieduckie

I’ve previously mentioned that the therapeutic relationship is a big element when it comes to disclosure as it helps to build a rapport with the service user. Which is a common theme that keeps coming up during this blog. Patients are going to want guidance and this first-hand experience can help as we’ve discovered and having that understanding helps a patient to feel relieved. No-one wants to feel alone as discussed in my blog a few weeks ago about the online community so, therefore, providing this extra bit of support can help someone during a difficult time.

I now feel a lot more confident about disclosure as I know it is okay to disclose. Yes, it’s not appropriate to tell someone your life story, but to give them a little help using first-hand experience is okay too. When I wrote my personal statement, I wrote ‘I’d like to be an occupational therapist because I can offer both professional and personal experience’ and I can. I’m not saying I’ll tell every service-user that I come across but, my weapon is there if I need to use it in an unbiased way.

Have a good Easter and stay safe!

Thank you for reading,

Georgia
@georgiavine4213
@GeorgiaVineOT