Therapists' Handling of Secrets Between Partners in Couple Therapy
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Western Michigan University ScholarWorks at WMU Dissertations Graduate College 12-2007 Therapists' Handling of Secrets between Partners in Couple Therapy Michael Alan Jansen Western Michigan University Follow this and additional works at: https://scholarworks.wmich.edu/dissertations Part of the Clinical Psychology Commons, and the Counseling Psychology Commons Recommended Citation Jansen, Michael Alan, "Therapists' Handling of Secrets between Partners in Couple Therapy" (2007). Dissertations. 875. https://scholarworks.wmich.edu/dissertations/875 This Dissertation-Open Access is brought to you for free and open access by the Graduate College at ScholarWorks at WMU. It has been accepted for inclusion in Dissertations by an authorized administrator of ScholarWorks at WMU. For more information, please contact [email protected]. THERAPISTS’ HANDLING OF SECRETS BETWEEN PARTNERS IN COUPLE THERAPY by Michael Alan Jansen A Dissertation Submitted to the Faculty of The Graduate College in partial fulfillment of the requirements for the Degree of Doctor of Philosophy Department of Counselor Education and Counseling Psychology Dr. Alan Hovestadt, Advisor Western Michigan University Kalamazoo, Michigan December 2007 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. THERAPISTS’ HANDLING OF SECRETS BETWEEN PARTNERS IN COUPLE THERAPY Michael Alan Jansen, Ph.D. Western Michigan University, 2007 This study examines couple therapists’ policies, procedures, and perspectives regarding secrets between partners in couple therapy. Handling secrets appropriately is necessary to avoid legal, ethical and therapeutic problems, especially when the secret involves contentious or potentially dangerous material such as infidelity, divorce, paternity, and HIV/AIDS infection. One hundred sixty randomly selected Clinical Members of the AAMFT participated in a 38-question researcher-generated mail survey. Data provided descriptive statistics and allowed for between-groups comparisons to explore for differences between therapists with regard to experience and several specific practices related to handling secrets. The study also examined whether courses in HIV/AIDS confidentiality law and limits increased the likelihood of a therapist’s adherence to state laws/statutes pertaining to such secrets. Most respondents reported verbalizing a “professional judgment” approach to secrets. Respondents varied greatly in the reported frequency with which they see partners individually during couple therapy. Clinical experience and supervision were reported as being the most influential in the formation of therapists’ secrets-related policies and practices. One quarter of the respondents indicated having had clients Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. raise a concern about their mishandling of a secret. Therapists’ approach to handling secrets did not appear to have an effect on the frequency of raised concerns. An extra-relational affair, wanting a divorce, and Internet infidelity/chatting were the three most frequently reported types of secrets. Most therapists reported discomfort with keeping secrets between partners, especially when the secret pertained to one partner’s positive HIV/AIDS-status. Couple therapists’ experience did not appear to have a relationship with 1) the approach utilized in handling secrets, 2) the frequency with which therapists see partners individually, 3) the provided level of informed consent, or 4) the frequency with which written consent to share information between partners is obtained. Additionally, most respondents reported not informing their clients of HIV/AIDS confidentiality limits or obtaining written consent to share confidential information between partners. While most respondents reported considerable awareness of HIV/AIDS confidentiality laws, this awareness was not demonstrated in therapists’ responses to vignette questions assessing clinical practice. Training in HIV/AIDS confidentiality laws appears to have an impact only on reported awareness, and not on actual practice. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. UMI Number: 3293171 Copyright 2007 by Jansen, Michael Alan All rights reserved. INFORMATION TO USERS The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleed-through, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. ® UMI UMI Microform 3293171 Copyright 2008 by ProQuest Information and Learning Company. All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. ProQuest Information and Learning Company 300 North Z eeb Road P.O. Box 1346 Ann Arbor, Ml 48106-1346 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Copyright by Michael Alan Jansen 2007 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. What is kept secret does not vanish, neither within the family, nor on the national level, and we keep such secrets from ourselves at our own peril. - Evan Imber-Black (1993, p. 29) Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ACKNOWLEDGEMENTS There are numerous individuals who have assisted me in the completion of this dissertation. First I would like to thank my wife, Wendy, for her eternal love, support and belief in me throughout the dissertation process. I would also like to thank my parents, Ben and Carol, and sisters for their unending support and encouragement. All of you have been, and continue to be, the greatest blessings in my life. I could not have done this without you. Thank you. I would like to express my deepest gratitude to my advisor and dissertation committee chair, Dr. Alan Hovestadt, for his support, knowledge and leadership which has guided me through this arduous process. His enthusiasm, commitment and devotion to his job, and me, are greatly appreciated. In addition, I would like to genuinely thank the other members of my dissertation committee, Dr. Gary Bischof and Dr. Peter Northouse, for their knowledge, dedication, and invaluable insight. My dissertation committee has enriched both my personal and professional growth, and each member has acted as an influential mentor in my life. I am indebted to each of them. I would also like to extend a special thanks to Dr. Paul Yelsma, Dr. Eric Sauer and Dr. Kelly McDonnell for their invaluable assistance and guidance at crucial times during this project. Their professionalism, knowledge, and dedication are noteworthy. A debt of gratitude must also be extended to Dr. Roger Rose, a dear friend and mentor, who has guided me in my professional aspirations since the beginning. Finally, I Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Acknowledgements-Continued would like to express my appreciation to Dan Beaudoin, my statistics technician, and Julie Davis, my editor, for their knowledgeable and professional assistance in completing this dissertation. Michael Alan Jansen iii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS ACKNOWLEDGEMENTS......................................................................................... ii LIST OF TABLES.................. ix LIST OF FIGURES.................................................................................................... x CHAPTER I. INTRODUCTION........................................................................................ 1 Statement of the Problem ........................................................................ 1 The Problems Secrets Can Present .......................................................... 2 The Working Alliance in Couple Therapy.................................... 3 Confidentiality in Couple Therapy................................................ 4 Handling Secrets in Couple Therapy...................................................... 6 The Study of Secrets ................................................................................. 9 The Purpose of the Present Study........................................................... 10 II. REVIEW OF RELATED LITERATURE............................................. 13 Definition of Terms................................................................................... 14 A Conceptual Overview of Secrets......................................................... 15 Separation and Divorce: Arguments for Handling Secrets Skillfully... 17 The Therapeutic Alliance in Couple Therapy........................................ 19 Approaches to Handling Secrets in Couple Therapy............................. 23 The Approach of “No Revelation”................................................ 24 The Approach of “Full Revelation”.............................................. 25 iv Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Table of Contents-Continued CHAPTER The Approach of Using