"When I saw his face, I recognized him": Visibility, complexity, and therapeutic negotiation of LGBTQ+ identity disclosure in social work practice.

Abstract

This study examines the experiences of lesbian, gay, bisexual, transgender, and queer/questioning, and related (LGBTQ+) individuals with psychiatric diagnoses regarding self-disclosure by LGBTQ+ social workers in mental health services. Understanding their perspectives and reflections contributes to deeper insight into the recovery process and the specific needs of LGBTQ+ clients. Twenty-nine LGBTQ+ individuals with psychiatric diagnoses receiving psychiatric rehabilitation services in Israel participated in semistructured in-depth interviews. Guided by intersectionality theory, this phenomenological study explores how shared identity shapes therapeutic relationships in mental health care. Findings revealed that therapist self-disclosure functions as a complex relational process. Visibility was experienced as a therapeutic resource that fostered trust, safety, and belonging and accelerated the development of the therapeutic alliance. At the same time, shared identity introduced ethical and relational complexities, including blurred boundaries, confidentiality concerns, and the risk of reducing clients' experiences to a single identity axis. Participants further described how professional stance and boundary negotiation enabled processes of rupture and repair, allowing challenges to be transformed into opportunities for deeper therapeutic engagement. The findings suggest that LGBTQ+ identity disclosure is neither inherently beneficial nor harmful, but depends on context, timing, implementation, and client interpretation. When enacted reflexively and supported by supervision, self-disclosure can enhance therapeutic care, reduce stigma, and promote equity in mental health services. These results underscore the need for structured training and institutional support to guide ethical and affirmative disclosure practices in clinical social work. Supporting LGBTQ+ visibility promotes social justice and inclusivity at the policy level. (PsycInfo Database Record (c) 2026 APA, all rights reserved).