The Use of Case Material: For Whose Benefit? Issues of Confidentialtiy and Therapist Self-Disclosure

Abstract

159 1 Private practice, Cambridge, MA. Correspondence should be addressed to Sara Emerson, MSW, LCSW, CGP, 21 High Street, Cambridge, MA 02138. E-mail: sjemerson1@comcast.net. Confidentiality and therapist self-disclosure are among the major dilemmas for me in using clinical material in teaching, presentations, and publications. Ethically, I believe we have a responsibility to inform our patients that we would like to use the group material in our writing, in essence, for our own benefit. Additionally, I feel that the group and patients should be offered the opportunity to read what we have written and ultimately to give their permission to use the material. How does the knowledge that the material they create will become case material impact or influence the group’s spontaneity? True, we attempt to disguise people’s identities, yet people in a group can often recognize themselves and the interactions that are recounted. On one hand, patients may feel flattered and honored to contribute to the field, allowing others to learn and benefit. On the other hand, they could feel used, violated, and exploited. They are, in fact, doing their job in participating as a group member and, in accordance with the group agreements, in being as open and honest as possible and interacting spontaneously. If they know the theme of the article, are they more likely to perform to that perspective? Many years ago, my then husband was writing about the impact on their partners of the women’s movement and of women having professional aspirations. The issue from his perspective was most relevant in terms of sharing parenting and household responsibilities, areas previously delegated to the wife and mother. One day, in the midst of an argument over some of these issues (as I was a full-time professional mother–wife–woman), he said, “Wait, hold that thought while I write it down! It’ll be perfect for the article I’m working on now.” I am not suggesting that