How to Facilitate a Formal Disclosure

1
Aaron Alan, MFT, CSAT Foundry Clinical
Groupaaron_at_foundryclinicalgroup.com310.721.1894
Marnie Breecker, MFT, CSAT, CCPS Center for
Relational Healingmarniebreecker_at_gmail.com310.86
0.9999
2
Facilitating a Formal Disclosure
Aaron Alan, MFT, CSAT Foundry Clinical
Groupaaron_at_foundryclinicalgroup.com310.721.1894
Marnie Breecker, MFT, CSAT, CCPS Center for
Relational Healingmarniebreecker_at_gmail.com310.86
0.9999
3
Why a CEU on Disclosure?

• To give therapists a common frame
• Stress importance of working systemically
• Purpose today is to give info on process rather
  than debate validity
• (thats a whole other conversation!)

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Defining Terms

• Addict person disclosing secrets/lies
• Partner person receiving information
• Discovery when partner first learns of sexual
  acting out
• Disclosure the formal process of sharing
  information about secrets lies related to
  sexual acting out

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What Is Disclosure?

• The transfer of information from one party to
  another
• NOT an amends, but is often considered a piece of
  the amends to a partner
• Disclosure is done only with primary relationship
• Is a part of healing relational trauma
• Is highly stressful for everyone

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Purpose of Disclosure

• To facilitate healing of the trauma created by
  the secrets lies
• Rebuilding trust and intimacy in rx
• (Re)establish equality in the relational dynamic
• To give partners the truth about their
  relationship and the person with which they have
  chosen to share their life.
• Shame reduction for the addict, surrender secrets
  
• Were only as sick as our secrets

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Not All Therapists Agree

• Some clinicians advocate against Disclosure
• Consider it harmful to rx
• Shaming for addict
• Traumatizing for partner
• Creates power differential
• Differ in methodology/protocol
• Differ in content

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Voluntary

• Both clients must agree to participate
• Either one can choose not to participate
• Therapists should tread lightly in advocating for
  disclosure
• Outcome cannot be guaranteed

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The Frame Is Key

• Structure/boundaries
• Carefully planned
• Therapist guided
• Done in session not over kitchen table

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Staggered Disclosure

• When pieces of information come out at different
  times (drips drabs)
• Partners often wonder when other shoe will drop
• Message is theres always more
• Perpetuates trauma for partner
• Similar to compulsively picking a wound

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But S/he Knows Everything

• Formal Disclosures are completed even when a
  partner has been told everything because
  information previously revealed can often be
  incomplete however well intended
• Dont know what they dont know
• Healing/catharsis in process

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When Is Disclosure Done?

• As soon as reasonably possible
• Addict is stabilized and is sexually sober
• After partner has begun therapy and is stabilized

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Contraindications

• When divorce is imminent or relationship is
  ending
• Either person is not emotionally stable
• Unaddressed psychiatric issues
• Unaddressed CD/substance abuse
• One of the treating therapists is NOT on board
• Partner has no therapist and/or deficit of
  support
• Partner is in acute state of trauma
• Addict is continuing to act out / not in recovery

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Preparation
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Pre-Disclosure

• Informed consent (potential pros and cons)
• Disclosure worksheets
• Informing of Disclosure timeline
• Cessation of detective work and
  disclosure-related questions
• No sexual contact
• From time Disclosure is scheduled through
  Post-Disclosure follow-up session
• Safety planning for day of Disclosure

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Informed Consent

• Potential benefits
• Rebuilding trust, intimacy
• End of denial
• Validation that partner is not crazy
• Partner receiving the information to make
  decisions about future
• Establishing equality
• Shame reduction for addict

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Informed Consent

• Potential drawbacks
• Increased conflict in relationship
• Intrusive thoughts for partner other trauma sx
  /retraumatization
• Anger/rage from partner
• Misuse of disclosure in a legal proceeding
• Destructive compensatory bx (addictions,
  compulsions)
• Emotional dysregulation for both people

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Immediately Disclosed Info

• Imminent risk of harm or actual harm
• e.g., safety, legal problems
• Sexually transmitted infections and other related
  health issues
• Imminent risk to reputation and/or social status
• Imminent risk or actual harm to household/family
• Imminent financial impact on household/family

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Consultation

• Confer with all members of treatment team
• Therapist for partner/addict
• Couples therapist (if applicable)
• Psychiatrist (if applicable)
• Group therapist (if applicable)

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Partners Preparation

• Managing of expectations
• Setting realistic expectations
• Psychoeducation about sex addiction
• Disclosure is voluntary
• Informed Consent given
• Exploration of information already known
• Exploration what information partner wishes to
  receive and NOT receive

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Partners Preparation (contd)

• Boundary setting (no detective work, no
  questions, stopping sexual contact with addict,
  etc.)
• Self-care planning for before, during after
• Partners can request certain items/information
  deleted or withheld from the Disclosure, if they
  so choose
• Use worksheets

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Addicts Preparation

• Education about denial and purpose of Disclosure
• Help in presenting information with ownership and
  responsibility-taking
• Understanding importance of empathy for partner
• Disclosure is voluntary
• Informed Consent given

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Addicts Preparation (contd)

• Education and prep for Disclosure process, format
  and structure
• Boundary setting (no sex with partner, etc.)
• Incorporate partners personal parameters into
  Disclosure
• Self-care planning for before, during after

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Disclosure vs. 9th Step

• Made direct amends to such people wherever
  possible, except when to do so would injure them
  or others.
• Disclosure is part of treatment
• Treatment addresses the relationship/system
• Amends is part of recovery
• Recovery addresses the individual
• Pain vs. Injury
• Pain is experienced when informed
• Injury occurred when acting out occurred

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Disclosure vs. 9th Step

• Like resetting a broken bone yes, its painful!
• Disclosure information transfer
• Accounting of the damage
• Necessary for a complete amends to be made
• Otherwise, partner cannot fully understand what
  apology is for
• Amends repairing the damage
• Information vs. taking responsibility and
  accountability

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Content of Disclosure

• Sobriety Date
• List of general addictive behaviors
• List of specific addictive behaviors, including
• Time frames of acting out (dates and/or events)
• Frequency/duration of acting out
• Places/locations of acting out that are relevant
• Money spent on acting out
• Behaviors that have involved another person/people

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Content of Disclosure (contd)

• Exact of sexual partners (or best estimate if
  exact number is incalculable)
• Identity of any acting-out partner that your
  partner may personally know
• Identity of any friends/family members who may
  already be aware of this problem

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Content of Disclosure (contd)

• Information starting from start of relationship
• In some cases, partners may prefer to receive
  information spanning the addicts adult life,
  which can be helpful to contextualize and
  depersonalize the addictive behaviors. In these
  cases, info preceding the relationship is general
  rather than specific.
• Any specific lies told in service of the
  addiction are clarified and the truth is given

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Structure of Disclosure Session
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Therapist Preamble

• What today looks like
• The purpose of Disclosure
• To have a clean slate
• To stop staggered Disclosure (drips drabs)
• There may be info revealed that contradicts what
  addict previously swore was the truth
• Sometimes addicts hold on to info (not to be
  duplicitous), but after Discovery addicts gave
  answer that they feel locked into or truth was
  soft-pedaled
• This is opportunity to come clean about that

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Therapist Preamble (contd)

• Its OK to have feelings about hearing
  contradictory information (normalize this!)
• Addict will read their Disclosure, giving info,
  no excuses, apology or rationale for behavior
• Recommend no physical contact
• OK to ask clarifying questions (timing, etc.)
• If question is more in-depth, we may ask that the
  question be parked so it can be discussed with
  therapist and asked later (post-Disclosure)

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Therapist Preamble (contd)

• Disclosure can be read twice
• Partner can take notes
• Partner leads the pacing
• foot on gas and brake
• OK to pause if partner needs to leave room
• Partner can end Disclosure at any point
• Are you both ready?

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Working Systemically Advocating for the Partner
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Advocating for the Partner

• Advocating for your client with a therapist you
  dont know and/or has differing opinions from you
  regarding Disclosure can be frustrating and
  extremely challenging
• It is important to focus only on doing what is in
  the best interest of your client and ensuring a
  thorough disclosure and safe experience for both
  partners
• Unfortunately, there isnt one universal
  Disclosure process that is agreed upon and
  adopted including within the community of sex
  addiction therapists

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Advocating for the Partner

• If the addicts therapist is a colleague with
  whom you share similar views and approaches to
  Disclosure, your task will be much easier
• Being on the same page regarding the structure
  and content of the disclosure in very important
• When this doesnt happen, each partner will
  receive conflicting information from his/her
  individual therapist, which can easily lead to
  more confusion and frustration for the couple

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Advocating for the Partner

• The time surrounding disclosure is typically
  overwhelming and emotionally excruciating and
  frequently causes further rupture to the
  relationship
• It is the therapists job to work together as a
  team to create the safety necessary for
  disclosure to occur
• Even the best intentioned therapists can succeed
  in splitting a couple when they engage in a power
  struggle over whose approach is best, as it
  leaves the couple arguing over whose therapist is
  right and wrong
• It is our responsibility to do what we can do to
  help our clients heal, not exacerbate their
  problems

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Advocating for the Partner

• Having our own ideas and opinions and being
  reluctant to stray from that doesnt take into
  account the individual needs of each client such
  rigidity makes negotiation, compromise and
  resolution nearly impossible
• If two therapists working with a couple differ in
  their opinions, there must be room for
  negotiation
• Sometimes therapists get caught up in ego, pride
  and/or personality conflicts and can lose sight
  of the goal of Disclosure

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Advocating for the Partner

• All actions should be in service of relational
  healing
• Therapists working together on a disclosure must
  base their decisions and planning first on the
  partners needs, then on the addicts needs
• It is important for therapists to manage
  expectations (both their own and those of their
  clients), as Disclosure does not necessarily mean
  that the couple will stay together or be
  successful in rebuilding intimacy and trust

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Advocating for the Partner

• When there are different opinions among the
  treating therapists, it may help to choose to
  work from a book such as Disclosing Secrets,
  which can ensure that both partners are being
  given the same information

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Timeline for Disclosure

• Once date is set, its imperative clts follow
  therapist recommendations (esp re boundaries)
• Safety planning (separate cars, 24 hrs apart,
  etc)
• If polygraph is incorporated, its usu done
  before Disclosure
• Allow 2 hrs for Disclosure session
• Partner usually has a support session immediately
  after Disclosure session
• Follow-up session is usually 3-7 days after
  Disclosure
• AKA Boundaries Consequences session
• Couples therapy often recommended at this point

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Post-Disclosure Boundaries

• No contact for 24 hours after Disclosure
• Allows partner to absorb info
• Conversations only to news, weather sports
• No physical contact initiated by addict
• No abuse (physical or verbal)
• Copy of disclosure is in partners therapist file
  for review in session
• Partner NEVER leaves with printed copy of
  Disclosure

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Use of Polygraph

• Controversial
• Can be effective as a therapeutic tool level of
  willingness to go to any lengths for repair of
  relationship
• Not gotcha experience (we want addict to pass)
• Is highly shaming for person taking polygraph
• Is highly anxiety-provoking for person waiting on
  results (partner)

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Protocol for Polygraph Use

• Addicts therapist gives polygrapher 2-4
  questions
• Is your disclosure complete and accurate to the
  best of your awareness/recollection?
• Have you acted out sexually since your stated
  sobriety date?
• (1-2 questions generated from partner)
• Results delivered as follows
• Polygrapher Addicts therapist
• Addicts therapist Partners therapist
• Partners therapist Partner

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Disclosure Follow-up Session

• Follow-up questions posed
• Boundaries consequences delivered
• Partner uses a worksheet to assist in processing
• What I need to feel safe in the relationship
  is
• If you are unable to hold this boundary, I will
  take care of myself by
• Cause effect rather than punative to addict
• Partner reads in session to the addict
• Addict SHOULD leave with a printed copy

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Mistakes Commonly Made

• Giving partner a print-out of the Disclosure
• Allowing content to include amends, excuses and
  rationale for behaviors/choices
• Disclosure written as a narrative rather than
  simply stating the facts
• Not editing out equivocations
• probably, maybe, something like (sounds
  like guessing)
• Better to use approximately

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Mistakes Commonly Made

• Not editing out lascivious content
• Better to use clinical terminology
• Failing to interrupt the asking of lascivious
  and/or punitive questions
• How large were her breasts?
• How could you do this if you loved me?
• Including sexual template info in Disclosure
• This is a violation against the addict

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Mistakes Commonly Made

• Allowing victim-stance statements in Disclosure
• I paid for sex because you rejected me that
  night
• Not working systemically
• Trying to manage Disclosure by self
• Not requiring the partner work with a therapist
  through his process even if its just temporary
• Being too rigid about the process
• Holding dates as more important than process /
  safety

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Resources

• Association of Partners of Sex Addicts Trauma
  Specialists (APSATS)
• Non-profit for training/certifying therapists
• Foundry Clinical Group
• www.foundryclinicalgroup.com
• The Center for Relational Healing
• www.lacrh.com
• Disclosing Secrets by Jennifer Schneider, MD

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Facilitating a Formal Disclosure
Aaron Alan, MFT, CSAT Foundry Clinical
Groupaaron_at_foundryclinicalgroup.com310.721.1894
Marnie Breecker, MFT, CSAT, CCPS Center for
Relational Healingmarniebreecker_at_gmail.com310.86
0.9999
50
Aaron Alan, MFT, CSAT Foundry Clinical
Groupaaron_at_foundryclinicalgroup.com310.721.1894
Marnie Breecker, MFT, CSAT, CCPS Center for
Relational Healingmarniebreecker_at_gmail.com310.86
0.9999