Working With Client Lies and Concealment

Resistance to treatment can often manifest as clients keeping secrets, minimizing their disclosures around significant clinical issues, and even occasionally lying. Clients' secrets and lies inevitably affect the process of psychotherapy and, unfortunately, therapists tend not to detect them as they occur.

In this video, Dr. Farber discusses the phenomenon of secrets and lies in therapy and demonstrate how he handles such resistance.

Using illustrative clips from the demonstration session, Dr. Farber discusses ways therapists can recognize and monitor client avoidance and dishonesty, understand the factors that inhibit or facilitate honest disclosure, determine when to accept and when to challenge clients' efforts to stay hidden, and learn to work with the clinical consequences of these behaviors when they occur.

This video features clients portrayed by actors based on actual case materials.

Often the best clinical approach to seemingly-avoided material is to simply ask. Therapists who don't introduce challenging topics can communicate to the client that these areas are off limits.

Whereas client honesty will never be totally unbounded, clinicians who address issues of emotional safety, trust, confidentiality, and disclosure in the earliest stages of therapy — and how these may be impacted by racial, ethnic, gender or sexual orientation differences — and who revisit these issues periodically throughout treatment, are likely to encounter more open and engaged clients. Greater client honesty should be both a focus and goal of clinical work.

Though sometimes such behavior is clinically justifiable in terms of "tact," at other times such behavior is more obvious to clients than therapists believe and can lead to significant alliance ruptures and termination from treatment.

Barry A. Farber received his PhD from Yale University in 1978, and the next year became a member of the clinical psychology faculty at Teachers College, Columbia University, where he's been ever since. He served as Director of Clinical Training there for 24 years, and also served two stints as Dependent Chair.

He has varied interests within the area of psychotherapy research, including the ways in which patients and therapists construct and use representations of the other to further the work of therapy, the nature and consequences of therapists' provision of positive regard, and the extent to which patients, therapists, supervisors and supervisees do and don't disclose to each other and sometimes even lie to each other.

His book, coauthored by Matt Blanchard and Melanie Love, Secrets and Lies in Psychotherapy, will be published by APA Press in the Spring 2019. He is also the author of Self-disclosure in Psychotherapy (Guilford Press), The Psychotherapy of Carl Rogers (with co-authors Patricia Raskin and Debra Brink; Guilford Press), and Rock 'n Roll Wisdom: What Psychologically Astute Lyrics Can Teach about Life and Love (Praeger).

In addition to his research, writing, and teaching, he maintains a small private practice of psychotherapy and is editor of Journal of Clinical Psychology: In Session.

• Blanchard, M., & Farber, B. A. (2016). Lying in psychotherapy: Why and what clients don't tell their therapist about therapy and their relationship. Counseling Psychology Quarterly, 29(1), 90–112.
• Farber, B. A. (2003). Patient self-disclosure: A review of the research. Journal of Clinical Psychology, 59, 589–600.
• Farber, B. A. (2006). Self-disclosure in psychotherapy. New York: Guilford Press.
• Farber, B.A., Berano, K., & Capobianco, J. (2004). Clients' perceptions of the process and consequences of self-disclosure in psychotherapy. Journal of Counseling Psychology, 51, 340–346.

APA Videos

• Behavior Therapy for Obsessive–Compulsive Disorder
  Samuel M. Turner
• Cognitive–Behavioral Therapy for Clients With Multiple Problems
  Gayle Y. Iwamasa
• Functional Analysis and Behavioral Activation for Substance Use
  Carl W. Lejuez
• Personality Disorders
  Jeffrey J. Magnavita
• Responding Therapeutically to Anger
• Responding Therapeutically to Negative Reactions
• Working With Anger
  Lorne Korman

APA Books

• Clinical Dilemmas in Psychotherapy: A Transtheoretical Approach to Psychotherapy Integration
  Douglas J. Scaturo
• How to Survive and Thrive as a Therapist: Information, Ideas, and Resources for Psychologists in Practice
  Kenneth S. Pope and Melba J. T. Vasquez
• Secrets and Lies in Psychotherapy
  Barry A. Farber, Matthew Blanchard, and Melanie Love
• Transforming Negative Reactions to Clients: From Frustration to Compassion
  Abraham W. Wolf, Marvin R. Goldfried, and J. Christopher Muran
• What Therapists Don't Talk About and Why: Understanding Taboos That Hurt Us and Our Clients
  Kenneth S. Pope, Janet L. Sonne, and Beverly Greene