Psychological inflexibility prospectively predicts client non-disclosure in outpatient psychotherapy

• Published in: Journal of contextual behavioral science 2021-01, Vol.19, p.36-41
• Main Authors: Lear, Mary K., Luoma, Jason B., Chwyl, Christina
• Format: Article
• Language: English
• Subjects: Disclosure; Psychological inflexibility; Psychotherapy; Secrets; Shame
• ISSN: 2212-1447; 2212-1455
• DOI: 10.1016/j.jcbs.2020.11.004

Psychological Inflexibility (PI) is reliably associated with adverse psychological outcomes but little research has explored how PI may affect therapeutic process in psychotherapy. The current study examined the longitudinal influence of PI measured at pre-treatment on likelihood of client non-disclosure of treatment-relevant information at 15-week follow-up and evaluated PI against an empirically supported predictor of non-disclosure, internalized shame. Sixty clients in outpatient psychotherapy at an evidence-based treatment center (Mage= 35.38; 62% female) completed self-report measures of PI and internalized shame at initiation of therapy, 3- and 9-week follow-up and a dichotomous assessment of non-disclosure at 15-week follow-up. We hypothesized that pre-treatment PI and internalized shame would uniquely and positively predict likelihood of non-disclosure at 15-week follow-up. Results indicated that, when tested simultaneously, only pre-treatment PI predicted likelihood of non-disclosure at follow-up (OR = 2.96). This is the first study to test the influence of PI on client non-disclosure and implicates PI as a relevant pre-treatment individual difference variable for identifying clients at higher risk for non-disclosure in psychotherapy. •Psychological inflexibility longitudinally predicts client non-disclosure.•Psychological inflexibility more robustly predicted non-disclosure than shame.•Forty-eight percent of outpatient clients reported non-disclosure in therapy.