Inferred Exposure and Self-Disclosure in Psychotherapy with Older Patients

The question of the therapists’ self-disclosure and exposure, deliberate or unintentional, has been extensively discussed in recent decades. Young therapists often grapple with the complexities of exposing their age-related information, particularly when working with older patients. We propose the term “inferred exposure” to denote situations in which the exposure is not a matter of choice, it being evident from the therapist’s appearance. In these cases, the therapist has no discretion about whether to divulge this information but how to navigate it constructively. The extant literature does not provide the tools and insights to support young therapists facing these challenges. This article focuses on specific challenges regarding inferred exposure and the need for self-disclosure when working with aging patients. In such cases, therapists are frequently younger than their clients, engendering inherent fundamental gaps that may be discussed or avoided but always influence the therapeutic process. We gathered information from group discussions and supervision sessions with graduate students in training. Using descriptions of therapeutic interactions, we present a framework for deliberating about this inevitable aspect of therapist exposure regarding their age and its effect on treatment. We integrate insights from the literature on self-disclosure to propose strategies for young therapists and their supervisors to utilize inferred exposure effectively, using self-disclosure, nurturing the therapeutic alliance, and addressing alliance ruptures.