Conducting psychotherapy in the Trump era: Therapists' perspectives on political self-disclosure, the therapeutic alliance, and politics in the therapy room

J Clin Psychol. 2019 Sep;75(9):1508-1518. doi: 10.1002/jclp.22801. Epub 2019 May 27.

Abstract

Objective: To examine therapists' perspectives on political self-disclosure, perceived shared values with patients, and the therapeutic alliance.

Method: Therapists from all US states completed a structured survey (N = 268; 62% Democrats; 7% Republicans; 23% independents; 8% others).

Results: Most therapists (87%) reported they discussed politics in-session; 63% reported political self-disclosure (21% explicit; 42% implicit). Therapists who perceived political similarity with most patients were more likely to report political discussions and self-disclosure. Therapists who reported shared political views with a higher percentage of patients, and those who explicitly disclosed, also reported stronger alliances. Clinton supporters reported significant observed preelection-postelection increases in political discussions, increases in patients' expression of negative emotions, and decreases in positive emotions. Trump supporters reported the opposite phenomenon.

Conclusions: Politics play an important role in therapeutic processes as in-session political discussions are common and perceived political similarity may affect decisions to self-disclose and alliance quality.

Keywords: patient-therapist agreement; politics; psychotherapy process; self-disclosure; working alliance.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Politics*
  • Psychotherapy*
  • Self Disclosure*
  • Therapeutic Alliance*
  • United States