Exploring Clients’ Experiences of Disclosing Childhood Adversity to Mental Health Professionals

Introduction: There are gaps within existing literature exploring the experiences of clients disclosing childhood adversity to mental health professionals. Whilst research concerning barriers to disclosing abuse and neglect from the professionals’ perspective exists, little is known about the clients’ experience of disclosure or the facilitators and barriers to disclosing many other forms of childhood adversity. The current study sought to explore the facilitators and barriers that clients face when disclosing their childhood adversity to mental health professionals, in addition to their experience of enquiry about childhood adversity by mental health professionals.

Methodology: Adopting a critical realist approach, a qualitative methodology was utilised to explore the disclosure experiences of 96 participants with childhood adversity. An anonymous, online survey was used to gather descriptive and qualitative data. The latter led to four content analyses.

Results: Several facilitators (dynamics between the client and MHP, the clients’ motivation to disclose, disclosure environment) and barriers (influence of the MHP, clients’ experiences, and session environment) to disclosure were identified by participants, including facilitators and barriers not previously identified by existing research. A range of emotional responses to mental health professionals’ enquiry (or lack of enquiry) about childhood adversity were also identified. Participants reported a range of childhood adversities besides abuse and neglect, including poverty, discrimination, bullying, adverse neighbourhood experiences, and foster care.

Conclusion: The current study contributes to existing research exploring disclosure of childhood adversity and provides insight into clients’ experiences of enquiry about childhood adversity by mental health professionals. The identification of facilitators and barriers to disclosing childhood adversity may expand the theoretical knowledge base surrounding the disclosure process and may inform training for mental health professionals and encourage increased provision of trauma-informed care in mental health services. The implications and recommendations for future training and research are considered.