The characteristics, effects, and predictors of self-disclosure during contraceptive counseling
Awarded 2011
Trainee Grants
Merritt Evans, MD
University of California, San Francisco

Effective contraceptive counseling is essential to providing women with high quality contraception that they can use correctly and consistently and thereby avoid unintended pregnancies, but what makes counseling effective is a growing area of research. One aspect of counseling that has received little attention is provider self-disclosure – defined as providers making statements regarding personal information to patients – which in other clinical contexts occurs in 15-34% of office visits. Although likely a common occurrence, the impact of self-disclosure on contraceptive counseling is unclear. It is possible that self-disclosure could have a positive effect by creating a sense of connection with patients and by normalizing their concerns and experiences. However, it is also possible that self-disclosure could make patients feel uncomfortable by transgressing boundaries during an already intimate encounter or could make patients feel pressured to choose the method with which the provider had personal experience. In this research proposal, we propose to fill this gap in knowledge by evaluating the characteristics, predictors and effects of provider self-disclosure during contraceptive counseling through direct observation and patient surveys. Given other research showing that patients view contraceptive counseling differently than other clinical encounters and expect a higher degree of intimacy with their provider, we hypothesize that provider use of self-disclosure will enhance patient satisfaction with counseling. This research will help practitioners counsel effectively about contraception by providing guidance on the appropriateness of self-disclosure in this context.