Practice Management Blog

Doorknob Confessions in Therapy: Handling Last-Minute Revelations

There’s a curious phenomenon in therapy known as the doorknob confession (or doorknob disclosure).

Imagine this…

The counseling session is coming to a close. You’re halfway through saying goodbye when the client pauses. And you know what’s about to happen. The client drops a revelation, and it’s serious. Suddenly, instead of mentally preparing for your next session, you’re grappling with how to best navigate the disclosure with no time left on the clock.

Sound familiar?

Doorknob confessions can offer unexpected learning opportunities if you understand why clients wait until the eleventh hour. And if you can effectively manage these moments, you have an opportunity to build trust and facilitate the client’s progress.

Let’s look at the underlying motivations behind doorknob confessions and explore practical strategies for handling these revelations with sensitivity and efficacy.

What Is a Doorknob Confession?

A doorknob confession refers to those pivotal moments in therapy when clients choose to reveal significant information or emotions right as the session is about to end. These disclosures are often unexpected, catching the therapist – and, sometimes, the client – off guard.

Doorknob confessions can look like:

  • Emotional revelations: A client may suddenly admit feelings of deep sadness or overwhelming anxiety they’d been struggling to express throughout the session.
  • New topics: Just as the session is ending, clients might introduce entirely new topics of discussion, such as past traumas or relationship issues.
  • Seeking reassurance: Clients may ask a question at the end of the session to obtain your opinion. They may say something like: “Also, I was wondering, what do you think about…?”
  • Thoughts of self-harm: Clients might disclose thoughts of self-harm or suicide as they prepare to leave.
  • Pseudo-emergencies: Clients may wait until the session is ending to announce that a seeming crisis is playing out in their lives (such as loss of employment).

Medical Emergencies

It’s important to clarify that true medical emergencies don’t qualify as doorknob confessions.

If your client suddenly requires medical assistance, the only appropriate response is to help them access the urgent medical intervention they need and, if necessary, reschedule your later appointments.

Doorknob Confessions vs Planned Discussions

You’ll also need to differentiate doorknob confessions from planned discussions within the therapy session.

Unlike planned topics, doorknob confessions often arise spontaneously within the limited window of time between the session ending and the client’s departure. They can quite literally happen as you’re opening the door to see them out of the therapy room!

Whereas planned topics unfold in a controlled manner, these disclosures tend to be haphazard and carry a heightened emotional intensity.

If not managed skillfully, this can impact the therapeutic process.

Why Do Clients Make Doorknob Confessions?

Clients make doorknob confessions for a variety of reasons, often stemming from complex and long-standing emotional dynamics and sometimes even as a result of the therapeutic relationship.

Understanding these underlying motivations can help therapists navigate and address doorknob confessions with empathy.

Common underlying reasons for doorknob confessions include:

Fear of Vulnerability or Judgement

Clients may fear being judged or rejected, making them hesitant to disclose sensitive information earlier in the session. As the session draws to a close, the urgency of their need to share outweighs their fears, leading to a last-minute confession.

Reluctance to Initiate Difficult Conversations

Some clients may struggle to broach challenging topics or confront painful emotions. By waiting until the end of the session, they avoid prolonged discomfort and postpone the discussion until they feel emotionally prepared.

Emotions Reaching a Peak

As the session progresses, clients may experience a buildup of emotions that eventually reach a tipping point. This heightened emotional state can compel them to share deeply personal or distressing experiences as the session nears its conclusion.

Testing Boundaries

In some cases, clients may test the therapist’s boundaries or try to gauge the therapist’s reaction by disclosing sensitive information at the last moment. This can be a way for clients to assess the safety and trustworthiness of the therapeutic environment or, in some cases, to assess the therapist’s reaction to provocative or shocking news.

Seeking Support in a Safe Space

Clients may perceive therapy as a safe and non-judgmental space to explore their innermost thoughts and feelings. Making a doorknob confession – especially for those who struggle with impulse control or emotional regulation – allows them to compel support and validation from their therapist before leaving the session.

Fear of Ending the Session

Some clients may find the thought of leaving a safe therapeutic environment triggering. At times, these clients may introduce a new dynamic to a session that’s drawing to a close in an attempt to extend the session time and delay separation from the therapist.

How Do Doorknob Confessions Affect Therapists?

Doorknob confessions can significantly affect you as a therapist, influencing both the practical aspects of your work and the dynamics of the therapeutic relationship.

To navigate the effects of doorknob confessions, therapists need to maintain a balance between professionalism and empathy. This becomes easier when therapists are prepared for the reactions that doorknob confessions can provoke.

Impact on Schedule

One immediate effect of a doorknob confession is the potential to disrupt the therapist’s schedule. These last-minute disclosures may require additional attention, which can threaten to extend the duration of the session and affect subsequent appointments.

Effect of Being Caught by Surprise

Doorknob confessions have a knack for catching therapists off guard, especially when they involve major revelations or emotionally charged content. This sudden disclosure can trigger countertransference, causing therapists to momentarily lose perspective and objectivity as they grapple with their own emotional reactions.

Imbalance in the Therapist-Client Relationship

The timing of a doorknob confession, occurring just as the session is ending, can create an imbalance in the therapist-client relationship. Therapists may feel pressured to respond quickly.
This has the potential to put the client in control of the therapeutic journey and risks sacrificing the opportunity for a more thorough exploration of the client’s concerns.

Emotional Toll

Unexpected disclosures can also affect therapists emotionally. They may experience annoyance, heightened levels of stress and responsibility, and may even feel violated due to professional and therapeutic boundaries having been blurred.

Last-minute disclosures may also provoke an instinctive need to protect the client, causing the therapist to worry about the client’s well-being long after the session ends.

Loss of Control

As allied health professionals, much effort goes into ensuring that therapists feel in control of even the most uncertain session. Doorknob confessions can cause therapists to feel that, despite their best efforts to direct their clients, they’ve lost control of the session and of the stability of the therapeutic relationship.

How Therapists Can Handle Doorknob Confessions

When faced with a doorknob confession, therapists can employ several strategies to effectively address the disclosure while maintaining the integrity of the therapeutic process.

Assess the Urgency of the Doorknob Disclosure

First and foremost, assess the urgency of the disclosure. If it indicates a risk of harm to the client or others, immediate intervention may be necessary. In these cases, you’ll need to employ professional discretion.

However, for general disclosures, acknowledge the disclosure respectfully and agree to explore it in greater depth in the following session.

Acknowledge the Client’s Courage

If appropriate, express appreciation for the client’s bravery in sharing their thoughts or feelings. Although the therapist will have to explain that the issue can only be fully explored in the next session, acknowledgment of the client’s bravery can help validate their experience and build trust in further unraveling the disclosure in future sessions.

If Time Allows, Briefly Explore the Disclosure

If time permits, briefly explore the disclosure to better understand the client’s concerns, emotions and intentions in sharing the information. This exploration can provide valuable insights for future sessions.

Schedule a Follow-Up Session if Possible

Schedule a follow-up session for more in-depth discussions or interventions to allow ample time for exploration and processing. With tools like online booking, you can direct the client to schedule the next appointment before they even leave your consulting room, providing them with confidence that they’ll have another opportunity to discuss their disclosure more fully in another session.

Reiterate the Importance of Open Communication

Highlight the importance of open communication throughout the therapeutic process, encouraging clients to express their thoughts and feelings freely, even if they arise at unexpected times.

Develop Plans for Sessions

To help eliminate doorknob confessions, therapists can collaborate with clients to develop plans for future sessions. This may involve setting specific goals or agendas, discussing potential topics for exploration, and establishing a comfortable pace for the therapeutic process.

In scenarios where the client has a pre-approved number of sessions, you can consider using the schedule of remaining sessions to plan your approach to working through the client’s doorknob confession.

Make Room for New Topics

Create space for clients to bring up new topics at the beginning of each session. By proactively addressing emerging issues, you can help ensure that sessions remain focused and productive.

By acknowledging the courage of clients who share their thoughts and feelings, therapists can create a safe and supportive environment where open communication thrives. Encourage clients to express themselves freely throughout the session to prevent the buildup of emotions that may lead to doorknob confessions.

You can document disclosures in secure therapy notes software to maintain confidentiality and ensure continuity of care. Systems like Power Diary offer therapists a streamlined solution for seamlessly managing client information, scheduling appointments and sending automated reminders.

Manage therapy sessions with confidence and enhance the experience for both you and your clients with a 14-day Free Trial of Power Diary. No credit card required.

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