Doorknob confession. Most therapists have experienced this moment … you start to wrap up the session and then the client drops a last-minute confession. Why does this happen and what can you do when it does happen?
What is a doorknob confession?
A doorknob confession is a last-minute communication from the client. In these situations, the client pushes to continue interaction with the therapist by eliciting ongoing discussion with the therapist in the last moments of the session. Picture your hand on the doorknob (actual doorknob or that “end session” button on your telehealth screen) while the client continues to push the boundaries of the session.
Doorknob confessions can include:
- An extended goodbye
- An entirely new topic to discuss
- Suggestive or indications of suicidal thoughts, self-harm, or abuse
- A major revelation
- The onset of tears, cries, or sobs
- Anxiety or panic attacks
Why do doorknob confessions happen?
Doorknob confessions can happen for a variety of reasons. Learning more about why it happens can help you as the therapist learn more about addressing and preventing the doorknob confessions.
Some clients may feel highly anxious to initiate discussion about a pressing issue. They may feel scared of how it would feel to share their issue or even worried about how the therapist would respond. These clients feel safer and even more in control of the discussion if they wait until the last minute to share their issue, especially when they think there is no time remaining in the session to discuss it. The doorknob confession supports their tendency to avoid, escape, or limit discussions on upsetting topics.
Other clients may use the doorknob confession as a way of testing boundaries or seeing how far they can push their limits with you. Either consciously or unconsciously they may try to see how much time you will give to them. Perhaps these clients may have suggested or discussed similar boundary issues with other relationships in their lives during your sessions.
For some clients, the doorknob confession may reflect their attachment style. When clients have an anxious attachment style or fear of abandonment, they tend to feel safe, secure, and want to remain in the session. They may feel motivated by this security need and drop the doorknob confession to extend this comfort or to avoid feeling abandoned when the session ends.
How can a doorknob confession affect therapists?
When clients drop a bombshell in the last moments of a session, it is natural to feel some emotions and struggles regarding this situation. Although our training, experience, and education guide us toward clinically understanding the reasoning behind a doorknob confession, it can still place a strain on us.
Some therapists may struggle with experiencing countertransference when a client gives a doorknob confession. The bombshell drop may trigger some of your issues as a person and a therapist. If you notice a pattern of countertransference (related or not-related to doorknob confessions), then it might help you to seek supervision, consultation, or therapy for yourself. When you become aware of experiencing countertransference with a session, then take a moment before your next session to try to figure out what might be triggering you or causing the distress.
Some therapists may feel resentment towards a client as the doorknob confession can cause stress, impact the therapist’s control over the session, and possibly interfere with the remaining scheduled sessions. It can remind us that despite planning our sessions, implementing boundaries with clients, and our training, we do not have as much control over the sessions as we think. It can help to remind yourself why your client has sought out your help. Their reason for coming to therapy likely relates to the reason for dropping a doorknob confession in your lap.
Doorknob confessions can trigger the therapist’s desire to help our clients when they present a concern. As therapists, we have the duty to assess for safety; and, report, protect or warn when necessary. When that doorknob confession triggers a safety concern, such as a suicidal threat or suggestion, we do need to act on it and cannot simply pass it along to the next session.
Other times the doorknob confession may be less immediate but a suggestion of a client making a decision that we know can lead to harm. For example, a client may tell you on the way out the door that they plan to contact an ex-spouse when you have been working hard in sessions on letting this relationship terminate. Your desire to protect the client and work on this issue at the doorknob may arise.
How to deal with doorknob confessions
As a therapist in private practice, you have many responsibilities, including managing the time before, during, and after a session. But when a client makes a doorknob confession, it can threaten your planning. Learning how to manage these situations can help you to regain some control over your sessions.
Some of the steps you can take to manage or prevent a doorknob confession include:
Plan for your session: Taking some time before the session to review the notes from the previous session and set your agenda can help you to keep control of the session. You will feel more confident about the goals and purpose of the current session and how to stay on track.
Discuss the agenda: At the beginning of the session, discuss the agenda with your client so that the plan is clear and mutual. You can ask your client at this point if they have other issues or needs that have arisen since the last session that they would like to address. Seeking this input from the client gives them the opportunity, and your permission, to bring up anything new or on their mind at the beginning of the session instead of waiting until the end.
Assess and manage risks: If your client presents with suicidal, self-harm, or other risks, then actively assess and manage from the beginning of your concern. You may have thought of waiting to see how the risk can resolve during the session but doing so leaves the possibility of the major bombshell dropping at the end of the session.
Pay attention to the time: It is not a secret or shameful that we have time limits for our sessions. Just like other services, therapy sessions do not go on indefinitely. Keeping a clock visibly located so the client can see it can help. As part of your agenda in a session, the final five or ten minutes can be used to summarize the session and assess for unresolved issues. Using wording such as “Before we finish our time together today, let’s review what we have discussed … Is there anything else you would like to discuss today and put on our agenda for the next session?”
Defer to the next session: When a client drops that doorknob confession, remind yourself that it benefits the client to adhere to your session limits and boundaries. You can acknowledge their issue and defer it to the next session. For example, you can tell the client, “I see this concern is very upsetting for you. Our time is up for today so let’s put it on our agenda for the next session.” When possible, you can offer an extra session to address the issue. You can tell the client “I see this is very stressful for you and must be important to you. I do have time to see you later this week if you would like an extra session to address it.”
Discuss the doorknob confession in the next session: It can help to prevent future doorknob confessions when you address the doorknob confession at the beginning of the next session. You can discuss with the client the limits and boundaries of the session and the concern presented by waiting until the last moment to bring up such important issues.
A doorknob confession can certainly throw your session off balance. Learning to recognize when it’s happening and to set limits with your clients will help you to minimize them. If you struggle with managing the sessions, frequent doorknob confessions, or your reaction to them, seeking out consultation and training can help.
TheraPlatform can help you manage time and scheduling with clients. They also offer practice management, EHR and teletherapy for therapists. In addition, they offer a free, 30-day trial with no credit card required. Cancel anytime.