The Formal Disclosure Process

Greetings,
The Formal Disclosure process is a complex and challenging part of recovery for both the addict and partner. The recovering sex addict typically experiences anxiety and fear, and it is important to remember that FD is also a traumatic event for the partner – even if she/he “knows everything.” Additionally, it can be an activating and anxiety-producing event for the clinical team.
The FD disclosure packet has been structured to walk you, the CSAT clinician, through the process step-by-step. The packet is organized in the following way:
1. Therapists Information and Documents (PDF)
2. The Recovering Addict’s Pre and Post FD Documents (Word)
3. The Healing Partner’s Pre and Post FD Documents (Word)
We have included informed consent forms that outline limits of confidentiality, release of information forms, and other supportive materials in Word document format so that you may brand the forms with your clinical information and logo. Please see our boundaries request and legal reminder below.
As you open this information packet and review the materials, we recommend that you, the therapist, first read over the Therapist Documents PDF in this order:
1. Therapist Document Overview – a guide to all of the forms and stages of FD
2. Therapist Formal Disclosure Stages and Guidelines – an outline of each stage and step in the FD process
As you read through the Therapists FD stages and guidelines document, you will easily be able to match up the forms for the addict and for the partner.
Remember: The Formal Disclosure Stages and Guidelines outline all stages. The titles of the forms correlate with each stage of the Formal Disclosure Process.

Important Legal and Ethical Reminder
• Formal Disclosure is to be facilitated by a Certified Sex Addiction Therapist or a clinician or candidate who is under the supervision of a CSAT supervisor.
• Every state has their own governing board and as such, legal and ethical guidelines may differ. Please check with your state’s legal and ethical mandates to make sure that you are operating within your scope of practice, duties and experience and providing the standard of clinical care as mandated by your state.
• Please do not perform a Formal Disclosure process in isolation, or take on both roles (seeing the addict and partner). If you are new to FD, it is advised that you work closely with a seasoned CSAT or a CSAT supervisor in supporting you.
• Please do all standard of care assessments and risk assessments with both the partner and addict prior to the FD, and have the addict and partner complete all FD forms including crisis management and an after care plan.
• Please assign adjunct support (EMDR, Couples Therapist, Psychiatrist) as needed and per standard of care and your clinical assessments.
• Please carefully assess the client to note any risks to moving forward with FD as outlined in the FD document.
• Growth Counseling Services Formal Disclosure Packet of Information is copyrighted and provided as a support to CSAT clinicians (or candidates under supervision). You are asked to respect the boundaries of the Formal Disclosure packet and to not share this or other related materials or packets with other clinicians, including CSAT therapists who have not purchased these materials.
• Please note that this information does not serve as advice or direction. You must make the appropriate clinical plan, as you are the treating therapist. If you choose to use the materials and forms provided by Mari A. Lee, LMFT, CSAT-S and Growth Counseling Services, you do so by your own volition.
• Clinicians who are interested in support with Formal Disclosure and would like to purchase this packet of information are welcome to contact Mari A. Lee, LMFT, CSAT-S directly at mari@growthcounselingservices.com. Thank you; we appreciate you honoring this boundary request.

Formal Disclosure Documents Overview
For the CSAT Therapist
The following describes the purpose of each of the Formal Disclosure documents for sex addicts and their partners. This is for clinical use only.
Forms for Sex Addicts
• Addict FD Consent – Consent for Formal Disclosure for the addict, which must be signed in order to begin the process of FD. Must be turned in at least 1 week prior to FD date.
• Addict FD Worksheet – Describes the Formal Disclosure process and intentions and guides the addict through building a self-care plan for after Disclosure. Must be turned in at least 1 week prior to FD date.
• Addict FD Writing Guidelines – A guide for the addict when writing his/her Formal Disclosure letter, including examples of appropriate and inappropriate writing. Describes the guidelines the addict must adhere to when writing his/her Formal Disclosure letter.
• Addict FD Letter of Restitution Support Guidelines – A guide to the addict describing the process of the Letter of Restitution meeting and includes consent to participate in the meeting.
• Release of Information form – Must be signed by the addict before any information can be shared with the partner.

Forms for Partners
• Partner FD Consent – Consent from the addict’s partner/spouse to participate in the FD process, which must be signed in order to begin the FD process with the partner. Must be turned in at least one week prior to FD.
• Partner FD Guidelines for Disclosure – FAQs describing the Formal Disclosure process for the addict and his/her spouse and also level of involvement of the partner, managing expectations, FD rules, etc.
• Partner FD Pre-Disclosure Prep Worksheet – Serves to prepare the partner/spouse with examples of what the FD disclosure from the addict may contain. Guides the partner/spouse through preparing questions and a guideline of how much information they would like to receive from the addict. This documentation is then provided to the addict’s CSAT therapist by the partner’s CSAT therapist.
• Partner FD After Care Plan – Guides the partner through creating an after FD self care plan. This must be in place with a copy for the partner 1 week prior to FD.
• Partner Guide to the Emotional Impact Letter – This is an outline and guide to support the partner post disclosure in writing her EI letter, a letter stating to the addict how his or her acting out has impacted the partner/spouse.
• Partner FD Addict’s Emotional Restitution Support Guidelines – Description and expectations of the addict’s Letter of Emotional Restitution process for the partner.

Therapist Formal Disclosure Stages and Guidelines ©
Formal Disclosure (FD) is an important part of recovery for the SA and Partner and is not a one-time event. It is a complex piece of the healing process that requires structure, collaboration among the treatment team, and an organized process in order to support the recovering couple.
Additionally, because FD has many moving parts, and is both an anxiety producing event for the addict, and a traumatic event for the spouse/partner, it is imperative that the clinical team have a focused road map in place to guide the clients.
It is also important to note that Formal Disclosure is not an appropriate process for every couple. There are certain situations where FD should not be facilitated.
While the list below is not all-inclusive, it does provide some examples of situations where Formal Disclosure is not an appropriate inclusion with treatment.
Formal Disclosure is not appropriate when:
• Spouse is profoundly mentally ill
• Spouse is dealing with a health emergency
• Spouse has a history of violence toward recovering Sex Addict
• Domestic Violence present
• Spouse has threatened to use Formal Disclosure against Sex Addict
• Spouse has threatened to divorce or take children
• Spouse or recovering addict are suicidal or homicidal
• Will pose a significant health risk to recovering Sex Addict (as noted in a medical note from doctor)
• Spouse is on death bed
• Spouse refuses to seek therapy
• Sex Addict is not in treatment

Four Stages of Formal Disclosure
Each stage of FD has it’s own process, structure, forms, materials and support. The stages and steps within each are broken down in the following sections.
Stage 1: Preparing Sex Addict and Partner for FD Process
Preparing the Sex Addict:
This is a time where you as the therapist will be building trust and rapport with the recovery addict.
The following outlines the preparation stages and steps that you (the therapist) and the Sex Addict (SA) must complete:
1. Initial assessments and procedures for intake
• Assessment with the SAST and SDI
• Assess for risk
• Schedule a psychiatric evaluation if clinically sensible for SA
• Have SA schedule a medical examination with STI and HIV testing (and provide you and partner with evidence of this during the course of treatment and at the appropriate time, usually when spouse is working with her therapist and is writing her safety and boundary request letter)
• Assign adjunct support (e.g. EMDR, group therapy, in patient or an IOP if needed)
• Assist the addict in putting together a community of support with 12 step and sponsorship
• Obtain Release of Information from SA for consulting with adjunct support
• Obtain Release of Information to meet with SA and spouse
2. Clinician assigns first recovery tasks and exercises while establishing trust.
In this stage you will share that Formal Disclosure is part of the recovery treatment plan for the SA and give a general outline of when this will happen, assess for risks in facilitating a disclosure and so forth.

3. Have partner join SA session for a check-in within the first month of treatment.
NOTE: A Release of Information from the Sex Addict IS MANDATORY before meeting can take place.
This session is not couple’s therapy. This is a time to build rapport with spouse, to provide psychoeducation on recovery, and to answer questions about the therapy PROCESS, not to discuss the confidential content the addict is sharing with you in therapy.
If the spouse/partner is not in therapy with a CSAT, you will provide him/her with a clinical partner support sheet that includes 12 step information, therapist referrals, inpatient, books and website resources. It is best that you create this sheet, as it will include 12 steps groups and adjunct support and therapy referrals in your area.
4. Once the above steps are established, and you have assigned the CSAT task work, the client is grounded in first steps in treatment, will have had the SA complete a full sex history timeline starting with first sexual memories.
During this time, the spouse will begin her work with her CSAT and will have had a session with her therapist and SA to go over her safety list and boundaries, and will fill out the partners FD worksheet and information, as well as her first recovery and trauma healing treatment tasks.
It may be important while the addict is preparing his FD, that the addict join the partner with her/his therapist in order to go over her/his boundary and safety list.
This list often includes a request for STI testing, boundaries around sex, sleeping arrangements and other safety requests and boundaries while the spouse prepares for FD.
5. Assign the FD worksheets and begin working with addict in preparing his FD.
• The partner’s FD worksheet and questions will help round out the SA’s FD.
• Once the addict’s sex history is complete, and you have the partner’s worksheet information and questions he/she is requesting be answered as part of FD (as part of her partner’s FD via the partner’s worksheet) the addict will then begin following the FD prep sheet to complete his/her FD letter.
• There are usually several drafts before the SA finalizes his/her formal disclosure.
• During this time the spouse is working with her therapist.
• Prior to FD it is advisable to have the couple begin couple’s therapy with a CSAT therapist.

Preparing the Partner:
This is a time where you as the clinician will be building trust and rapport with the recovering partner.
The following outlines the preparation stages and steps that you (the clinician) and the partner must complete:
1. Initial assessments and procedures for intake
• You will go through a through assessment with the PTS-I
• Assess for risk
• Partner will have STI and HIV testing done
• Schedule a psychiatric evaluation if required
• Assign adjunct support (e.g. EMDR, group therapy, in patient or an IOP if needed)
• Assist the partner in putting together a community of support with 12 step and sponsorship.
2. You will also assign first recovery tasks and exercises while establishing trust.
In this stage you will share that FD is part of the recovery treatment plan.
• Please note exceptions to FD in recovery: If the spouse has a profound mental illness, is suicidal or homicidal, is not working with a CSAT therapist, has threatened to use FD against the addict in a divorce or child custody hearing, has threatened to make public FD and so forth.
3. You will help the partner manage expectations for immediate FD providing information around how long this may take.
• For the spouse or partner who may be pushing for disclosure it will be important to discuss with them that they deserve to have a thorough FD that includes all information, and that this will take time while the addict’s therapist works to build trust and rapport, to establish sobriety, to go through all assessments, to put into place adjunct support, and to go through the sex history timeline and FD letter writing process. Treat the partner with compassion and understand that she is likely safety seeking when/if he/she is pushing for FD.
• It can be helpful to have this outlined in a one page FD pyschoeducation handout for the spouse.

4. You will help partner prepare his/her boundary and safety list to discuss with an early meeting with the addict.
As part of this, the partner may request STD and HIV testing and evidence, sexual sobriety, that the addict move to another room or location, etc.
5. You will want the addict join a session with the spouse/spouse’s therapist to establish rapport as a check in as this therapist will be joining the FD.
6. As the addict moves forward in his recovery, once his sex history timeline is complete, and before writing FD, therapist must have partner’s worksheet and consent form from the other treating therapist in order to include those questions.
7. Important: Once FD letter is complete, a date is set for Formal Disclosure.
• Consent forms are signed on both sides
• All releases of information are in place.
• Once documentation is in place, the SA’s therapist give the partner/spouses therapist a copy of the FD and no earlier than 24 hours prior to the FD meeting so as not to put the partner’s therapist in a position of a secret keeper.
PLEASE NOTE: If the spouse is unable to fully trust the addict will be fully disclosing all secrets in the FD, a polygraph may be requested of the addict prior to FD in order to support the healing process.
Stage 2: Formal Disclosure and Clarification Meeting
1. The meeting is set up for 3 hours, usually on a weekend.
• These meetings are usually in the partner’s therapist office with both therapists present.
• The partner does NOT receive a copy of the FD, rather his/her therapist will meet with partner after disclosure to go over any questions or trauma he/she is dealing with and his/her after care plan.
• Therapist discusses rules and boundaries before beginning FD. Make sure clients are sober, remind clients of breaks as needed.
• The addict reads his FD.
• The partner is given time to respond.
2. If there are clarifying questions, a second (part II) of FD will be set for the following week or two to review and discuss questions.
3. Clarification meeting.
• Spouse will work with her therapist to compile a list of any remaining questions to be addressed post FD.
• Spouse and addict meet with either therapist or couples therapist to discuss clarifying questions within 2 weeks.
Stage 3: Post Disclosure – The Emotional Impact Letter
1. The partner begins to work on her Emotional Impact (EI) Letter prep
Be sure to honor the partner in giving her/him time to move through their EI letter and have the time and hours needed to read and process after.
2. The EI letter meeting is set up
• This can be done with couple’s therapist at this point, or with the partner’s therapist.
• It is important to note that this can be an activating time for both the partner/spouse, and for the addict around shame reactivation.
• The partner may resort to safety seeking behaviors (e.g. snooping, drinking, yelling, interrogating) as she works through how the SA’s behavior and actions have impacted her.
• And/or the addict may feel triggered to act out due to shame and pain of hearing the impact his behaviors have had on his partner.
• This is the stage to increase the treatment, and 12 step meetings and prep the couple.
Stage 4: Emotional Restitution
• The Emotional Restitution (ER) letter is the letter the addict writes to make amends, take ownership and make an apology from the heart expressing empathy to his/her partner.
• It is important to note that this requires a sincere expression of empathy. This is likely not going to happen at the very start of recovery and healing.
• It takes time for addicts to begin to even show empathy for themselves let alone the partner, thus, FD is a process that unfolds over time. We do not want the partner to be kept in the dark for months and months, but we also do not want to rush into the process and then have an incomplete FD or an insincere ER.
1. SA drafts the Emotional Restitution (ER) Letter.
Note: This process for the SA should not be rushed. There are usually several drafts. The letter is read in-group, and will include points from the partner’s own EI letter. This is to be a heartfelt letter of apology.
2. ER meeting is set up (typically 2 hours).
This meeting can be facilitated in either couple’s therapy followed by individual treatment, or with one of the individual treatment therapists (usually the partner’s) as long as there has been at least 2 prior check-ins with the SA and the spouse/spouse’s therapist.
Final Suggestions for the Therapist
The Formal Disclosure process is a complex and stressful part of recovery for the couple and, at times, for the therapist and clinical team.
Here are some important reminders to support you:
• Do not do this work in isolation, you need a team of support
• Work with a CSAT supervisor to support you if you are new to FD
• Work with other CSATs on the treatment team
• Have a structured FD process
• Have signed consent forms
• Assess for risk (health, suicide, homicide, domestic violence)
• Remember instances that make FD an inappropriate course of treatment (divorce, threats, life risk, pregnancy, profound mental illness, history of violence, etc.)
• The primary treatment team consists of sex addict therapist, partner therapist, and couples therapist. The secondary would be a psychiatrist, EMDR therapist, etc.
• The treatment consists of individual treatment, group treatment, and couples treatment
• Adjunct support may consist of psychiatric evaluation, EMDR, in-patient, IOP, medical treatment, sober coach, etc.
• Work closely with the treatment team in every stage
Important note: Do not share private information from the individual treatment.
This is especially important on the timing of when the partner’s therapist receives the SA’s FD letter from the SA therapist. It is best not to send the FD letter until the night prior to the FD meeting.
• Manage expectations on when partner can expect FD. We must support the partner in her need for disclosure and safety while managing expectations on how quickly this will happen.
Some partners expect this within the first month of treatment which may be unrealistic or too soon in the process of recovery as the addict will need time go through assessments, to build trust and rapport with his or her therapist in order to be rigorously honest with their disclosure, and to move through first steps and tasks of treatment, to maintain sobriety, and to build first steps of empathy toward wounded spouse or partner. As a result, this will not happen ASAP.
• Accept that you, the therapist, cannot control all aspects of this process, and that this is the client’s process
• It is not our role as a therapist to coerce a client into Formal Disclosure; it is a choice that only they can make
• Spouse does not receive copy of FD
• Sex addict does receive a copy of the EI letter
• Spouse does receive a copy of the ER letter (unless otherwise indicated)
• Connect with adjunct support in your area (e.g. know where the “good” 12 step meeting are held, an EMDR therapist, a psychiatrist, a couple of CSAT therapists, IOP or in patient center, a polygraph professional, etc.)
You will want to have made contact with these professionals before starting FD rather than scrambling last minute.
Remember, assess for risk, follow legal and ethical guidelines of your state, do not work in isolation, seek supervision when needed, and have a focused process.