Publishing December 2026 · Routledge

When the
Therapist Is Ill

Navigating Vulnerability, Self-Care, and Self-Disclosure in Clinical Practice

When we have an illness, a disability, or an impairment, our personal lives are thrown into disarray. We feel vulnerable and terrified, and we need to care for ourselves with compassion and sensitivity for our particular needs. As our personal and professional lives converge, we face a range of painful questions, clinical responsibilities, and ethical concerns. This groundbreaking relational book for psychotherapists, and anyone in the helping and healing professions, will help us navigate this unfamiliar and unsettling terrain.

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When the Therapist Is Ill: Navigating Vulnerability, Self-Care, and Self-Disclosure in Clinical Practice, by Roberta Rachel Omin, LCSW
Why This Conversation Is Necessary

The missing chapter in our training

We are clinically trained in working with beginnings, processes, ruptures, repairs, boundaries, and ethical care. Yet, like most therapists, we receive little guidance about the ethical dilemma: what to do when illness enters our own lives and begins to impact the safety, trust, and integrity of the therapeutic relationship and environment.

When the Therapist Is Ill addresses the relational, clinical, ethical, practical, and deeply personal questions that emerge when a therapist must face:

This is not a peripheral issue. It is one of the missing conversations in our profession.

A More Personal Invitation

If you have ever asked…

i.

What do I disclose?

ii.

How do I know what is relationally appropriate?

iii.

What do I owe my clients if my health changes?

iv.

How do I care for myself without compromising the work?

v.

What if I need to pause, transfer, or stop?

vi.

How do I prepare for what I hope never happens?

vii.

How can I make my disclosure appropriate for each client?

This book was written with you in mind.

Inside the Book

A relational and human approach

This book does not approach a therapist's illness as a purely technical and logistical problem to be solved. It understands illness as a relational event. Drawing from over 150 qualitative interviews, lived experience, clinical reflection, parts work, and attachment theory, it offers a compassionate roadmap through the themes below.

When the Therapist Becomes Ill

A different way of thinking about vulnerability, one that helps us tell the difference between what is happening now and what the illness may stir up from our past.

What Illness Brings Up for the Therapist

Illness can touch shame, grief, privacy, identity, unmet needs, and our wish to take care of others. Looking inward helps the therapist respond with greater clarity.

Do I Need to Tell My Clients?

What to consider before sharing: what to say, when to say it, and how to keep my client's needs at the center of the conversation.

The Attachment Stories We Bring With Us

How the attachment histories of both therapist and client can shape responses to illness, disclosure, care, and dependence.

What Disclosure Brings Up for the Client

A therapist's disclosure may awaken old fears, losses, or longings in our client. When handled thoughtfully, it can also lead to important and healing work.

Why Colleagues Matter

Trusted colleagues and consultants can offer perspective, practical help, and a place for the therapist to speak openly during a difficult time.

Planning for the Unexpected

What therapists need to know about professional wills and continuity plans, and why many of us have such a hard time creating them.

Saying Goodbye Well

Endings are part of every therapeutic relationship. This section looks at how to approach transition, closure, and goodbye relationally and with honesty and care.

Core Themes

The ideas the book returns to

✦

Illness narrows the distance between the personal and professional.

✦

Disclosure is not merely informational; it is relational.

✦

Clients are affected not only by what we say; they are also affected by what we leave unspoken.

✦

Healthy vulnerability is not weakness; it is grounded openness.

✦

Self-care is not abandonment of the client.

✦

The therapeutic bond deserves honesty, self-determination, preparation, continuity, and thoughtful endings.

✦

Our humanity is not outside the work; it is part of the ground of the work.

A book about how therapists can remain deeply human.
Relationally grounded.
Ethically clear.
When life does not unfold according to plan.

Who This Book Is For

When illness enters a therapist's life, it can also touch the therapy room

This book is for therapists who are ill, disabled, facing a new diagnosis, or living with medical uncertainty. It is also for colleagues who care about them and want to support them well.

It is written for clinical social workers, psychologists, marriage and family therapists, psychiatrists, psychoanalysts, mental health counselors, and other clinicians working in private practice, group practices, hospitals, schools, graduate courses, and community settings.

It may be especially helpful for:

✓ Therapists wondering what, if anything, to share with clients, and when, what, and how
✓ Clinicians trying to think carefully about privacy, boundaries, ethics, and continuity of care
✓ Colleagues supporting a therapist who is navigating illness alongside clinical work
✓ Supervisors, consultants, therapists, and training institutes preparing clinicians for realities that are rarely addressed in training
✓ Those who have already lived through this experience and know how lonely and complicated it can feel
Advance Praise

What colleagues are saying

“Roberta Omin sorts big questions, reviews potential ethical dilemmas, lays out options, and offers useful templates. Let this book take your hand.”

Martha Sweezy, PhD
Assistant Professor, part-time, Psychiatry, Harvard Medical School; author on Internal Family Systems Therapy

“This brave, soulful, and deeply important book fills a profound gap in our therapeutic conversation. She brings extraordinary warmth, honesty, clinical wisdom, and ethical clarity to crucial, complex questions of vulnerability, self-disclosure, and the delicate boundary between the personal and the professional. This book is a gift to the field.”

Patricia L. Papernow, Ed.D.
Psychologist; Director, Institute for Stepfamily Education; author of three books on stepfamilies

“Roberta Omin’s book shines an unwavering, bright, and insightful light on a complex and often unacknowledged issue in the world of mental health professionals. This book is good medicine for our collective soul.”

David Chernikoff, M.Div.
Author of Life Part Two; guiding teacher, Insight Meditation Community of Colorado

“An invaluable and overdue resource for mental health practitioners struggling with one of the most difficult dilemmas clinicians ever have to face.”

Laura Melano Flanagan, LCSW
co-author, Inside Out / Outside In

“A brilliant and needed contribution to therapists and health care providers. The therapeutic relationship is a sacred one, built on love, trust, and encouragement.”

Patricia Kuusisto, LCSW
founder, the Diversity Center, White Plains

“She encourages us to be brave as we consider both our needs and our clients’ needs. A must-have for therapists, new and experienced.”

Katie Devine, Ph.D.
psychologist; instructor, Adelphi University

“A gift to therapists and clients: where the unspeakable becomes spoken, shared, and human, and brought back into the therapeutic frame.”

How we say goodbye matters.

Bring This Conversation Into the Field

Speaking, workshops, and consultation.

The profession is ready for a more relational, more truthful, and more compassionate conversation about therapist illness, vulnerability, self-care, self-disclosure, continuity, client care, and a relational goodbye.

Invite Roberta to Speak Explore Consultations →
Free Guide for Clinicians

The 7 Biggest Concerns

When therapists face their own illness, the same seven concerns surface again and again. This free guide offers compassionate guidance for navigating each one, in Roberta's voice. Join the list and it is yours free, with updates as the book launches.

Westchester County, NY · IFS, IFIO, Gestalt — Roberta
About the Author

Roberta Rachel Omin, LCSW

Roberta has practiced psychotherapy and counseling for over fifty years in Westchester County, New York. She holds a Master's in Social Work and Post-Master's Certificate in Advanced Clinical Social Work, and is certified in Internal Family Systems (IFS), Intimacy from the Inside Out (IFIO), and Gestalt Therapy.

She has served the Westchester County, New York State Society of Clinical Social Work as President, Annual Conference Chair, Education Chair, and Annual Film Discussion Facilitator. She worked with Westchester Oncology Social Workers from 1986 to 2012.

Her own experience living through breast cancer informed her sensitivity to clients navigating illness, grief, and transition, and seeded the questions inside When the Therapist Is Ill.

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