Advocacy Evaluation for Counselors Serving LGBTQ Populations

ABSTRACT

Advocacy and social justice initiatives for lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) clients in counseling emphasize counselor and client collaboration in challenging discrimination and oppression and promoting LGBTQ inclusive sociopolitical changes. Although researchers have highlighted the counseling and advocacy needs of LGBTQ populations, few have yet examined processes for assessing the outcomes of advocacy efforts. Advocacy evaluation may provide counselors and counseling organizations with a framework for monitoring and assessing the outcomes of LGBTQ advocacy initiatives. The authors discuss the goals and elements of advocacy evaluation and review the LGBTQ Counseling Advocacy Evaluation Self Assessment.     

Culturally Appropriate Career Counseling With Gay and Lesbian Clients

This article details the current knowledge regarding the provision of culturally appropriate career services to gay and lesbian clients. It is divided into 5 parts: history and context for the delivery of career counseling services to gay and lesbian clients, counselor self‐preparation for working with gay and lesbian clients, client‐focused interventions useful for counseling with gay and lesbian clients, program‐focused interventions useful for addressing the special issues that this group presents, and appropriate advocacy or social action interventions. Issues of multiple cultural identities and the intersection of lesbian and gay issues with race and ethnicity are also addressed.     

Including Curriculum Content on Lesbian and Gay Issues

Abstract

This paper presents a rationale for requiring content on lesbian and gay issues in the social work curriculum. Recent research suggests that a considerable percentage of social workers possess homophobic attitudes. Some support exists for making education a tool to reduce negative attitudes toward the gay population. However, students are unlikely to receive adequate information about this population before they enter the social work curriculum. The goals of including content on lesbian and gay issues are to decrease homophobic attitudes and to prepare students to provide effective social work practice with lesbian and gay clients. Methods and resources for incorporating content on lesbian and gay issues in human behavior, direct practice, policy, community organization and research courses of the social work curriculum are presented.     

Beginning Practice with Preoperative Male-to-Female Transgender Clients

Abstract

Preoperative male-to-female transgender clients often present with specific and unique psychological and social issues distinct from gay male and lesbian clients. Therapists must be ready to assess and help diagnose these in preparation for work with gender queer clients. Therapists must also be prepared to face and resolve the various counter-transference dynamics inherent in therapeutic relationships with transgendered individuals. This Practice Note focuses on the author's beginning clinical and social case management experience working with two preoperative male-to-female transgender individuals.     

Correlates of Homophobia and Use of Gay Affirmative Practice Among Social Workers

ABSTRACT

Research on social work practice with gay and lesbian clients has historically focused on examining social workers' attitudes towards gay and lesbian individuals, however, no studies have examined the relationship between attitudes and practice using validated measures to assess practice. The focus of this study was therefore to examine the relationship between attitudes and practice with gays and lesbians using the recently developed and validated Gay Affirmative Practice Scale (GAP). Significant relationships were found with the GAP and two measures of homophobia as well as with measures that assessed feelings about lesbians and gay men, contact with gays and lesbians, attendance at workshops that focused on gay and lesbian issues, relationship status, sexual orientation, political party, and primary area of practice. Relationships with measures of attitudes were also examined. Implications for social work practice, education, and research are discussed.     

Lesbian Therapists and Lesbian Clients

Abstract

The authors, on the basis of their own experience, explore issues specific to therapists working openly as lesbians with lesbian clients. Their discussion covers the structure of a private practice, the therapeutic relationship between lesbian therapist and lesbian client, and personal challenges for the lesbian therapist. Questions are raised and direction given with the aim of facilitating congruence among the therapist's personal capacities, the therapeutic setting, and the psychological intention of the therapeutic work. The authors note the therapist's need to tolerate the exposure of her personal life and the pressure toward fusion that are both entailed in work with lesbian clients, and they suggest that these special challenges, when the lesbian therapist's engagement with them is conscious, offer rich material that can deepen the therapeutic relationship and the therapeutic work.     

A Program Evaluation of Los Angeles ACORN's Welfare Case Advocacy

SUMMARY

Bureaucratic confusion and client dissatisfaction since the 1996 changes in welfare policy opened opportunities for third party advocacy on behalf of welfare clients. This paper evaluates Los Angeles ACORN's case advocacy program for welfare clients. Outcomes analyzed include client satisfaction with ACORN's advocacy and effects of the program on welfare clients who later became ACORN members. Ninety-one percent of clients surveyed (N = 99) stated they were satisfied with the resolution of their welfare case complaint. Eighty-eight percent of respondents stated ACORN did a better job resolving their problem compared to the welfare department. Unique aspects of the program include peer advocacy and opportunities for welfare recipients to join ACORN and work on welfare policy changes among other issues.     

Lesbian Survivors of Intimate Partner Violence

Abstract

Service barriers of lesbian domestic violence survivors were identified from the perspectives of six service providers using qualitative interviews. Constant comparative methods identified service barriers including: Systemic barriers (laws and policies of criminal/justice system, social and cultural attitudes, and theories regarding domestic violence dynamics), institutional barriers (ambiguous and inconsistent policy, assigning lesbian clients to specific staff members, lack of commitment to serving lesbians, and using heterosexist language), and individual barriers (attitudes/actions of lesbian survivors, heterosexual female clients, staff members, and police/court officers). Participants expressed motivation to serve lesbian survivors and indicated the potential to influence institutional policies and practices.     

Psychotherapy with Lesbian and Gay Clients from an Adult Life Course Perspective

Abstract

A life course perspective of gay and lesbian adulthood enriches our understanding of clinical presentations and modifies our conception of psychotherapy. The author describes shifts in his psychotherapeutic orientation characterized by an increasing recognition of the importance of social, cultural, and historical forces that shape gay and lesbian mental health. Given the uncharted nature of many gay and lesbian lives across adulthood, existential questions about the meaning of life choices are often present in the consulting room. Therapists working with gay and lesbian clients embark on an empathic journey informed by treatment skills as well as our joint participation in a world of significant social change.     

Social Justice Advocacy Readiness Questionnaire

Summary

Social service providers of consultation, counseling, and education can benefit from determining their social justice awareness, knowledge, and skills to ensure culturally competent practice and to challenge the multiple oppressions facing clients and staff on individual, cultural, and institutional/systemic levels. The Social Justice Advocacy Readiness Questionnaire (SJARQ) provides a means to advocate for social justice with persons of multiple cultural identities, including all sexual orientations and gender identities. The SJARQ instrument contains three areas of self-assessment for social services staff: individual social justice advocacy awareness, comfort, and values; cultural social justice advocacy knowledge; and institutional/systemic social justice advocacy skills.     

The Views of Social Work Students Toward Gay and Lesbian Persons

Abstract

Since it is estimated that 2.5 to 9% of men and 1.5 to 4% of women in the U.S. population are gay or lesbian, it is very likely that social workers will encounter gay or lesbian people as clients, co-workers, and/or supervisors. The Council on Social Work Education stresses nonjudgmentalism and acceptance as important social work values and requires that undergraduate social work students be exposed to content concerning gay and lesbian persons. This study was designed to examine the differences between the views of students choosing a social work major and students choosing other majors. Generally, social work students exhibited more positive attitudes than did students in other majors, even after controlling for personal attributes such as religiosity, gender, age, race, and political affiliation.     

Practice with Immigrants and Refugees

Abstract

Immigrant clients and their social workers can provide useful insights regarding elements of productive practice. Thirteen social workers and 19 clients were interviewed about their experiences. Two major themes were derived: Multifaceted Perception of Self and Other, as revealed in multiple connection pathways, multiple levels of cultural incorporation, and multiple communication avenues, and Proactive Service Provision through cultural bridging, brokering for services, and advocacy for system sensitivity. Practice implications are discussed.     

Facilitating Transition Among Transgender Clients: Components of Effective Clinical Practice

Although transgender clients seek services in a number of settings in which social workers practice, there is a dearth of scholarly literature available to guide effective clinical practice with this population. When transgender issues are included in the practice literature, the trend has been to consolidate the needs of transgender clients with those of the larger lesbian, gay, and bisexual community or to simply focus on increasing the comfort level of clinicians working with this population. This is concerning because transgender individuals represent a vulnerable subgroup of clients with unique and specific treatment needs related to the transition experience. Social workers play a critical role; they may serve transgender clients and their families in many ways: as advocate, educator, diagnostician, and individual, couples or family therapist. The purpose of this article is to identify several key components of trans-specific clinical practice and the role of social workers in supporting and facilitating client transition. Specifically, the authors will discuss: (a) relevant definitions and terminology, (b) emerging issues related to depathologizing the needs and experiences of transgender individuals, (c) the critical elements of trans-specific clinical assessment, and (d) clinical advocacy associated with the medical legal and social aspects of the transition process. Specific recommendations for trans-affirmative social work practice will be offered.     

A Client Perspective on Therapist Self-Disclosure

Abstract

Options of “coming out” in differing therapeutic modalities are considered. Modalities considered include traditional psychotherapy, alternative therapies, and managed care systems. Therapist disclosure situations are discussed from the viewpoint of both client and practitioner. Vignettes describing therapy experiences of adult lesbian and gay clients in a variety of clinical settings are presented. Clinical issues pertaining to therapist disclosure of sexual orientation receive consideration in terms of client self-determination as well as in terms of the options or limitations imposed by different modalities. Distinctions are drawn between disclosure in predominately lesbian and gay practice settings and disclosure in predominately heterosexual settings.     

Counselor Trainees' Assessment and Diagnosis of Lesbian Clients with Dysthymic Disorder

SUMMARY

Graduate-level counselor trainees completed an Assessment and Diagnostic Inventory consisting of clinical vignettes and a series of questions pertaining to conceptualization of client problem, diagnosis, and assessment of overall level of psychopathology.We hypothesized that participants would assign different diagnoses to clients with lesbian versus heterosexual sexual orientation. Participants responded to vignettes in which clients were identified as either a lesbian or a heterosexual female, with all other content identical. Participants were significantly more likely to perceive lesbian clients' problems to be related to sexual orientation for the vignette corresponding to dysthymic disorder. However, they were not more likely to assign personality disorder diagnoses, nor did they attribute a greater degree of psychopathology to lesbian clients with dysthymic disorder.     

Boundary Issues in Gay and Lesbian Psychotherapy Relationships

Abstract

Gay and lesbian psychotherapists face unique challenges when working with clients who also identify as gay or lesbian. Of particular importance are the roles professional boundaries play in working with sexual minorities. For example, clinicians must decide whether it is in the client's best interests to know the therapist is gay. Issues of contact outside of the therapy hour also become important, particularly when the therapist lives in a small community, or otherwise risks the possibility of seeing the client in the community. This chapter addresses some of these issues, and poses options for therapists on how to minimize professional boundary or ethical violations.     

Lesbian,Gay Male,Bisexual and Transgendered Elders: Elder Abuse and Neglect Issues

ABSTRACT

Unfortunately, due In large measure to our society's still-pervasive social prejudice against and ignorance about sexual orientation and gender minorities, there have been few studies of this population of elders, and virtually no one has examined how this population's culture affects its experience with elder abuse. Based on the author's knowledge of this community and discussions with social workers and domestic violence specialists who serve it, these clients are likely to be more resistant than other clients to accepting services. Greater awareness of the existence and circumstances of lesbian, gay male, and transgendered elders should help protective services staff in building rapport with these clients and in getting them the services and assistance that they need.     

Integrated Behavioral Health and Counseling Gender and Sexual Minority Populations

abstract

Counselors are increasingly expected to operate within an integrated behavioral health framework across systems of care. This critical literature review provides an overview of the integrated behavioral health paradigm, including the practice of interprofessional collaboration, with specific application to lesbian, gay, bisexual, transgender, queer (LGBTQ), and other gender and sexual minority issues. Implications for practice and research are discussed, along with a focus on concrete recommendations for application practicing interprofessionally with and on behalf of LGBTQ clients.     

A Gay and Lesbian Congregation Seeks Social Justice for Other Marginalized Communities

SUMMARY

The Cathedral of Hope in Dallas, Texas, is the world's largest gay and lesbian congregation. As an unabashedly liberal church, the Cathedral of Hope views social justice as the foundation of theological beliefs and the heart of community building activities with other marginalized and oppressed people. These actions of social justice and community building have produced an unexpected outcome. Social justice has been returned to this congregation in the form of community affirmation, acceptance, recognition, and advocacy. Thus, one significant way for gays and lesbians to achieve social justice is to work for the same with other oppressed people, devoid of strings or hidden agendas.     

Integrating Environmental Issues into Social Work Practice: Lessons Learnt from Domestic Energy Auditing

Abstract

This study of domestic energy audit practice draws on current literature and focuses on a program at Kildonan UnitingCare. It explores and highlights the relevance of natural environmental issues for social work practice and includes practical ideas for addressing financial, social, and environmental issues within case work practice and advocacy. The overlap between energy audit and social work practice is said to apply to both service user issues and the professional skill base of social workers. Finally, a transformation in social work thinking practice and education is suggested, within a vision that is community focused and holistically integrated.