Therapy with Lesbian Couples

Speaking as a therapist and a heterosexual, the author discusses her work with lesbian couples. She suggests that necessary components of good therapy are the therapist's awareness of his or her own views, fears and assumptions about homosexuality, and an understanding of the ways that society, including the world of therapy, still subjugates same sex relationships. Working with lesbian couples raises challenges that are pertinent to the wider issue of the redefinition of couple therapy in a society where the couple relationship itself is being redefined.     

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.     

How a Therapist Responds to Cultural Versus Noncultural Dialogue in Cross-Cultural Clinical Practice

A therapist's capacity to respond appropriately to a client is crucial in fostering positive therapeutic relationships and outcomes in general but it is even more important in cross-cultural therapy. Given the clinical significance of the dyad-specific and dynamic nature of the therapist's responsiveness, our study explores one white female therapist's responsiveness with three racial/ethnic minority clients in the beginning phase of therapy sessions. Using the structural analysis of social behavior and conversation analysis, the turn-by-turn intensive analysis of culturally relevant and nonrelevant talk in therapy illustrates how a therapist, who is appropriately and positively responsive to clients in other contexts, becomes disengaged and even negatively oriented during culturally relevant talk. This finding illustrates the challenges involved in maintaining positive engagement and responsiveness in cross-cultural therapeutic communication. Our findings also highlight the usefulness of focusing on moment-to-moment interactions in cross-cultural clinical practice.     

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.     

The Therapist's Imagination of Self in Relation to Clients: Beginning Ideas on the Flexibility of Empathic Imagination

The therapist's capacity to imagine is one specific part of the endeavour of empathy which lies at the heart of the processes of the therapeutic relationship. This article offers beginning ideas about the significance of therapist's imagination of self in relation to her/his clients in the task of trying to understand their experience. In seeking to ‘understand’ the experience of others, the therapist is able to move between an imagination of sameness/identification with the client/s, and an imagination of difference/‘foreignness’. The family therapy orientation of curiosity and ‘not‐knowing’ relies on the imagination of self as different to our clients; more traditional understandings of empathic connection rely more heavily on the imagination of sameness/identification with clients. This article argues that flexibility in the therapist's use of self in moving between these positions allows an expanded capacity for therapeutic connectedness. These ideas have special valence in the practice territories of impasse and intercultural therapy.     

The Masculine Principle in Lesbian Families: A Jungian Understanding

ABSTRACT

Using the concepts of individuation and masculine and feminine principles from Jungian psychology, the author explores the use of the masculine principle in parenting male children in families without an embodied father. The role of lesbian parents' own relationship with the masculine within themselves, features of the initiation process, and the function that team sports can play in a boy child's development are presented and examined. Lesbian parenting of sons is explored from both personal and professional perspectives.     

Lesbian Books,Lesbian Book Reviewing

Abstract

The emergence of lesbian book reviewing as a genre has several causes: the boom in lesbian book publishing; the increased visibility of lesbian books in mainstream bookstores; heterosexual readers' current fascination with lesbians and lesbianism; a growth in academic and feminist interest in lesbianism and “queer studies”; a general appetite for the “good” lesbian fiction that has appeared recently; and a new world market for lesbian writing. Responsible lesbian book reviewing should have as its goals to review as many books by lesbian authors as possible, including those not “about” lesbian issues or topics; to review books about lesbianism and lesbian issues, including those written by heterosexuals; to cover the entire range of genres, from serious academic books to popular romances; to seek out and publicize lesbian writers from around the world; to make known smaller lesbian and lesbian-friendly presses; and to present a wide range of responsible reviewer comments on the books reviewed, as the lesbian book market continues to grow, lesbian book reviewing should let readers know what's available, create dialogue about the ideas presented in lesbian books, establish ethical stances, support lesbian publishing, become a responsible member of the “lesbian community,” and create a wider space for lesbian writing in the world of readers.     

Lesbian Stepfamilies

ABSTRACT

Cherlin's (1978) model of remarriage as an incomplete institution is used to show how lesbian families' experiences are similar to and different from those in heterosexual stepfamilies. We examine how heterosexism and homophobia enhance the marginalization of lesbian stepfamilies. Despite the importance of the partner's role in the family, much of the lesbian stepfamily research neglects her. Ways to involve the partner's perspective in practice and research and to broaden research perspectives on lesbian stepfamilies are suggested.     

Marital Therapy — The Therapist

This article applies systems principles to an appreciation of the couple therapist. It offers an overview of the changing role of therapists and addresses the philosophical debate of the therapist as scientist or artist. It demonstrates how the worldviews, beliefs and values of clients and therapists are influenced by, and in turn influence, the therapeutic and wider social contexts to which they belong. The question of how a therapist simultaneously maintains personal values and neutrality is considered. The implications of examining the therapist's role from a systems framework are discussed. It is concluded that research needs to adopt a more holistic methodology and that impasses need to be analysed by examining beliefs at different levels within the systems involved. Finally, a personal account of the effect that therapy has on the therapist is offered.     

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.     

Vicarious resilience from attachment trauma: reflections of long-term therapy with marginalized young people

The concept of vicarious resilience captures the therapist's emotional growth occurring as a direct result of therapeutic engagement with traumatized clients. Three chronological case scenarios are presented for exploration of vicarious resilience in relation to attachment trauma. The purpose is to increase awareness and appreciation of the positive functions it serves for client mentalization, therapist skill and resilience factors for both parties. The reflective methodology considers the intrapsychic worlds of the client and the therapist and details how the therapist comes to experience the client's distressing projections. The potential for vicarious resilience begins from the outset of the therapist's actions of containment upon these projections. Advancing early ideas, it is advocated that vicarious resilience requires the therapist to have both the capacity and willingness to maintain a constant reflective stance.     

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.     

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.     

Teaching social work is teaching to ask questions: an inter-subjective approach to social work practice

Abstract

This paper sets out to provide examples of how quotations from literature can come to and work on a therapist's mind when engaged with clients. A consideration of Sylvia Plath's poetry and writings provide a number of examples of how some knowledge and understanding of her material has contributed to and enhanced work with distressed and disturbed clients. Work with a woman who had made allegations of Satanist abuse is then discussed with particular reference to the relevance of Hamlet to the work. Examples from a therapeutic group are provided which illustrate how literature can function as a communicator of feeling at an unconscious level. Consideration is then given to the wider social and political relevance of subjective feeling with reference to the work of Franz Kafka. There is also acknowledgement of how recourse to literature could be used as a defence against painful material rather than contributing to an understanding of it. The paper concludes with an attempt to understand why it is that claims are made for the healing value of literature and the arts and how these healing processes can operate in the therapeutic encounter.     

Building a Translengua in Latina Lesbian Organizing

ABSTRACT

This article discusses the challenges and rewards, as well as the affective labor, involved in forging a Latina lesbian “translengua,” in other words a common language in the context of Latina lesbian organizing. I explore how members of Latina Lesbians en Nuestro Ambiente (LLENA) and Amigas Latinas, Chicago-based Latina lesbian organizations, attempted to foster consensus for collective action in the face of language differences and preferences. Through analysis of archives and interviews with activists, I untangle how LLENA and Amigas Latinas negotiated deeply personal and sensitive issues around language use as they worked to build an inclusive movement. I also identify strategies used to enact a translengua that could bridge linguistic differences within the Latina lesbian community.     

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.     

Mentoring for Gay and Lesbian Youth

Abstract

Coming to terms with one's sexual identity always has presented a challenge to gay and lesbian adolescents. Older gays and lesbians have useful knowledge to contribute to the younger generation, whose members usually lack role models of successful gay and lesbian adults. Mentoring programs that involve gay and lesbian youth and adults are an important, but overlooked resource for sexual minority youth.     

Being a Gay or Lesbian Professional in a Psychiatric Hospital for Adolescents

Abstract

Differing styles and ranges of self-disclosure are highlighted through interviews with lesbian and gay clinical staff at an in-patient setting in the Midwest. Each staff, three men and one woman aged 44 to 62, is presented through a psychosocial history concerning religious, marital, and coming out issues. Participants are interviewed about their style and degree of disclosure of homosexuality to staff, clients, and family. The author concludes that degree of “coming out” correlates with positive adjustment to sexual orientation for the interviewees more than with fears about job loss or personal reprisal.     

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.     

Becoming Lesbian Adoptive Parents

ABSTRACT

Legal, public policy, and social biases make the process of becoming a family difficult for lesbian and gay parents. Currently Massachusetts prohibits discrimination on the basis of sexual orientation against individuals who apply to become adoptive parents, and allows second parent adoptions enabling adults to adopt a partner's child. We surveyed lesbian adoptive parents, heterosexual adoptive parents, and lesbian parents who used assisted fertilization to determine if the adoption process is similar for lesbian and heterosexual couples, and if lesbian adoptive parents are similar to lesbian parents who use assisted fertilization. The adoption process was similar for both lesbian and heterosexual parents, but lesbian adoptive parents perceived more discrimination and were more inclined to omit information during the home study. Lesbian biological parents found conception, pregnancy and birth “easy.”