Systemic Therapeutic Approaches with Sexual Minorities and Their Families

Abstract

GLBTQ families encompass very diverse forms, all of which are interwoven with other differences such as class, race, ethnicity, religious and spiritual beliefs. This article will familiarize the reader with some challenges faced by families of sexual minorities and how different family therapy approaches might be applied. Training issues for therapists are identified and future areas for development are discussed.     

Being Heard on Sexual Orientation

Abstract

In 2001, Maryland became the twelfth state to pass legislation that prohibits discrimination against gays, lesbians, and bi-sexuals in employment, housing, and public accommodations. As part of a ten-year effort to pass such protections, the Governor of Maryland established a Commission to Study Sexual Orientation Discrimination. The Commission held five public hearings throughout the state in 2000 and used the testimonies to prepare a report which helped pave the way for the passage of the legislation. This article is an analysis of 113 oral testimonies, both for and against the legislation. Such information may be helpful in other states where anti-discrimination efforts are on-going.     

Empirical Validations of a Multidimensional Model for Assessing Sexual Orientation

ABSTRACT

The purpose of this study was to validate Chung and Katayama's (1996) multidimensional model for assessing sexual orientation. Participants included five independent samples: (1) 32 Asian American gay men; (2) 201 lesbian, gay, and bisexual persons; (3) 149 lesbian and bisexual women; (4) 103 lesbian and bisexual women; and (5) 207 lesbian and bisexual women. Respondents completed a demographic questionnaire and items assessing sexual identity and sexual orientation. Results supported the validity of the multidimensional model. Across all samples, affective and physical attractions were moderately to highly correlated, whereas attractions to men and women were relatively independent. Practical and research implications are discussed.     

Incorporating Information from Neuroscience and Endocrinology Regarding Sexual Orientation into Social Work Education

ABSTRACT

The brains of heterosexual males and heterosexual females are different. Moreover, the brains of gay men are similar to those in heterosexual females, whereas the brains of lesbians are similar to those in heterosexual males. Gender-atypical features in gays and lesbians are not limited to brain structures but extend to other physical features (auditory function, finger print patterns, relative size of index and ring fingers) and interest patterns and behaviors. The research supporting these postulates is reviewed. The gestational processes that might explain the differences in brain structure and function corresponding with sexual orientation are reviewed. A discussion of the physiological bases for the expression of gender-related traits and a discussion of factors contributing to sexual identity are provided. Throughout the article, alternative ways to think about gender are suggested. The importance of integrating the information presented in this article into the curriculum of social work education is explained.     

Does Sexual Orientation Have an Impact on Nonverbal Behavior in Interpersonal Communication?

This study explores the impact of sexual orientation on the nonverbal behavior of individuals in dyadic communication situations. It is hypothesized that the patterns of nonverbal behavior displayed in dyads with and without an individual with an open homosexual orientation are different from those in dyads with heterosexual participants only. An observational study was conducted with a total of 24 participants, 12 with a heterosexual orientation and 12 with a homosexual orientation (6 males and 6 females in each group). Participants were videotaped during a 20-min conversation which took place in dyads that were composed of individuals of the same biological sex with either the same sexual orientation (homosexual or heterosexual) or differing sexual orientations. Results show that in dyads which include a homosexual person nonverbal behavior is different from that displayed in dyads consisting of heterosexual participants only in terms of self-touch, body posture, body orientation, and gaze. Results are interpreted in terms of stereotyping and presentation rules.     

Missing from the Conversation: Sexual Risk Factors Across Young People by Gender Identity and Sexual Orientation

Abstract

Objectives: Lesbian, gay, bisexual, and queer/questioning (LGBQ), and transgender/nonbinary (trans/NB) youth experience health disparities. Much research combines gender identity with sexual orientation or siloes them, ignoring intersections. Methods: Logistic regressions with representative data from 2015 Healthy Kids Colorado Survey (n?=?15,970) explores sexual risk. Results: Findings indicate LGBQ and trans/NB youth have differential levels of sexual risk (drugs during sexual interactions, not using condoms) compared to cisgender heterosexual peers. Other identities, mental health, and bullying are also related. Conclusions: There is a need for culturally responsive bullying prevention, mental health support, education, and sexual health services for marginalized populations.     

Asking About Sexual Orientation During Assessment for Drug and Alcohol Concerns: A Pilot Study

ABSTRACT

An assessment tool was designed to assist service providers in identifying lesbian, gay and bisexual (LGB) clients who present for assistance related to substance use concerns. Items were designed to facilitate self-disclosure of the individual's sexual orientation and identify concerns of LGB clients that will be relevant to treatment planning for substance use concerns. Therapists in general assessment and LGB-specialized services of a large treatment agency were trained to use the tool. This paper presents client and therapist comments made during the pilot study regarding the use and value of the assessment tool.     

Well-Being Among Spanish Lesbian,Gay, Bisexual and Heterosexual Adults: Disclosure of Sexual Orientation to Family and Friends

Relevance of disclosure of minority sexual orientation on subjective (SWB) and psychological well-being (PWB) was analyzed. Participants were 236 men and 238 women self-identified as lesbian, gay, and bisexual (LGB) or heterosexual. No differences in SWB were found between heterosexuals and LGBs. Heterosexual women showed greater environmental mastery than bisexual men and greater purpose in life than lesbian and bisexual women. Outcomes showed greater well-being among LGBs who disclosed their minority sexual orientation to parents later in life. Disclosing minority sexual orientation to parents was related with greater PWB. Further research that takes a differential approach to improve well-being for LGBs is needed.     

Integrating Reflective Practice in Family Therapy Supervision

This paper discusses how to integrate reflective practice in the family therapy supervisory relationship. This enables family therapists to think creatively, be insightful, and develop a range of perspectives regarding systemic formulation and practice. It encourages review of the past and promotes understanding in the present with the aim to improve therapists work with families in the future. Reflective practice encourages independent thinking and learning and helps therapists to develop a systemic process of critical enquiry to investigate and critique their own practice. It encourages therapists to be self‐reflective and develop confidence to think hypothetically regarding change. This allows them to pose questions for exploration, construct a new lens to conceptualise therapy and the therapeutic relationship and develop awareness of the personal as well as the professional self.     

Intentional Families: Fictive Kin Ties Between Cross‐Gender,Different Sexual Orientation Friends

This study explores the nature of intentional family relationships between friends of different genders and different sexual orientations. Drawing on in‐depth interviews with 46 members of 23 friendship dyads, I first make the case that the friends considered one another family and I specify the criteria they use for making such designations. I then focus on the ways in which gender and sexual orientation influenced relationships between lesbians and straight men and between gay men and straight women. The data provided evidence that the dyad members identified one another as family and served the functions of family for each other. The findings also suggest that various gender issues affect cross‐gender, different sexual orientation relationships. Exploring the meaning and functioning of these intentional family ties documents their existence and illuminates their meaning and maintenance.     

Family of Origin Supervision in the Workplace: Impacts on Therapist and Team Functioning

The Adolescent and Family Unit at Redbank House carried out a trial of Bowen's Family of Origin Coaching that has prompted us to comment on the usefulness of this approach as a component of clinical supervision. This article will describe how this trial came about, the process adaptations required to make it possible and how some of the ethical dilemmas raised by this approach were addressed. Personal reflections from the team members will be shared, and our observations in terms of impact of this form of supervision on clinical functioning, team cohesion and service provision will then be discussed. In essence, we aim to provide an anecdotal account of our experience and ask the question, ‘Is supervision that focuses on the therapist's individual functioning as a product of their intergenerational patterns a valid use of resources in a clinical setting?’     

Lesbians and Gay Men Embrace Their Sexual Orientation After Conversion Therapy and Ex-Gay Ministries

Abstract

This article examines narratives of gay men and lesbians who participated in conversion therapies and/or ex-gay ministries in order to change their sexual orientation to that of heterosexual. Data for this study were gathered through an analysis of the stories of 14 people, published in a document titled Finally Free, who describe their negative experiences with conversion therapy through ex-gay ministries. Analysis of the data revealed seven common psychosocial issues faced by gay men and lesbians who turned to conversion therapy in an attempt to become heterosexual. These issues provide knowledge for social workers' intervention with gay men and lesbians seeking healing and personal growth after participating in conversion therapy and ex-gay ministries.     

Dialogical Research in Supervision: Practical Guidelines from Experienced Supervisors in Family Therapy,Child Protection,and Specialty Mental Health Services

This two‐year qualitative participatory research project examines practical guidelines for supervision. Sixteen experienced supervisors across professional settings of family therapy, child protection, and specialty mental health services in the geographical regions of Northern Norway and Northern Sweden outline four main practical guidelines in supervision based on their supervisory practices: (1) elaborating an agreed‐upon contract; (2) exploring potential formats; (3) exploring contents; (4) acknowledging responsibility for process and dilemmas. Participants summarised how they generated mutual growth in supervisory relationships, while being respectful of the first‐person perspective of supervisees. The study challenges pre‐dominating guidelines about deficit‐ or developmental stage‐oriented supervision. It illustrates reflecting processes and a polyphonic orientation in supervision by welcoming diversity, wondering, and tolerance for the not‐yet‐decided among involved persons in a mutual exploration and calibration of relevant knowledge. It outlines a dialogical research for sharing, exploring, and questioning knowledge as beneficial for whom, told by whom, and evaluated by whom.     

The Equality Deficit: Protection against Discrimination on the Grounds of Sexual Orientation in Employment

The provisions of UK law offer no specific protection to gay men and lesbians suffering discrimination in the workplace on the grounds of sexual orientation. Such discrimination may take many forms and can result in ‘fair’ dismissal in certain circumstances. This article considers the degree of legal protection available under current provisions and investigates possible sources for the development of specific anti‐discrimination legislation. It is concluded that, despite the application of certain aspects of employment law, the level of protection afforded to this group of workers amounts to an equality deficit in comparison to the legal redress available to those discriminated against on other grounds. Although the development of human rights legislation may have some application in this context, the combination of institutionalized discrimination and wider public policy concerns suggest that the introduction of specific legislation aimed at eliminating such discrimination in the United Kingdom is still some way off.     

Questioning the Suitability of Traditional Self-Report Family Functioning Measures for Single-Parent Families with Young Children

Family functioning is a common interest of social science and health researchers. Most often, well-established self-report instruments are used to measure family functioning. Although these instruments have been used with families of diverse compositions, our experiences using one of the commonly used instruments, the McMaster Family Assessment Device (FAD), suggest that it is not appropriate for single-parent families with young children. In addition to describing the difficulties we encountered with the FAD, we discuss our experiences in relation to current research findings about the processes and effectiveness of family functioning in single-parent families. As well, we examine other frequently used self-report family functioning instruments, the results of which lead us to question the suitability of any of the commonly used self-report family functioning instruments for single-parent families with young children. We conclude by arguing for the development of family functioning instruments that are appropriate for diverse family structures and compositions.     

Stages of Change Theory in Family Therapy for Sibling Sexual Assault

Family therapy understands the benefits of therapeutically supported dialogue amongst family members when there are challenging themes and topics that need to be discussed. This paper is an attempt to explore ways that family therapists can work with family members who are thrust into therapy rather than ‘voluntarily’ signing up for it. It applies ideas from the drug and alcohol field such as Stages of Change theory and Motivational Interviewing. The paper explores how these ideas and approaches might help family therapists to formulate a concept of resistance and to make helpful dialogue more likely. They are applied to families experiencing sibling sexual assault, where they become involved with a legal response that necessitates a therapeutic intervention.     

Cut the Crap: Language — Risks and Relationships in Systemic Therapy and Supervision

This article concerns the use of language in both therapy and supervision, and how it contributes to the necessary risk‐taking that will be a part of therapists' and supervisors' repertoires. The focus will be on my own examples in both roles, and will refer to both successes and failures, while questioning the usefulness of either concept. Within a postmodern paradigm, and influenced by thinkers including Foucault and Bakhtin as well as systemic clinicians, I will examine the use of language (including in cross‐cultural settings where risks can sometimes be amplified) and of humour and self while exploring the meanings of identity. I contend that all relationships contain some element of risk and the ways in which we create a safe enough context, through the uses of language as well as nonlinguistic means, are the crucial elements in our endeavours as supervisors and therapists. I favour the idea that therapy is more of an art than a science and that this is most exemplified in the graceful use of language by which we strive to engage rather than alienate people. The article may be considered by some as being useful advice, and by others as a risk too far, such is the controversial nature of language, which highlights the importance of relationships and context.     

Tracking the Sexual Behavior-Specific Effects of a Foster Family Treatment Program for Children with Serious Sexual Behavior Problems

Few treatment programs exist for very young children with serious sexual behavior problems. Fewer still have produced data relating to their effectiveness, and the sparse data that have emerged have focused on global social adjustment or improvement rather than on sexual behavior- specific changes. This study tracked both frequency of problem sexual behaviors and care giver estimates of the propensity to re-offend of six initial clients referred to a treatment-intensive foster care program for sexually reactive children and pre-adolescent sexual offenders. A simple pre-post (basepoint-treatment) design was used, and in-treatment data gathered over a two-year interval are presented. Initial results indicate that the problem sexual behaviors of most of these youthful clients were effectively and immediately suppressed in the context of their treatment intensive foster placements, but that the program's impact on the clients' propensity to re-offend given the opportunity—a crude measure of treatment internalization—was much less immediate, less pronounced, and less predictable across clients. Recommendations based on these data are offered concerning the viability of foster care intervention for sexualized and offending children, as well as optimal durations for such treatments. The strengths and weaknesses of the novel progress tracking method are discussed.     

Transitions on the Margins of Work and Family Life for Low-Income African-American Fathers

Few studies explore linked transitions in work and family life for low-income African-American men. I examine patterns of work engagement among three cohorts of fathers and explore how they shape transitions in family residence and dynamics of family life. Establishment of a household was considered a shared project with partners and extended kin networks. Findings indicated that most fathers nested residence in households within sporadic spells of employment. Younger cohorts were less able to secure stable work and family arrangements at early ages, in comparison to older and middle cohorts. Implications for social policy include recognition of family formation beyond marital status, including negotiation of household establishment and arrangements for multiple providers in extended kin networks.This study was conducted with support from the National Institute for Child Health and Human Development R03 HD42074-2 to Kevin M. Roy and the Purdue Research Foundation at Purdue University in West Lafayette.     

Single Parenting in the African American Community: Implications for Public Policy and Practice

The percentage of female-headed African American families has increased significantly since the 1960s. It is now estimated that over half of all African American children will grow up in a female-headed household. This article examines factors related to the formation of these households as well as the challenges associated with these households. Policies and programs that have been implemented to treat these families are examined.