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.     

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.     

Career Development With Lesbian and Gay Clients

Trends in career counseling with lesbian and gay clients are reviewed along with discussions on considering lesbian women and gay men a different cultural minority. The role and direction of career development with lesbian and gay clients is presented based on current information regarding employment discrimination, the decision to pass as heterosexual on the job, counselor and student training issues, age-related factors, and differences between gay men and lesbian women with respect to careers. Concrete suggestions are made to career counselors who wish to prepare themselves to work with this group or to extend their effectiveness, and suggestions for services are also presented.     

Health Care Professionals' Experience,Knowledge, and Attitudes Concerning Homosexuality

The purpose of this study was to examine the experience with attitudes towards, and knowledge about homosexuality of three groups of health care professionals. Subjects were 97 registeres nurses, social workers, and psychologists who responded to a six-page mailed questionnaire. Professional discipline of the subject, gender of the client, and gender of the client's lover in a fictitious scenario did not significantly affect ratings or suggested diagnoses of the client. Most subjects felt that they needed moer training in working with homosexual clients, which was consistent with their high but not perfect scores on a knowledge test. Subject's mean scores of the Attitudes Toward Lesbians (ATL) and Gay Men (ATGM) scales of Herek (1998) reflected significantly less prejudice than his college samples. More knowledgeable respondents were less prejudiced and had more positive attitudes about working with gay and lesbian clients; those with more positive attitudes toward clients also showed less prejudice on the ATL and ATGM scales. The authors argue that training health care professionals to be more knowledgeable about gay and lesbian issues would lead to more positive attitudes and better services for gay and lesbian clients.     

Straight therapists working with lesbians and gays in family therapy

This article uses a cultural literacy model to sensitize straight marital and family therapists (MFTs) to work with gays, lesbians, and their families. While most MFTs number gays and lesbians among their clients, differences in sexual orientation between therapist and clients are often insufficiently addressed, closing off therapeutic possibilities. Marital and family therapists are asked to systematically assess homophobic and heterosexist assumptions in both personal attitudes and professional theory and practice and to educate themselves about gay culture and family life. The role of disclosure, trust, and collaborative meaning making in creating a therapeutic relationship that is culturally sensitive, clinically effective, and ethically responsible is examined.     

Childhood Sexual Trauma in Gay Men

Summary

Social context is a crucial lens through which to see and understand the experience of gay men who have been sexually abused as children. Clinicians who recognize the complex interplay of forces within this context will be better able to serve their gay male sexual abuse survivor clients. Given the trauma inherent in a cultural context which stigmatizes, devalues, pathologizes and punishes homosexuality, the added trauma of childhood sexual abuse in effect exponentially intensifies the trauma and the task of healing. It is particularly important that clinicians assist clients to separate sexual abuse and its effects from sexual orientation. Ideally, the former comes to be seen as imposed from without due to another's pathology, and the latter as an intrinsically good and positive part of self that exists entirely apart from the former. The phenomenon of an “Imprinted Arousal Pattern” (IAP), common among sexual abuse survivors, induces the individual to continue to be eroticized by stimulation and circumstances that overtly or covertly resemble the abuse circumstances. Case illustrations are provided to aid the reader in understanding and assisting others to work through this dynamic.     

Adapting Social Work in Working with Muslim Clients

Current social work education programmes and textbooks often underestimate the hypothesis that providing effective services to different cultural groups requires cultural understanding. One approach that has been recommended is the localization of social work: using a fundamentally different social work knowledge base and approach with different cultural groups. To date, however, little scholarship considers how to localize social work in working with Muslim communities. On the basis of interviews with over 50 social service providers in Canada who work with Muslim clients, the present article provides insight into strategies and methods that involve localizing social work in Muslim communities, focusing on possible client characteristics, challenges, and needs from the perspective of the practising social worker. Issues of racism, spirituality, acculturation, help seeking, and client expectations of service are particularly relevant. Properly responding to these factors ultimately involves the coordinated efforts of educational institutions, agencies, and social workers, but none of this will be possible without a thorough understanding of cultural values meaningful to Muslim clients.     

Intersections of Identities

ABSTRACT

This paper addresses several key issues related to counseling lesbian, gay, bisexual, and transgender (LGBT) Asian-Americans. An understanding of the intersections of these identities is important, yet can be complex because of the diversity within Asian-American cultural groups (i.e., ethnicity, generation, skin color, religion, levels of minority stress, and acculturation) and within LGBT communities. These factors may influence counselors' selection of developmentally appropriate and culturally sensitive counseling approaches for LGBT Asian-American clients. We propose a framework for understanding the intersection of racial/ethnic and sexual identity development, the Racial Ethnic and Sexual Orientation Identification Chart (RSIC), which is designed to assist therapists in determining relevant counseling issues and strategies. A case study is included along with a discussion of multidimensional assessment and clinical implications.     

Does Affirmative Training Matter? Assessing CFT Students’ Beliefs About Sexual Orientation and Their Level of Affirmative Training

This study examined couple and family therapy (CFT) students’ beliefs about sexual orientation, their self-reported competency working with lesbian, gay, and bisexual (LGB) clients, and the level of affirmative training students received in their CFT programs. One hundred and ninety students from accredited CFT programs completed the study. While participants reported feeling only somewhat competent to work with LGB clients and less than half reported receiving any training on affirmative therapy, the majority of the participants did appear to hold positive attitudes toward LGB clients. The results support the literature arguing for CFT programs to include specific training on affirmative therapy practices, as the level of affirmative training was directly related to participants’ self-reported clinical competency working with LGB clients.     

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.     

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.     

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.     

Motivational,ethical, and epistemological foundations in the treatment of unwanted homoerotic attraction

A recent special section of the Journal of Marital and Family Therapy (October, 2000) focusing on the mental health needs of gay, lesbian, and bisexual individuals neglected to address the clinical needs of homosexual persons who desire to increase their heterosexual potential. This article attempts to correct this omission by outlining common motivations for pursuing change, updating the current state of knowledge regarding the effectiveness of change efforts, and providing some ethical guidelines when therapists encounter clients who present with unwanted homoerotic attraction. Finally, to assist marriage and family therapists (MFTs) in more deeply understanding divergent perspectives about reorientation treatments, an examination of the role of moral epistemology is presented and some examples of its potential influence are described. MFTs are encouraged to recognize and accept, rather than ignore or deny the valid needs of clients who seek to modify their same-sex attraction.     

Culturally responsive social work practice with D/deaf clients

ABSTRACT

D/deaf individuals are often marginalized in our society. A lack of cultural understanding among social workers serving this population, coupled with communication barriers, inconsistent access to interpreters, or misperceptions of culture, adds to the potential for further marginalization. D/deaf individuals seeking mental health and social services live in a unique cultural context with which social workers may not be familiar and experience persistent issues surrounding access to mental health and social services. This article reviews some useful best practices, cultural points to be aware of, and suggests some strategies for providing culturally responsive social work when working D/deaf clients.     

Coming Out to Tell Our Stories: Using Queer Theory to Understand the Career Experiences of Gay Men in Public Relations

Despite the increasing focus on understanding the diversity of public relations, academics and practitioners have largely ignored gay men. Grounded in queer theory, this qualitative study examines the experiences of gay men working in public relations. We used in-depth interviews and focus groups to allow participants to discuss their careers openly. Practitioners indicated that they enjoyed working in public relations, although they pointed out areas of dissatisfaction and suggested ways to improve the working environment for gay men. These include an increased awareness of personal lives and the gay community, reduction of stereotypes, and adopting diversity-friendly policies.     

Psychotherapy with Gay and Lesbian Families: Opportunities for Cultural Inclusion and Clinical Challenge

Many gay men and lesbians are making decisions to have children, either through pregnancy, adoption, or by blending their families. These families may seek psychotherapy for help with dynamic issues which confront all families from time to time. This article presents a context for clinicians to deepen their understanding of cultural and clinical aspects of gay and lesbian parenting. This context will be discussed through the application of concepts frm self psychology within the framework of narrative theory in order to validate gay and lesbian family experiences by through the creation and understanding of their family narratives.     

Achieving Competent Family Practice with Same-Sex Parents

Abstract

Due to the increasing recognition of same-sex marriage in different jurisdictions and growing numbers of parents raising children in the context of a same-sex relationship, it is becoming ever more important for family therapists to attain clinical competence in working with families headed by same-sex parents. This paper takes as its premise that good intentions and general acceptance of diversity are not sufficient in working with this population of families. Rather, clinical competence rests on experience working with lesbian and gay clients and knowledge of the impact of heterosexism on parenting in the context of same-sex relationships. Equally critical to competent family therapy practice is a theoretical framework that pulls together complementary concepts from different bodies of theory to analyze family structures and functions in the social context of heterosexism. To this end, this paper reviews family systems theory, structural social work, ecological systems theory and queer theory with an eye to culling complementary constructs relevant to working with same-sex parents. Specific aspects of family functioning such as maintenance of boundaries around and within families and role differentiation between parents are then explored using this theoretical framework. Finally, implications for the clinician working with families led by same-sex parents are reviewed.     

What Is Love without Mourning? Male Intimacies and Cultures of Loss

In this article, the author considers loss and mourning in relation to male homosexual love. He uses mourning as a framework through which to raise questions about the social and cultural status of gay male love in contemporary societies. He argues that loving within heteronormative cultures of intimacy creates forms of vulnerability for gay men and that this is often compounded at times of personal loss. He uses a psychoanalytic framework to consider the important role of culture in the mourning process and reflects on the ways that cultural forms, practices and representations provide the context through which mourning can be both facilitated and disabled. Recent examples from popular culture are used to consider the important role, and often significant absence, of symbolic frameworks through which gay men can enter into dialogues of mourning. In conclusion, the author argues that the social valuing of loss is intimately bound up with the social valuing of love.     

Social Work Educators’ Attitudes Toward Gay Men and Lesbians: A National Assessment

A sample of 927 U.S. social work educators expressed limited negative attitudes toward lesbians and slightly more negative attitudes toward gay men in this cross-sectional, national study using standardized survey instruments with proven psychometric properties. Faculty most likely to express negative attitudes toward lesbians included those employed at a religiously affiliated university (whether sectarian or non-sectarian), identifying as African-American and male, working in an urban or suburban setting (rather than a rural one), and having probationary tenure-track status. These individual and institutional characteristics accounted for 7.8% of the variance in social work educators’ negative attitudes toward lesbians. Faculty most likely to express negative attitudes toward gay men included those identifying as African-American, employed at a religiously affiliated university, identifying as heterosexual and male. These variables explained 12.4% of the variance in social work educators’ negative attitudes toward gay men. Implications for social work education are addressed and suggestions generated regarding how social work educators and their educational programs can ensure that they are preparing competent, unbiased practitioners who can advance social justice and reduce oppression among gay and lesbian clients.     

Defining Culturally Competent Practice with Sexual Minorities: Implications for Social Work Education and Practice

In recent years, social work has placed an increasing emphasis on culturally competent practice. Although use of that term has referred primarily to practice with ethnic and racial minorities, the concept has been broadened to include social work with other culturally diverse populations. This article examines the application of cultural competence principles to practice with gay, lesbian, bisexual, and transgendered clients. Attitude, knowledge, and skill components are addressed to delineate a culturally competent approach to social work with sexual minorities. Implications for practice, education, and the profession are also discussed.