Differentiation of Self and Clinicians’ Perceptions of Client Sexual Behavior as “Problematic”

Abstract

Clients regularly come to psychotherapy wanting to discuss sexual concerns. Clinicians (across mental health professions) often lack training and comfort in addressing sexual concerns. Empirically, it is still unclear how clinicians manage their own level of comfort, values, and implicit beliefs about client characteristics associated with sexuality. Differentiation of self may be a useful construct for understanding the influence of (dis)comfort with sexuality, value commitments, and client characteristics (e.g., gender, marital status, exclusivity) on clinicians’ perceptions of client sexual behavior; though no study to date has empirically explored this possibility. To test the role of differentiation of self, participants, both licensed mental health professionals (n = 89) and clinicians-in-training (n = 109) were recruited from across the United States (M age = 36.40; 83.8% female; 80.3% White). Participants were asked to respond to a vignette about a client presenting with sexual behavior concerns and then completed a series of measures on differentiation of self, comfort with sexuality, personal values, and demographic items. As hypothesized, participants’ level of differentiation had nonlinear and linear conditional effects on how participants rated the client’s sexual behavior described in case vignettes. Implications emphasize the role for differentiation of self in clinicians’ management of sexual comfort, personal values, and client characteristics when encountering clients’ sexual concerns.