Bisexual Clients Research Articles

Sandra C. Anderson, Substance use disorders in lesbian, gay, bisexual, and transgender clients: Assessment and treatment

Sandra C. Anderson, <i>Substance use disorders in lesbian, gay, bisexual, and transgender clients: Assessment and treatment</i>

Perceived Competency in Working With LGB Clients: Where Are We Now?

Lesbian, gay, and bisexual (LGB) clients use counseling services at higher rates than their heterosexual counterparts, yet current training for counselors may be inadequate. In this online study, 234 graduate counselor education and counseling psychology students completed the Sexual Orientation Counselor Competency Scale (Bidell, 2005) and provided information about their training in working with LGB clients. Participants viewed themselves as more competent on the Awareness and Knowledge subscales than on the Skills subscale. Increased level of training (doctoral vs. master's), number of LGB clients seen in practica, and attendance at LGB‐focused workshops and conferences were associated with increased competence. Implications for programmatic development are discussed.

To what extent are UK clinical psychologists adequately trained to work confidently and effectively with lesbian, gay or bisexual clients?

How to develop clinical psychologists’ confidence and effectiveness in working with lesbian, gay and bisexual (LGB) clients is considered in light of evidence that doctoral training programmes do not appear to be adequately facilitating learning in this area.

Gay affirmative psychotherapy with lesbian, gay, and bisexual individuals: Implications for contemporary psychotherapy research.

Although a fair amount has been written about gay affirmative psychotherapy, there has not been a clear consensus on what actually constitutes gay affirmative therapy. Because there are no real theoretical framework, operational definitions, or outcome measures, pychotherapists are left unsure about how to incorporate it into their practice and researchers are unsure how best to investigate it. This article offers recommendations to identify gay affirmative therapy as a culturally competent approach for working with lesbian, gay, and bisexual clients and offers future research directions including how to utilize the "coming out" narrative in gay affirmative therapy.

Knowing what we do not know about sexual orientation change efforts.

Comments on the original article, "Guidelines for psychological practice with lesbian, gay, and bisexual clients," by the American Psychological Association (see record 2011-19419-001). The present authors notes that the APA has provided a very helpful document for those who do clinical work with individuals experiencing same-sex attractions. Psychologists no doubt need to be familiar with the literature described in these guidelines as a part of ethical practice. However, the present authors register concern regarding how the guidelines address sexual orientation change efforts (SOCE). They focus their critique on how the guidelines portray two issues pertaining to SOCE-effectiveness and harm-and conclude with a proposal to move the discussion forward via science.

Guidelines for psychological practice with lesbian, gay, and bisexual clients.

Guidelines for psychological practice with lesbian, gay, and bisexual clients.

Science meets practice in determining effectiveness of sexual orientation change efforts.

Comments on the original article, "Guidelines for psychological practice with lesbian, gay, and bisexual clients," by the American Psychological Association (see record 2011-19419-001). Guideline 3 of the acknowledges the diversity of human sexual orientation and that "efforts to change sexual orientation have not been shown to be effective or safe" (p. 14). As noted in the Report of the American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation (APA, 2009), "Current criteria for effective treatments and interventions are specific in stating that to be considered effective, an intervention has consistent positive effects without serious harmful side effects [emphasis added]" (p. 26). The present authors note that half a century of scientific research on a variety of sexual orientation change efforts (SOCE) has not demonstrated their effectiveness according to the criteria of consistent positive effects and absence of serious harmful effects. Guideline 3 (APA, 2012) therefore urges psychologists to closely assess the motivations of clients who seek SOCE in the context of stigma and internalized prejudice about their non-heterosexual orientation. In addition, the guideline also recommends that psychologists obtain truthful, thorough, and thoughtful informed consent and that they focus on personal integration instead of sexual orientation change. The burden of proof has been on advocates of SOCE, and the present authors assert that it has not been met.

A Narratology of Lesbian, Gay, Bisexual, and Transgender Clients’ Experiences Addressing Religious and Spiritual Issues in Counseling

Although spiritual and religious themes have been found to be salient for lesbian, gay, bisexual, transgender (LGBT) individuals, a paucity of research has explored how these themes are attended to in the counseling context. This qualitative investigation used a narratology approach to explore the counseling experiences of seven LGBT clients around spiritual and religious issues. The narrative which emerged included (a) negative counseling experiences, (b) client perseverance in locating additional counseling, (c) positive counseling experiences, and (d) a reframing of counselor responsibility. The results of this study contain implications for future research, clinical practice, and counselor training.

Lesbian, Bisexual, and Queer Women's Spirituality in Feminist Multicultural Counseling

This article discusses considerations for integrating spirituality into feminist multicultural counseling (FMC) with diverse lesbian, bisexual, and queer (LBQ) women clients. First, the authors describe the historical conflict between LBQ women and conservative religions and explain how hierarchical, patriarchal assumptions and values of conservative religions may have a negative effect on well-being and empowerment. Second, the authors describe the positive influences of affirming religions and spiritualities on LBQ women's resilience within oppressive sociocultural contexts. Third, the authors explore the relevance of FMC when integrating spirituality into counseling with LBQ women. Fourth, the authors provide an overview of a model of FMC framework for integrating spirituality into FMC. Finally, we provide a client vignette example.

Finding the Spirit Within: Religion, Spirituality, and Faith Development in Lesbian, Gay, and Bisexual Individuals

This article addresses the interconnectedness between gay identity and spiritual development as well as explores the unique challenges that lesbian, gay, and bisexual individuals face when trying to incorporate a sense of spirituality into their sexual identity. This article addresses what counselors and other mental health practitioners can do to help facilitate spiritual exploration with their sexual minority clients and reexamine the notion of “faith development” and what it means for lesbian, gay, and bisexual clients to find the spirit within. The article also presents traditional and nontraditional methods to find spiritual fulfillment by introducing a four-part counseling framework and how this can contribute to overall mental health.

A Collaborative-Affirmative Approach to Supervisory Practice

As gatekeepers of the profession, supervisors must work to ensure that supervisees do no harm to their clients. At times this requires a more hierarchical approach to supervision, which may pose difficulties for supervisors working from a collaborative stance. These matters may become intensified when supervisees work with lesbian, gay, or bisexual clients and affirmative supervision becomes necessary, which tends to come from a “knowing” stance. By highlighting the aspects of collaborative and affirmative supervision and the necessity of affirmative supervision, this article provides an affirmative approach to supervision that is congruent with collaborative supervisory practices. A way of including the presence of the lesbian, gay, or bisexual client in supervision in an effort to merge collaborative and affirmative supervision is addressed. An overview of the collaborative-affirmative approach, as well as supervisees who may be suitable candidates for receiving collaborative-affirmative supervision are discussed. The implications of the approach and its possible limitations are provided.

Helping Christian Lesbian, Gay, and Bisexual Clients Recover Religion as a Source of Strength: Developing a Model for Assessment and Integration of Religious Identity in Counseling

Spirituality, including its expression in religious identity, has been increasingly recognized as a vital source of strength in coping that can be integrated in the counseling process to affect positive outcomes. However, lesbian, gay, and bisexual clients frequently experience conflicts between their religious and sexual orientation identities that complicate or prevent their access to religion as a source of support. Complicating matters, counselors may feel ill equipped to address religious concerns in counseling settings that are not faith based. The Goals, Renewal, Action, Connection, and Empowerment (GRACE) model is offered as a means to assess and integrate religious identity with lesbian, gay, and bisexual clients in the counseling process. A composite hypothetical case illustrates the application of the model with a client.

Handbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual Clients

Handbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual Clients

Deconstructing Heterosexism: Becoming an LGB Affirmative Heterosexual Couple and Family Therapist

The purpose of this article is to propose a three-step model to help heterosexual therapists become more aware of the influence of their own heteronormative assumptions, heterosexual privileges, and heterosexual identities on the therapy process. This article also provides definitions of concepts central to the practice of affirmative therapy with lesbian, gay, and bisexual clients and strategies that therapists and clients can use to deconstruct heterosexism in the context of therapy.

How do you see me? Coming out in counselling

ABSTRACT Recent large-scale survey research has raised serious concerns in both the counselling community and the mass media about the ways in which counsellors work with lesbian, gay and bisexual (LGB) clients. The current questionnaire-based research focused on client experiences of their own, and their counsellor's, self-disclosures of sexuality. Most clients did not require counsellor disclosure. However, failure of the counsellor to disclose could result in problems and assumptions being made by the client. We conclude that LGB awareness is improving, but there is still much need for training in this area to challenge limiting assumptions by some counsellors and to avoid the need for clients to educate them.

Psychologists' competence to treat lesbian, gay and bisexual clients: State of the field and strategies for improvement.

Recognizing research which suggests that many practicing psychologists enter the field without training or with inadequate training in the knowledge, skills, and awareness needed to treat lesbian, gay, and bisexual (LGB) clients, the authors in this Focus on Ethics provide suggestions for psychologists seeking competence with this population. In the lead article, Lyons fleshes out the contours of competent practice, presents the current state of psychologist competence, and calls for greater levels of competence. Next, Bieschke and Dendy respond by applying the Ethical Acculturation Model to describe the question of competence for those who may come from cultures not condoning of an LGB affirmative stance. Worthington provides hypotheses for the current rates of competence in the field and encourages the use of evidenced-based training and practice to increase competence. Finally, Georgemiller confirms the role of practicing psychologists who are heterosexual allies and identifies resources for gaining competence.

In Her Own Words: Ethnic-Minority Bisexual Women's Self-Reported Counseling Needs

Literature on counseling competence with lesbian and gay clients has been growing; however, research on bisexual-specific counseling is in its early stages. The counseling needs of ethnic-minority and female bisexual clients remain largely unexamined. Qualitative interviews with 14 ethnic-minority bisexual women were conducted to investigate the counseling considerations for this population. Consensual qualitative research analysis was used. Analyses revealed that counselor knowledge of the ethnic-minority bisexual experience, client concerns regarding counseling, specific therapeutic tasks, counselor's need for awareness of biases and client preferences for counselor characteristics were important counseling considerations. Implications for theory, practice, and research are explored.

Differences in Outcomes, Completion Rates, and Perceptions of Treatment Between White, Black, and Hispanic LGBT Clients in Substance Abuse Programs

Research suggests that the needs of lesbian, gay, bisexual, and transgender (LGBT) clients from racial minority groups may not be adequately addressed in substance abuse treatment. Few research studies, however, have been performed to examine this issue. In New York, 191 LGBT former clients of substance abuse programs completed surveys to determine differences in outcomes, completion rates, and perceptions of treatment among white, black, Hispanic, and “other” participants. No differences in outcomes or completion rates were found between racial groups. White participants, however, in comparison to nonwhite respondents, reported less satisfaction, less connection to the treatment program, and in a multivariate analysis, less therapeutic support.

The positive aspects of a bisexual self-identification

Bisexual clients (Page, 2007) and lesbian, gay and bisexual (LGB)-affirmative therapists (Godfrey, Haddock, Fisher, & Lund, 2006) agree that facilitating a positive identity is one of the most important therapeutic tasks. However, the task of achieving a positive identity may be particularly challenging for bisexual-identified individuals (Rust, 2002). To assist in this effort, the authors conducted an online survey that asked bisexual-identified individuals to respond to an open-ended question about the positive aspects of bisexual identity. Findings from an international sample of 157 adult participants (age 18–69; 67% female; 25% Canadian; 19% British; 51% American; 5% other) revealed 11 positive identity aspects: freedom from social labels, honesty and authenticity, having a unique perspective, increased levels of insight and awareness, freedom to love without regard for sex/gender, freedom to explore relationships, freedom of sexual expression, acceptance of diversity, belonging to a community, understanding privilege and oppression and becoming an advocate/activist. Each of these positive aspects is illustrated with quotes from participants. The authors offer suggestions for incorporating these findings in bisexual-affirmative counselling and therapy.

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.