Counseling Lesbian _ Gay_ Bisexual_ Transgendered and

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Counseling Lesbian _ Gay_ Bisexual_ Transgendered and Powered By Docstoc
					    Counseling Lesbian, Gay, Bisexual,
 Transgendered and Questioning Clients:
Techniques, Homework, and Activities for
          Working with Adults

         Megan Mahon, PhD, PCC
           Heidelberg University
          Tara Hill, PhD, PCC/S
          Old Dominion University
         Amber Lange, PhD, LPC
            University of Toledo
 Introduction
 Affirmative Therapy
    Foundation
 Education and Training Considerations
    Competencies
 Treatment
    Themes & Issues
    Techniques
    Homework
    Cases
Affirmative Therapy - Foundation

 Definition
 Physical Environment
 Language

Chernin & Johnson (2003)
Psychological Assessments
 Scales with Heterosexist Bias
     Omission bias
     Connotation Bias
     Contiguity Bias
       Minnesota Multiphasic Personality Inventory (MMPI-2)
 Scales with Non-Inclusive Language
     Social Readjustment Rating Scale (SRRS)
     Sexual Addiction Screening Test (STAST)
 Scales with Inclusive Language
     Strong Interest Inventory (SII)
     Beck Depression Inventory (BDI)

Chernin & Johnson (2003)
Useful Assessment Tools for the Practitioner

    Self assessment
        Sexual Orientation Counselor Competency Scale (SOCCS)
    Internalized homophobia
        Nungesser Homosexuality Attitudes Inventory (NHAI)
        Index of Homophobia (IHP)

   Chernin & Johnson (2003)
                  Sample Inclusive Form
                     ADMISSION FORM
                     Name: _____________________Date:_____________________
                     Address: _____________________________________________
                     City: __________________State:_______ Zip: _____________
                     Phone #: _________________E-mail address: _______________
                     Ethnicity: ____________________Age: _____Birthdate: __/__/___
                     Highest grade completed:___________
                     Employer: _________________________________________
                     Address: _______________________________________________
                     City: _____________State:_____ Zip: ______Phone #:_________
                     May I contact you at work? Yes ____ No _____
                     Relationship status: Single _____ Married/significant other________
                     Divorced/relationship dissolved (date) _________________________
                     Widowed/death of partner (date) _____________________________
                     Spouse/partner name: _____________________________________
                     Spouse/partner employer: __________________________________
                     Address: ________________________________________________
                     City: _____________State:_____ Zip: ______Phone #:_________
                     Emergency contact: ______________________ Phone #:_________
                     Source of referral: ________________________________________

Chernin & Johnson (2003)
Education and Training Considerations

 Competencies
 Counselors and the LGBT experience
 Sexual Orientation Counselor Competency Scale (SOCCS;
   Bidell, 2005)

ALGBTIC (2009); Bidell (2005)
LGBT Counselor Competency- History

 ALGBTIC competencies endorsed

Logan & Barret (2005)
LGBT Counselor Competencies

 Human Growth and Development
 Social and Cultural Foundations
 Helping Relationships
 Group Work
 Professional Orientation
 Career and Lifestyle Development
 Appraisal
 Research

ALGBTIC (2009)
Human Growth and Development

 Biological, familial, and psychosocial factors
 Identify the heterosexist assumptions
 Chronological ages/developmental stages
 Identity formation/stigma management
 Adolescents
 Seniors

ALGBTIC (2009); Logan & Barret (2005)
Helping Relationships

 Acknowledge the societal prejudice and discrimination
 Be aware of your sexual orientation and gender identity
 Seek consultation or supervision
     such efforts may be detrimental or even life-threatening
     empirical evidence of lasting change is lacking

ALGBTIC (2009); Logan & Barret (2005)
Social and Cultural Foundations

 Acknowledge and understand:
     Heterosexism
     Internalized prejudice
     Developmental tasks of LGBT women and people of color

ALGBTIC (2009); Logan & Barret (2005)
Group Work

 Allies
 Norms
     Safety
     Inclusion
     Voluntary self-identification
     Self-disclosure
 Intervene

ALGBTIC (2009); Logan & Barret (2005)
Professional Orientation

 Know history
 Be familiar with needs/issues/resources
 Educate and challenge
 Professional development

ALGBTIC (2009); Logan & Barret (2005)
Career and Lifestyle Development

 Occupational stereotypes
 Employment discrimination
 Increase client awareness
     viable career alternatives
     facilitate both identity formation and job satisfaction

ALGBTIC (2009); Logan & Barret (2005)

 Homosexuality, bisexuality, and gender nonconformity ≠
 Presenting problems
 Be aware of heterosexist bias in the interpretation of
  psychological tests and measurements

ALGBTIC (2009); Logan & Barret (2005)

 Carefully formulate research questions
 Consider the ethical and legal issues
 Acknowledge the methodological limitations
 Recognize the potential for heterosexist bias

ALGBTIC (2009); Logan & Barret (2005)
Affirmative Therapy

 Themes and Issues
   Techniques
   Homework
   Cases
Couples, Family, and Group Work
                             CASE STUDY-TERESA
Theresa, a 72 year-old African American woman, calls you for an appointment. She
  is agitated and talks about having insomnia and anxiety. Her partner of 22 years,
  Susan, broke her hip and was admitted to a nearby hospital. Susan’s children do
  not want Theresa to be at the hospital at the same time that they are visit. In
  addition, the last time she was at the hospital, Theresa overheard Susan's
  children talking about contesting Susan's will, which leaves everything to
  Theresa. Theresa is afraid that they might take her to court, which would drain
  much of her savings.

Theresa is facing the devastation of having a partner with failing health, in addition
  to having to cope with stress related to the way Susan’s family has reacted. What
  kinds of diagnoses would you consider? What would you do if she refused a
  psychiatric referral or if she seemed scattered and disoriented? How would you
  help empower her or advocate for her?

Chernin & Johnson (2003)

 HOMEWORK-Spiritual Autobiography
     Spiritual Heritage
     Sexual Orientation and Spirituality
     Cultivating Spiritual Wellness

Whitman, Boyd, & Associates (2003)
Social Relationships

 Family of Origin/Friendships
 TECHNIQUE-Self Perception
     How I see myself
     How others see me
     My ideal self

Whitman, Boyd, & Associates (2003)

 Coming out at work
 Blending
 Covering
 Openness about sexual orientation correlates with job
   satisfaction (Ellis & Riggle, 1995)

Chernin & Johnson (2003)
Relationship to Self

 Coming out, Loss of life image, substance abuse, eating

TECHNIQUE-Bisexual Clients
 Conflict Split-Empty Chair-Critical and Experiencing Sides
     Opposition Stage
     Identification and Contact
     Integration Stage
     Final Stage

Chernin & Johnson (2003);Whitman, Boyd, & Associates
HIV/AIDS, Dating, and Relationships

 Risk factors
 HIV Testing
 Adjustment to diagnosis
 Adjusting to HIV/AIDS diagnosis
 Identity Development
 Depression
 Suicide, Euthanasia, Bereavement

Chernin & Johnson (2003)
HIV/AIDS, Dating, and Relationships
                     CASE STUDY-MARTIN AND RICK
Mark and Rick have been together for 10 years. They are entering therapy because
  they have been experiencing major problems in their relationship. Mark, who
  has AIDS, called you for the initial appointment. In session, Mark says he found
  a phone number in Rick's pocket and later caught Rick and another man having
  sex in their apartment. He says that Rick violated two agreements: there can be
  no "call-backs" (that is, only anonymous sex with others is allowed), and they
  cannot have sex with another partner in their apartment. Rick replies that,
  because of his increasing fear of contracting HIV and their "boring" sex life, he
  will continue to see Joe, though he agrees not to have sex with Joe in their
  apartment again.

Is there any way to reach a compromise in this situation? What do you think is
    really going on in this relationship? If Mark is increasingly dependent on Rick,
    could this be Rick's way of asserting his independence? What does it mean that
    Rick is not going to honor their agreement? And what will that do to the

Chernin & Johnson (2003)

 Thank you for coming!!
 Feel free to contact Megan Mahon, PhD. PCC with any
  questions or concerns at:

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