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
OBJECTIVES
Introduction
Affirmative Therapy
Foundation
Education and Training Considerations
Competencies
Treatment
Themes & Issues
Techniques
Homework
Cases
Affirmative Therapy - Foundation
LGBTQIQIA
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
CACREP
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
DO NOT ATTEMPT TO ALTER OR CHANGE THE
SEXUAL ORIENTATIONS OR GENDER IDENTITIES OF
LGBT CLIENTS
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)
Appraisal
Homosexuality, bisexuality, and gender nonconformity ≠
psychopathology
Presenting problems
Be aware of heterosexist bias in the interpretation of
psychological tests and measurements
ALGBTIC (2009); Logan & Barret (2005)
Research
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)
Spirituality
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)
Occupation
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
disorders
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
(2003)
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
relationship?
Chernin & Johnson (2003)
BE AN ACTIVIST AND ALLY!
Questions????
Thank you for coming!!
Feel free to contact Megan Mahon, PhD. PCC with any
questions or concerns at: mmahon@heidelberg.edu