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Contents
- Abstract
- Method
- Participants
- Procedures
- Results
- Description of Clients
- Entry in Therapy
- Presenting concerns
- Selection of therapists
- Agency and Environmental Factors Affecting Therapy
- Type of setting
- Involvement of other professionals
- Agency environment
- Regional factors
- Content of Therapy
- Theoretical approach
- Therapeutic alliance
- Interventions and client responses
- Descriptions of the Situations
- Helpful situations
- Unhelpful situations
- Consequences of the Situations for the Clients
- Helpful situations
- Unhelpful situations
- Consequences of the Situations for the Therapists
- Positive consequences
- Negative consequences
- Discussion
- Implications for Practice
- Implications for Research
- Limitations
- Conclusion
Figures and Tables
Abstract
The purpose of this exploratory study was to identify a broad range of variables that characterize psychotherapists’ perceptions of helpful and unhelpful therapy experiences of lesbian, gay, bisexual, and transgender individuals. In-depth, semistructured interviews were conducted with a diverse sample of 14 psychotherapists to identify such variables and patterns among them. Results suggest that a wide range of variables, including the therapeutic relationship, therapist response to the client’s sexual orientation/gender identity, type of presenting concern, and the therapy environment, may affect the therapy experiences of this population. The data also suggest that factors such as ethnicity, gender identity, therapy needs, and socioeconomic status should be considered when providing mental health services to this population. Clients dealing with multiple types of marginalization may be particularly challenging for practitioners. Implications for future research and clinical practice are discussed.
Research on the therapeutic experiences of lesbian, gay, bisexual, and transgender (LGBT) individuals is essential because of the relatively high rates of therapy use for gay men and lesbians (Bieschke, McClanahan, Tozer, Grzegorek, & Park, 2000) and the risk factors associated with sexual minority status, such as increased suicide rates, depression, and experiences of stigmatization or victimization (Cochran & Mays, 2000; Remafedi, French, Story, Resnick, & Blum, 1998; Safren & Heimberg, 1999). In addition, the American Psychological Association advocates for services that are responsive to the needs of LGB clients (Division 44/Committee on Lesbian, Gay, and Bisexual Concerns Joint Task Force on Guidelines for Psychotherapy With Lesbian, Gay, and Bisexual Clients, 2000), and current literature calls for the inclusion of transgender individuals in discussions of LGB psychology (Carroll, Gilroy, & Ryan, 2002; Gainor,...