Homework Assignments and Handouts for LGBTQ+ Clients

A Mental Health and Counseling Handbook

Joy S. Whitman, Cyndy J. Boyd, Joy S. Whitman, Cyndy J. Boyd

• Publisher: Routledge
• Year: 2020
• Print ISBN:
  9780367542726
• eBook ISBN:
  9781000198638
• Topic: Social Sciences
• Subtopic: Human Sexuality in Psychology
• Index: Social Sciences

Featuring over 70 affirming interventions in the form of homework assignments, handouts, and activities, this comprehensive volume helps novice and experienced counselors support LGBTQ+ community members and their allies.

Each chapter includes an objective, indications and contraindications, a case study, suggestions for follow-up, professional resources, and references. The book's social justice perspective encourages counselors to hone their skills in creating change in their communities while helping their clients learn effective coping strategies in the face of stress, bullying, microaggressions, and other life challenges. The volume also contains a large section on training allies and promoting greater cohesion within LGBTQ+ communities.

Counseling and mental health services for LGBTQ+ clients require between-session activities that are clinically focused, evidence based, and specifically designed for one or more LGBTQ+ sub-populations. This handbook gathers together the best of such LGBTQ+ clinically focused material. As such, it will appeal both to students learning affirmative LGBTQ+ psychotherapy/counseling and to experienced practitioners. Offering practical tools used by clinicians worldwide, the volume is particularly useful for courses in clinical and community counseling, social work, and psychology. Those new to working with LGBTQ+ clients will appreciate the book's accessible foundation to guide interventions.

SECTION V

HOMEWORK, HANDOUTS, AND ACTIVITIES FOR GENDER AND SEX IDENTITY EXPLORATION

By focusing on gender and sexual identity exploration, the contributors to this section move beyond helping clients with concerns about coming out and instead offer clinicians creative mechanisms by which they can assist their clients to more deeply appreciate their gender and sexual identities. As clients with diverse gender and sexual identities reach for authenticity, integrating their gender and sexual identities into the totality of their individuality is important. Making the invisible more visible, using mindfulness-based interventions, and integrating expressive arts into the therapeutic process are common themes in this section.

The section begins with Chapter 37, by K. Jod Taywaditep, “The Matrix for Sexuality and Gender: My Sexual and Gendered Self in the World of Sexual and Gender Diversity.” Using the Klein Sexual Orientation Grid (Klein, Sepekoff, & Wolf, 1985), Taywaditep offers therapists a matrix through which clients can deconstruct and then reconstruct their understanding of their sexual and gender identities. Use of this activity provides clients and clinicians with a means by which private and public identities can be explored, milestone events highlighted, and gender and sexuality appreciated along multiple dimensions.

The intersections of sexual and gender identities are also discussed in Shannon Solie’s “Mapping of Desires and Gender: Explorations at the Intersections” (Chapter 41). Informed by multiple theories, though based primarily on the sexual configurations theory (SCT) (van Anders, 2015), Solie creates an activity useful for individuals, couples, or groups that operationalizes SCT so that clinicians can help clients explore how oppression and socialization have affected their understandings of their gender and sexual expressions and identities. Clients are guided to map identities using a key they create and to identify those aspects of themselves that are static and fluid.

In “Asexuality: An Introduction for Questioning Clients” (Chapter 42), Emily M. Lund, Bayley A. Johnson, Christina M. Sias, and Lauren M. Bouchard speak to the often stigmatized identity of asexuality, noting that those who identify as asexual often do not come out because of stigma and shame. By offering a handout with which therapists can educate their clients, the authors compassionately guide clients toward a deeper recognition of their sexuality, moving them gently from shame to acceptance and appreciation.

For many LGBTQ people, integrating religious and sexual identities can be difficult and result in internal conflict (Haldeman, 2004). Matt Zimmerman’s “Managing Religious and Sexual Identity Intersections” (Chapter 47) helps clinicians assist clients’ exploration and integration of these identities in healthy ways. Zimmerman suggests using the Religious, Spiritual, and Sexual Identities Questionnaire (Page, Lindahl, & Malik, 2013) to help clients address conflicts between religious and sexual identity. By completing the questionnaire, clients have an opportunity to pinpoint troublesome areas and find a more compassionate intersection of competing identities.

Trauma and gender identity are explored in “Creative Interventions for Traumatized Transgender and Gender-Nonconforming (TGNC) Youth” (Chapter 39), by Alexandra M. Rivera and Crystal Morris. They note how the majority of transgender youth have experienced at least one traumatic event in their lives (Fallot & Harris, 2001). Those who hold multiple minority identities may find that their pain is exacerbated by the level of oppression they face. For this reason, the authors suggest the use of trauma-informed art therapy to promote healing by building on the powerful connection between the arts and neurodevelopment, which can ultimately lead to a deeper processing of the trauma. This activity allows for the engagement of the whole body, facilitating better regulation of physiological reactions and affect.

Use of alternative methods to talk therapy are presented in three chapters. Marilia S. Marien’s “Using Mindfulness to Enhance Identity Integration for LGBTQ Clients” (Chapter 46) highlights the effectiveness of mindfulness-based practices in treatment and their application to identity integration for LGBTQ clients. Marien invites clients to explore the habitual thoughts and feelings with which they may struggle in regard to their identities and move toward acceptance. As a result of greater awareness, clients can begin the process of letting go of harmful internalized judgments, permitting space for integration of multiple aspects of the self.

Jean Georgiou uses expressive art therapy to help LGBTQ youth put words to their identities. In Chapter 44, “Using Expressive Art Therapy with LGBTQ Youth: A Picture Is Worth a Thousand Words,” she invites youth to create self- and family portraits and collages to represent how they fit into their world. This activity helps bypass the hesitation that youth sometimes experience when talk therapy feels threatening or when it cannot fully capture their feelings. Through art therapy, LGBTQ youth can share their feelings of being different, heal from bullying and harassment, and move toward self-acceptance.

In Chapter 43, “Inhabiting Our Bodies: Working with Gender Dysphoria in Transgender and Gender-Nonbinary Children and Adults through Body Maps,” Natasha Distiller offers an activity in which clients can explore body image and the societal messages they have received about their bodies. In a gender-affirming approach, Distiller acknowledges the fluidity of gender and offers clients a nonverbal means to connect to their bodies through a body mapping activity. Recognizing that body images change, this exercise is one that clients can return to as they connect more fully and organically to their nonbinary gender identity.

The remaining chapters in this section focus exclusively on gender identity integration. In M. Killian Kinney and Richard A. Brandon-Friedman’s “Exploring Gender Identity with a Photo Diary” (Chapter 38), readers are introduced to the use of photo diary as a means to facilitate pride in clients’ gender identity. The authors propose that because of societal pressure to conform to scripted gendered behavior, many clients have not fully permitted their internal sense of gender to be visible. By using photos, drawings, or collages, clinicians can normalize the range of gender expression and thereby playfully give voice to those hidden and authentic gendered self-representations.

It is also of the utmost importance in working with any client to ensure that the clinician’s assessment tools are inclusive of all identities. Specifically, for clients who identify as nonbinary, clinical forms that force a limited choice in gender identity represent a microaggression. Andrew Suth and Sorrel Rosin provide an excellent example of an assessment form designed to highlight the clinician’s open and affirming stance on gender identity in Chapter 40, “The Importance of Language: Creating Nonbinary Assessment Forms That Reflect a Full Range of Gender Iden tities.” In presenting this information, the authors help therapists begin the therapeutic relationship in an ethical, compassionate, and welcoming manner.

The topic of gender representation continues in Chapter 48, “Rose as a Name Is So Much Sweeter: Navigating the Name-Change Process with Trans-gender and Gender-Nonbinary Clients,” by Cadyn Cathers. The process of changing one’s name to more accurately represent one’s gender is important, as it deepens clients’ comfort with their identified gender and moves them to social affirmation. The name-change process can uncover a variety of emotions and memories for clients who have experienced micro-aggressions when called by a name that does not fit with their gender identity. Cathers’s handouts provide clinicians a vehicle by which they can guide their clients to explore name choices and to find safe places where they can experiment using their chosen name.

Acknowledging the influence and importance of social support and group work for transgender and gender-nonconforming clients, Julie M. Mullany’s contribution, “An Eight-Week Identity Exploration Group for Transgender and Gender-Nonconforming Individuals” (Chapter 45), addresses the healing power of connecting with others at varying stages of identity integration. Mullany offers the reader a planned group experience that encourages members to explore and integrate the intersection of their gender, ethnic, and other identities and to use others’ experiences not only to support their journey but also to challenge internalized messages about their gender. Each week is structured around a specific topic and activity in which group members are creatively and gently guided toward identity integration.

In the final chapter of this section, Dorian Kondas addresses the concerns of aging transgender clients. In Chapter 49, “The Aging Transgender Client: Mapping the Acceptance of Experience,” Kondas notes the possibility of increased gender dysphoria owing to many factors, such as oppressive health-care options and dependence on family members who may be transphobic. Through the use of acceptance and commitment therapy (Hayes, Strosahl, & Wilson, 2012), Kondas guides clients to explore their values, obstacles to the goals these values embody, how they regulate their emotions toward goal achievement, and how they can move toward acceptance of what was lost and the resilience they have, all within the framework of their identity as an aging transgender individual.

References

• Fallot, R. D., & Harris, M. (2001). A trauma-informed approach to screening and assessment. New Directions for Mental Health Services, 89, 23–31. https://doi.org/10.1002/yd.23320018904.
• Haldeman, D. C. (2004). When sexual and religious orientation collide: Considerations in working with conflicted same-sex attracted male clients. Counseling Psychologist, 32, 691–715. doi:10.1177/0011000004267560.
• Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change, 2nd edition. New York: Guilford.
• Klein, F., Sepekoff, B., & Wolf, T. J. (1985). Sexual orientation: A multi-variable dynamic process. Journal of Homosexuality, 11, 35–42. doi:10.1300/J082v11n01_04.
• Page, M. J. L., Lindahl, K. M., & Malik, N. M. (2013). The role of religion and stress in sexual identity and mental health among LGBT youth. Journal of Research on Adolescence, 23 (4), 665–677. doi:10.1111/jora.12025.
• van Anders, S. M. (2015). Beyond sexual orientation: Integrating gender/sex and diverse sexualities via sexual configurations theory. Archives of Sexual Behavior, 44, 1177–1213. doi:10.1007/s10508-015-0490-8.

37
THE MATRIX FOR SEXUALITY AND GENDER: MY SEXUAL AND GENDERED SELF IN THE WORLD OF SEXUAL AND GENDER DIVERSITY

K. Jod Taywaditep

Suggested Uses: Activity, homework

Objective

The Matrix for Sexuality and Gender (MSG) delineates and organizes aspects of the self that pertain to sexuality and gender. The MSG offers a reflective framework for clients to consider sexuality and gender as complex, multidimensional, fluid, and dynamically interacting with factors in their personal, developmental, cultural, and political contexts. The exercise aims to stimulate clients’ conceptual curiosity and clarity, increase personal insights and critical consciousness, and affirm their sexual and gender experiences.

Rationale for Use

When individuals have sexual, affectional, and gender experiences that do not fit with the traditional norms of sexuality and gender, they often experience conflict, confusion, and distress (see Lev, 2007; McCann & Sharek, 2015; Schneider, Brown, & Glassgold, 2002). Internalized prejudices and rigid notions of sexuality and gender undermine the mental health of these individuals, who are often already culturally and politically oppressed (Bieschke, Perez, & DeBord, 2007). LGBTQ-affirmative therapists’ tasks are manifold: they must help promote clients’ positive ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication Page
• Contents
• Foreword
• Introduction
• SECTION I Homework, Handouts, and Activities for the Coming-Out Process across the Life Span
• SECTION II Homework, Handouts, and Activities for Managing Oppression and Building Resilience
• SECTION III Homework, Handouts, and Activities for Relationships
• SECTION IV Homework, Handouts, and Activities for LGBTQ Parenting and Family Therapy
• SECTION V Homework, Handouts, and Activities for Gender and Sex Identity Exploration
• SECTION VI Homework, Handouts, and Activities for Substance Use Disorders
• SECTION VII Homework, Handouts, and Activities for Career, Employment, and Education Issues
• SECTION VIII Homework, Handouts, and Activities for Use in Outreach Programming and Training Workshops
• About the Editors and Contributors
• Index