Handbook of LGBTQ-Affirmative Couple and Family Therapy

Rebecca Harvey, Megan J. Murphy, Jerry J. Bigner, Joseph L. Wetchler, Rebecca Harvey, Megan J. Murphy, Jerry J. Bigner, Joseph L. Wetchler

• Publisher: Routledge
• Year: 2021
• eBook ISBN: 9781000479096
• Edition: 2
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

This comprehensive second edition inspires therapists to utilize clinical work to pragmatically address intersectional oppressions, lessen the burden of minority stress, and implement effective LGBTQ affirmative therapy.

A unique and important contribution to LGBTQ literature, this handbook includes both new and updated chapters reflecting cutting-edge intersectional themes like race, ethnicity, polyamory, and monosexual normativity. A host of expert contributors outline the best practices in affirmative therapy, inspiring therapists to guide LGBTQ clients into deconstructing the heteronormative power imbalances that undermine LGBTQ relationships and families. There is also an increased focus on clinical application, with fresh vignettes included throughout to highlight effective treatment strategies.

Couple and family therapists and clinicians working with LGBTQ clients, and those interested in implementing affirmative therapy in their practice, will find this updated handbook essential.

Section V Training Issues

23 “Why Can’t We Just Learn about Normal Couples?” LGBQ Affirmative Training Strategies for CFT Faculty and Programs

CHRISTI R. MCGEORGE, ASHLEY A. WALSDORF, and KATELYN O. COBURN

DOI: 10.4324/9780429274626-29

The literature clearly highlights the need for couple and family therapists (CFTs) to be prepared to work with lesbian, gay, bisexual, and queer clients (LGBQ¹; Bernstein, 2000; Edwards et al., 2014; Hartwell et al., 2012; Henke et al., 2009; Rock et al., 2010). Specifically, research suggests that LGBQ individuals seek therapy services at a rate of 25%–77%, which is two to four times the rate of heterosexual individuals (Cochran et al., 2003). Given the likelihood that CFTs will have LGBQ clients in their caseloads, they must be prepared to provide skillful and just services to this population.

Over the past two decades, researchers and educators have been critical of the lack of training CFTs receive to work with LGBQ clients (Godfrey et al., 2006; Long, 1996; Long & Serovich, 2003; McGeorge & Carlson, 2016; Rock et al., 2010). Several studies have corroborated this critique, finding that graduate students in clinical training programs reported feeling inadequately prepared to provide competent therapy to LGBQ clients (Anhalt et al., 2003; Carlson et al., 2013; Rock et al., 2010). For example, Rock et al. (2010) found that 60.5% of their sample of 190 students in accredited CFT programs reported that they received no training on LGBQ affirmative therapy practices. This lack of LGBQ affirmative training is problematic, particularly since it is associated with students’ self-reported clinical competence with LGBQ clients (Rock et al., 2010). With graduate school being the primary training agent for therapists, the absence of LGBQ affirmative training is likely to lead to therapist inadequacy in this area (Dworkin & Gutierrez, 1989).

In addition to the overall lack of training provided in clinical programs, there remains a dearth of published work that addresses working with LGBQ clients (Hartwell et al., 2012). In particular, a content analysis revealed that only 173 (2%) of the 8,781 articles published from 1996 to 2009 in the 17 primary family therapy-related journals addressed topics relevant to LGBQ people (Hartwell et al., 2012). To determine if this lack of scholarly research paralleled continuing education opportunities, we reviewed the conference presentations on LGBQ topics for the 2009 American Association for Marriage and Family Therapy (AAMFT) annual conference. In 2009, only four (3.5%) of the 113 presentations and five (4.1%) of the 121 posters focused on topics relating to sexual orientation. We then contrasted these findings with the topical composition of the 2018 AAMFT conference. In 2018, seven (6.5%) of the 107 presentations and 12 (9.4%) of the 128 research discussions (previously poster presentations) focused on sexual orientation. The limited increase in affirmative training opportunities at the AAMFT conferences, coupled with the lack of preparation students report, suggests that there continues to be a need for inclusive training to ensure that all clients receive ethical and just clinical services.

^* Although lesbian, gay, bisexual, and transgender individuals are often grouped together, this chapter focuses on sexual orientation rather than gender identity and expression, which are explored in other chapters in this volume. Additionally, queer is used to acknowledge the broad range of non-binary sexual orientations (e.g., pansexual, demisexual) as well as to recognize queer as an identity in its own right.

A primary challenge to the CFT field in becoming increasingly affirmative is the immense influence of heteronormativity, a pervasive societal belief in the inherent normalcy and value of opposite-sex relationships. Heteronormative beliefs often inform all levels of the systems they surround, ranging from national policies that limit LGBQ people to the content that is included in CFT training programs. Heteronormativity thus drives students and faculty members’ lack of preparedness to work with LGBQ clients, in addition to CFT programs’ readiness to create such a learning environment.

This chapter focuses on training in LGBQ affirmative therapy, which is defined in the literature as “an approach to therapy that embraces a positive view of LGB[Q] identities and relationships and addresses the negative influences that homophobia and heterosexism have on the lives of LGB[Q] clients” (Rock et al., 2010, p. 175). Importantly, affirmative training involves not only teaching about topics related to LGBQ identities but also helping CFT students develop positive beliefs and attitudes about LGBQ communities. The primary components of LGBQ affirmative therapy are (a) therapists’ self-awareness about their own biases and beliefs; (b) knowledge about LGBQ related topics (e.g., the historic struggle for civil rights, state and federal laws that both discriminate against and support LGBQ communities); (c) clinical abilities applying these topics, including acknowledging experiences of discrimination and assisting clients in navigating a heterosexist society; and (d) skills related to advocacy both within and outside of the therapy room. The aim of this chapter is to help aid faculty in their preparation of students through fostering the self-awareness and knowledge necessary to provide competent therapy services to LGBQ clients. Following a review of the literature, the chapter details strategies for faculty ranging from more individual-level to more systems-level suggestions. These include self-of-the-faculty work, training and educational strategies, and, finally, transformational ideas CFT programs might implement to create more inclusive and affirmative program environments. Each strategy section concludes with a brief case illustration and questions for reflection.

Literature Review

The following section reviews the available literature on LGBQ affirmative therapy, including (a) the practice of LGBQ affirmative therapy, (b) preparing students to provide affirmative therapy, and (c) challenges of training students in LGBQ affirmative therapy.

The Practice of LGBQ Affirmative Therapy

The literature on LGBQ affirmative therapy practice highlights two primary areas of therapist development: a process of critical self-reflection and developing specific skills to work with LGBQ clients (Coburn & McGeorge, 2019; Long & Lindsey, 2004; Matthews, 2007; McCann, 2001; McGeorge & Carlson, 2011). The goal of the self-reflection process i...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication Page
• Table of Contents
• Acknowledgments
• List of Contributors
• Introduction
• Section I Foundations of LGBTQ-Affirmative Therapy
• Section II Working with Couples
• Section III Family and Identity Considerations
• Section IV Special Issues
• Section V Training Issues