Examples of the Effective Application of Competencies
Understanding how Sexual Orientation Affects the Family of Origin
The therapist understood how deeply affected the client was by her conservative family of origin. The two counselors discussed this and the client's hesitance to lesbian- related issues, although this discussion did not necessarily add to my understanding of the client's issues. One main issue that seems to continue to resurface for the client is the idea that her family would not accept her as a lesbian. This is causing her a tremendous amount of pressure and stress, and is most likely interfering with her open ability to explore a lesbian lifestyle. The power of her family socialization was the primary issue in her ability to freely explore an alternative lifestyle. The counselor understood the extent of her socialization and its effect on the client.
Recognizing the Unique Issues of Lesbians
One of the unique issues related to lesbians is the complexity of raising children (Sue & Sue, 2008). The therapist explored the idea that having a family in a lesbian relationship is a rewarding alternative family situation. This discussion seemed to open up a new range of thinking for the client. The counselor made no inappropriate judgments or biased statements regarding lesbians with families. She also engaged the client in thinking about having a family in a lesbian relationship, which opened up a new way of thinking about an alternative family style that was attractive to the client. I appreciated the counselor's discussion of her approach to open her client to alternative family situations, although it seemed obvious from observation.
Understanding the Effects of Bias on Lesbians and the Greater Society
The therapist seems to understand how the effects of bias are intrusive and negatively
pervasive for the client as well as her family. The client believes she might become estranged from her family if they learned she was a lesbian. She knows her family thinks negatively about lesbians and their lifestyle, that it is sinful, and against their religious beliefs. It seemed apparent that the client has her own negative perceptions of this alternative lifestyle. As described by Sue and Sue (2008), the American culture seems to exhibit contradictory attitudes, and the negative ones can be internalized by the lesbians themselves. Patzel (2005) identified internal homophobic feelings that stem from societal pressures. Certainly, this client has not escaped the contradiction of wondering about her sexuality while simultaneously fearing it. The therapist seems to have a good sense of the client's fears and apprehension and the implications of bias in her overall perceptions and concerns.
Understanding Homosexuality is not Indicative of Mental Illness
The American Psychological Association (2012) and Division 44/Committee on Lesbian, Gay, and Bisexual Concerns Joint Task Force on Guidelines for Psychotherapy With Lesbian, Gay, and Bisexual Clients (JTF) (2000) suggest the values and bias of counselors significantly affect the counseling process for lesbians. Broverman et al. (1970) suggest counselors' perceptions may continue to hold subtle bias and stereotypes. The therapist's use of affirmative therapy, which states that homosexuality is not indicative of mental illness, demonstrates the therapist's support of alternative lifestyles. She encouraged the client to explore being a lesbian without forcing personal values on her. In the dialogue between the therapists, neither stated that homosexuality is not indicative of mental illness but both were obviously in agreement that it is not. In the counselors' discussion, both seemed supportive of exploring alternative lifestyles.
Therapist's Effectiveness in Cultural Competency
The therapist seemed competent in working with the client as she explored a lesbian
lifestyle. She seemed authentically interested and aware of the issues inherent in questioning sexuality. The therapist did not make inappropriate judgments or invalidate the client's issues. She seemed comfortable and maintained meaningful and genuinely thoughtful dialogue with the client. I appreciated that the therapist did not want to make any judgment or prognosis on her client's decision. She seemed to provide an unbiased environment in which the client could question and explore without fearing judgment or being stereotyped. I appreciated observing affirmative therapy. It seems critically important to develop "models of therapy that affirm LGB [lesbian, gay, and bisexual] identities and seek to foster the development of all aspects of an LGB client's identity and the enhancement of an LGB individual's experiences" (Pachankis, & Goldfried, 2004, para.16).
Recommendations for Improvement
I thought the therapist was interruptive at times. She could have implemented more silence to allow the client a little thinking time. I also thought it was interesting that the therapist assumed the one brother who was referred to as the black sheep of the family, modeled a healthy relationship with his family. His relationship may not have been at all healthy, and without exploring this individual as well as how he functioned within the family dynamic, it may be inappropriate to use him as a model for his sister. At times, the therapist's facial expressions seemed contrived and almost fake, but given the session was simulated, this could explain the manufactured nature of her demeanor. Overall, the counselors' discussion seemed mostly intrusive and a repetition of the obvious. Their conversation seemed mundane and without a definitive point at times. However, listening to the therapist reiterate her process and its meaning was interesting. I might have better appreciated a post narrative by the therapist to provide an overview of her process with the client.
American Psychological Association. (2012). Issues in Psychotherapy with Lesbian and Gay Men: A Survey of Psychologists. Lesbian, Gay, Bisexual and Transgender Concerned Gay Men: A Survey of Psychologists. Retrieved July 12, 2012, from http://www.apa.org/pi/lgbt/resources/issues.aspx
Broverman, I. K., Broverman, D. M., Clarkson, F. E., & Rosenkrant, P. S., & Vogel, S. R. (1970). Sex-role stereotypes and clinical judgments of mental health. Journal of Consulting and Clinical Psychology, 34(1), 1-7. doi: 10.1037/h0028797
Division 44/Committee on Lesbian, Gay, and Bisexual Concerns Joint Task Force on Guidelines for Psychotherapy With Lesbian, Gay, and Bisexual Clients (JTF). (2000). Guidelines for psychotherapy with lesbian, gay, and bisexual clients. American Psychologist, 55(12), 1440-1451. doi: 10.1037//0003-066X.55.12.1440
Hays, P. A. (2008). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy. (2nd ed.). Washington: American Psychological Association.
Laureate Education, Inc. (Executive Producer). (n.d.). Virtual Field Experience™: Affirmative Therapy. Baltimore: Author.
Pachankis, J. E. & Goldfried, M. R. (2004, Fall). Clinical issues in working with lesbian, gay, and bisexual clients. Psychotherapy: Theory, Research, Practice, Training, 41(3) 227– 246.
Patzel, B. (2005). Lesbian partner abuse: Differences from heterosexual victims of abuse. A review from the literature. Kansas Nurse, 80(9), 7-8.
Sue, D. W., & Sue, D. (2008). Counseling the culturally diverse: Theory and practice (5th ed.). Hoboken, NJ: John Wiley & Sons, Inc.