LGBT Treatment Suggestions

I have a plan to watch the psychotherapy video shown in class week again and again, it was that good!  Why?  Because one psychotherapist noted that LGBT clients seek out therapy more than heterosexuals and because 95% of therapists will have at least one LGBT client.

Several elements to the videos were helpful.  First, it is important to understand the concept of internalized homophobia and the continuum from awareness about one's orientation leading to integration.  This continuum has four general categories.

1. Integration = sexual orientation is fully realized

2. Acceptance = some acceptance of sexual orientation

3. Awareness = some awareness of sexual orientation

4. Little or no awareness of sexual orientation

To help LGBT clients, it is vital to understand where the client is on the continuum.  When the gay client  is fully integrated in his identity, then a treatment plan can be developed as usual because their orientation is not causing them distress. However, the LGBT client with little or no awareness about their orientation, their distress may be complicated or generated in a small degree by their lack of awareness. The video provides a great example of helping a client move along the continuum towards integration.  The therapist finds just the right balance between being directive and empathetic. 

The video was equally helpful in demonstrating the coming out process. The therapist uses the continuum to show how the client has changed so wouldn't it make sense for family members to change just as he did?  This is a excellent example of hypothesis testing, a great therapeutic concept for all types of sexual orientation.

Another important point made is that societal stigma should not be overpathologized or underdiagnosed when dealing with LGBT clients.  This is equally important when treating same-sex couples who may differ in where they are in the coming out process.

This blog is just some of the highlights from the video, it was that jam-packed with helpful information.  With the news of another tragic transexual suicide this week, this information takes an even more importance.