Effective Counseling With Lesbian, Gay, and Bisexual Clients

Professional organizations mandate that effective counseling be provided to lesbian, gay male, and bisexual male and female (LGB) clients. This article presents the characteristics, challenges, and needs of sexual minorities, along with therapeutic strategies that practitioners may use in facilitating a positive self-image among the lesbians, gay men, and bisexual men and women whom they counsel. ********** In society, variations in sexual identity are found in every nationality, race/ethnicity, creed, and gender. This prevalence, coupled with the facts that the college years are a key time in the formation of sexual identity and that lesbians, gay men, and bisexual men and women frequently seek the support of counseling professionals (Hancock, 1995), necessitates that college counselors achieve competence in providing services to lesbian, gay male, and bisexual male and female (LGB) clients. Professional codes of conduct for counselors (American Counseling Association, 1996), psychiatrists (American Psychiatric Association, 1998), psychologists (American Psychological Association, 1992), and social workers (National Association of Social Workers, 1999) acknowledge this necessity. Yet many counseling professionals receive inadequate training in this area (Phillips, 2000). In this article, we endeavor to contribute toward meeting our ethical and professional mandates, by informing trainees and professionals of th e characteristics and needs of lesbians, gay men, and bisexual men and women and by demonstrating methods for helping individuals who may acknowledge an LGB identity or who may be questioning their sexual identity. (Reader's Note. We note that transgendered persons have experiences similar to LGB populations but also have social and psychological dimensions unique to their identity. Given these unique qualities and the marked absence of research with transgendered people, we do not examine concerns specific to that population. Rather, we believe that many of the therapeutic strategies outlined may be applied in providing effective counseling to a transgendered client.) Overview of Issues Faced by LGB Clients Requisite to achieving competency in the care of LGB populations is gaining a relevant knowledge base. Counselors who work with LGB clients need to be informed about appropriate terms and about the experiences and conditions of particular relevance to the lives of LGB clients. For example, although homosexual has traditionally been used to connote an individual whose primary sexual arousal is toward individuals of like gender, contemporary scholars and practitioners discourage use of this term. This avoidance is largely due to the psychopathological connotations ascribed to the word in early editions of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1968). A bisexual identity refers to affectional and sexual interest in both men and women. Interest in one gender or another may be manifest serially or simultaneously (Bohan, 1996). The term sexual orientation is used to describe this behavioral predisposition. Yet, as Bohan (1996) noted, lesbians, gay men, and bisexuals also experience an affectional orientation--acknowledging attraction that is not exclusively based on sex. More inclusive of both the sexual and the affectional dimensions of self is the term sexual identity. Even when these terms are defined clearly, debate remains as to how sexual identity is developed. LGB Identity Formation There are varied theoretical explanations for the development of sexual identity, each with unique implications for counseling LGB clients. Traditionally, theorists have operated from an assumption that homosexuality is a fixed or stable characteristic (Cass, 1979). This led to developmental models that identify behaviors and cognitive strategies that typically lead to labeling one's self as gay (Cass, 1979, 1996), lesbian (Sophie, 1985), or bisexual (Weinberg, Williams, & Pryor, 1994). …