Therapy with Gay and Lesbian Clients: Implications for Music Therapists

ABSTRACT: The purpose of this paper was to examine current literature regarding therapy practices with gay and lesbian clients. The author chose the selected articles based on their suitability for application to music therapy practice, and reviewed them in the following four categories: (a) General Issues and Approaches, (b) Attitudes Towards Therapy, (c) Choice of Therapist, and (d) Straight Therapists working with Gay and Lesbian Clients. Based on the reviewed articles, and a cultural competency model, implications for music therapy clinical practice are provided. As more persons from diverse cultures live and work in the United States, health professionals, including music therapists, must be willing and able to respond to the needs and values of clients from different cultures (Toppozada, 1995). It is widely accepted that in order for therapists to be effective with culturally diverse clients, they must become culturally literate, developing knowledge of their client's heritage and cultural identities (Bernstein, 2000). This process not only involves exploring the various cultures that might be encountered during therapy, but also examining potential issues, difficulties, and differences that might arise between the therapist's and the client's cultural values (Bradt, 1997). The creative arts in therapy, specifically music, are highly effective with culturally diverse clients, not only because they have the ability to "span many dimensions of human existence and therapeutically link people to one another" (Henderson & Gladding, 1998, p. 183), but because they have permeated societies and cultures throughout the world (Henderson & Gladding, 1998; Hodges, 1996). While a number of recent articles address multicultural issues in music therapy practice (Bradt, 1997; Darrow & Molloy, 1998; Lewis, 1997; Moreno, 1988; Sloss, 1996; Toppozada, 1995), no articles were found that discuss sexual minorities as part of multicultural music therapy practice. Research has shown that gays and lesbians are more likely to see a therapist than heterosexuals (Morgan, 1992), and the number of gay and lesbian clients seeking therapy is increasing (Liddle, 1997). As therapists become aware of and respond to the cultural differences with Asian, African, and Latino clients, to name a few, so must they be aware of those within the gay and lesbian culture. Although a small number of books discuss music therapy with gay AIDS patients (Bruscia, 1991; Lee, 1996; Rykov & Hewitt, 1994), the paucity of articles related to music therapy practice for both gay and lesbian clients in a variety of clinical settings is marked. Review of Literature In reviewing the literature regarding psychotherapy with gay and lesbian clients, the author chose articles that present implications for music therapy clinical practice. Although sexual minority culture includes lesbian, gay, bisexual, and transgender (LGBT), the articles reviewed address issues specific to gays and lesbians. While many of the points made in the articles can be generalized to all sexual minorities, the author felt that bisexuals and transgenders have specific issues that should be addressed separately. The articles were organized into the following four categories: (a) General Issues and Approaches, (b) Attitudes Towards Therapy, (c) Choice of Therapist, and (d) Straight Therapists working with Gay and Lesbian Clients. General Issues and Approaches Baron (1996) discussed the history of the mental health view of homosexuality. Homosexuality was declassified as a mental illness only as recently as 1973, and at that time, more than a third of the membership of the American Psychiatric Association was opposed to this declassification. Baron noted that although the official views of homosexuality by the mental health establishment reflect increased tolerance, attitudes and behaviors of individual practitioners still vary. In addition to discussing past views of homosexuality, Baron provided three common issues in psychotherapy practice with gay men and lesbian clients. …