Therapeutic Guidance information
Guidelines for Psychotherapy with Lesbian, Gay, and Bisexual Clients
Introduction
The Division 44 Committee on Lesbian, Gay, and Bisexual Concerns Joint Task
Force, as part of the American Psychological Association, developed a set of
affirming guidelines designed to underpin psychological work with lesbian, gay
and bisexual clients. The full text of this guidance is available on APA website
The guideline headings, which offer useful principles for therapeutic work with
LGB people, are:
Attitudes toward Homosexuality and Bisexuality
Guideline 1
Psychologists understand that homosexuality and bisexuality are
not indicative of mental illness.
Guideline 2
Psychologists are encouraged to recognize how their attitudes
and knowledge about lesbian, gay, and bisexual issues may be
relevant to assessment and treatment and seek consultation or
make appropriate referrals when indicated.
Guideline 3
Psychologists strive to understand the ways in which social
stigmatization (i.e., prejudice, discrimination, and violence) poses
risks to the mental health and well-being of lesbian, gay, and
bisexual clients.
Guideline 4
Psychologists strive to understand how inaccurate or prejudicial
views of homosexuality or bisexuality may affect the client's
presentation in treatment and the therapeutic process.
Relationships and Families
Guideline 5
Psychologists strive to be knowledgeable about and respect the
importance of lesbian, gay, and bisexual relationships.
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Guideline 6
Psychologists strive to understand the particular circumstances
and challenges faced by lesbian, gay, and bisexual parents.
Guideline 7
Psychologists recognize that the families of lesbian, gay, and
bisexual people may include people who are not legally or
biologically related.
Guideline 8
Psychologists strive to understand how a person's homosexual
or bisexual orientation may have an impact on his or her family
of origin and the relationship to that family of origin.
Issues of Diversity
Guideline 9
Psychologists are encouraged to recognize the particular life
issues or challenges that are related to multiple and often
conflicting cultural norms, values, and beliefs that lesbian, gay,
and bisexual members of racial and ethnic minorities face.
Guideline 10
Psychologists are encouraged to recognize the particular
challenges that bisexual individuals experience.
Guideline 11
Psychologists strive to understand the special problems and
risks that exist for lesbian, gay, and bisexual youth.
Guideline 12
Psychologists consider generational differences within lesbian,
gay, and bisexual populations and the particular challenges that
lesbian, gay, and bisexual older adults may experience.
Guideline 13
Psychologists are encouraged to recognize the particular
challenges that lesbian, gay, and bisexual individuals experience
with physical, sensory, and cognitive-emotional disabilities.
Education
Guideline 14
Psychologists support the provision of professional education
and training on lesbian, gay, and bisexual issues.
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Guideline 15
Psychologists are encouraged to increase their knowledge and
understanding of homosexuality and bisexuality through
continuing education, training, supervision, and consultation.
Guideline 16
Psychologists make reasonable efforts to familiarize themselves
with relevant mental health, educational, and community
resources for lesbian, gay, and bisexual people.
Transgender Emergence – a developmental model
Introduction
The following model offers a useful guide to assist in facilitating greater
understanding of the transitionary processes that transgender people go
through.
Arlene Istar Lev (see details below) developed this model based on her own
experience of supporting transgender people and is intended as a guide for
therapists.
The developmental model outlines six broad stages.
As with any model, be aware that it offers a framework for understanding rather
than a defined route, and that as people are individuals no two journeys will be
the same, even although they may share common themes.
A note on language
The term Gender-Variant is commonly used in the US but less so in the UK.
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Stage
The therapeutic task…
Awareness
In the first stage, gender-variant people are Is the normalisation of the
often in great distress.
experiences involved in emerging
transgendered
Seeking information/reaching out
In the second stage, gender-variant people
seek to gain education and support around
transgenderism.
Is to facilitate linkages and
encourage outreach
Disclosure to significant others
The third stage involves the disclosure of
transgenderism to significant others –
spouses, partners, family members, and
friends.
Involves supporting the
transgendered person’s integration
into the family system.
Exploration: identity and self-labelling
The fourth stage involves the exploration of Is to support the articulation and
various transgender identities.
comfort with one’s gendered
identity.
Exploration: Transition issues/possible
body modification
The fifth stage involves exploring options
for transition regarding identity,
presentation and body modification.
Is the resolution of the decisions
and advocacy toward their
manifestation
Integration: Acceptance and posttransition issues
In the sixth stage the gender-variant person Is to support adaptation to
is able to integrate and synthesise
transition-related issues.
(transgender) identity.
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Reference
Lev, Arlene Istar. Transgender Emergence: Therapeutic Guidelines for Working
with Gender-Variant People and Their Families. New York, the Haworth Clinical
Practice Press (2005)
Other publications
Finally, there are other publications providing guidance for therapists working
with lesbian, gay, bisexual and transgender clients, all of which are available on
www.amazon.co.uk
Pink Therapy: A Guide for Counsellors and Therapists Working with
Lesbian, Gay and Bisexual Clients Open University Press 1996. Dominic
Davies & Charles Neal (Editors)
Issues In Therapy With Lesbian, Gay, Bisexual And Transgender Clients
(Paperback) Open University Press, 2000
Charles Neal and Dominic Davies
Therapeutic Perspectives on Working with Lesbian, Gay and Bisexual
Clients (Paperback) Open University Press 2000
Dominic Davies & Charles Neal (Editors)
Handbook of Affirmative Psychotherapy with Lesbians and Gay Men
(Hardcover) The Guilford Press 2002
Kathleen Y Ritter and Anthony I. Terndrup (Authors)
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