Issues in Psychotherapy with LGBT-clients. Interview with Psychotherapists Sabelnikova Natalia Institute of Psychology and Pedagogics Altai State Pedagogical Academy Sabelnikova Natalia Institute of Psychology and Pedagogics Altai State Pedagogical Academy

Paper presented at the 2nd session of the Project "Gender, Sexuality and Power“ Kiev, March,9, 2012

The goa l The goal of the present study was to reveal the range of problems that psychotherapist of gay lesbian, bisexual and transgender clients can face in his work and to provide an empirical basis for the development of guidelines and suggestions for the graduate and professional training.

Method Participants: Six female psychotherapists at the ages of 24 – 44 (M= 34) self-identified as heterosexual with consulting experiences from 2 to 11 years having the experience of consulting gay and lesbian clients living and working in Barnaul participated in the interview. The semi-structural interview was designed to collect information about the psychotherapists’ experiences of consulting of the LGBT-clients, their difficulties and major challenges in this process. It contained some background questions and questions concerning methods and approaches they used and experiences they had got. The data were subjected to qualitative analysis. Participants: Six female psychotherapists at the ages of 24 – 44 (M= 34) self-identified as heterosexual with consulting experiences from 2 to 11 years having the experience of consulting gay and lesbian clients living and working in Barnaul participated in the interview. The semi-structural interview was designed to collect information about the psychotherapists’ experiences of consulting of the LGBT-clients, their difficulties and major challenges in this process. It contained some background questions and questions concerning methods and approaches they used and experiences they had got. The data were subjected to qualitative analysis.

Results. Analysis of the interview responses Two of 6 therapists believed that homosexuality per se was a form of psychopathology, psychological disorder. Three others considered it as a norm and a form of diversity. They considered sexual orientation as one of many attributes that characterized a client’s personality. And one of them was not certain what to answer. At the time of interview 5 of 6 psychotherapists were aware of many LGBT-issues, read some literature on it and were familiar with internet LGBT-resourses. All of them currently assumed that clients’ sexual orientation was not necessarily relevant to the client's problems. Two of 6 therapists believed that homosexuality per se was a form of psychopathology, psychological disorder. Three others considered it as a norm and a form of diversity. They considered sexual orientation as one of many attributes that characterized a client’s personality. And one of them was not certain what to answer. At the time of interview 5 of 6 psychotherapists were aware of many LGBT-issues, read some literature on it and were familiar with internet LGBT-resourses. All of them currently assumed that clients’ sexual orientation was not necessarily relevant to the client's problems.

Homophobia issues All the respondents articulated difficulties connected with their homophobia. All of them experienced mixed feelings at the first session. “I felt confused and at the first moment I experienced some rejection and resistance. But I tried not to show it.”, “I tried to be tolerant and to accept my client as he was, but all the time I felt inner homophobia and I realized that I had to do something with it”. “For the first time I was not ready to manage with my homophobia feelings. I had never minded it previously. It would be very good if I knew about it and had worked on it before my first session with the LGBT-client”. “I was not ready to face my feelings and to manage the situation during the first session”.

Intervention Therapists’ perceived competence All respondents mentioned lack of special training, literature and other resources on LGBT- psychotherapy which could have made their first experiences as LGBT- psychotherapists easier and more fruitful. “During some first sessions I did not feel at ease because I was doubtful of my competence as LGBT-psychotherapist. Only after some period of time I realized that I had enough knowledge to work with lesbian and gay clients”. “Only after having conducting therapy with some LGBT- clients. I became more self-confident as LGBT- psychotherapist and was able to deal with my own homophobia”. All respondents mentioned lack of special training, literature and other resources on LGBT- psychotherapy which could have made their first experiences as LGBT- psychotherapists easier and more fruitful. “During some first sessions I did not feel at ease because I was doubtful of my competence as LGBT-psychotherapist. Only after some period of time I realized that I had enough knowledge to work with lesbian and gay clients”. “Only after having conducting therapy with some LGBT- clients. I became more self-confident as LGBT- psychotherapist and was able to deal with my own homophobia”.

Intervention Therapists’ perceived competence In all cases the client and his problem were considered as a completely special at first sight and as needing a completely different approach and methods in which the therapist wasn’t skilled. All of the respondents reported lack of relevant knowledge and experience at least at the first session.“I’ve realized that I know nothing about LGBT-community and LGBT-issues in psychotherapy”. “I read some information preparing to my first session with gay client but it was not enough. I felt completely incompetent”. In all cases the client and his problem were considered as a completely special at first sight and as needing a completely different approach and methods in which the therapist wasn’t skilled. All of the respondents reported lack of relevant knowledge and experience at least at the first session.“I’ve realized that I know nothing about LGBT-community and LGBT-issues in psychotherapy”. “I read some information preparing to my first session with gay client but it was not enough. I felt completely incompetent”.

Intervention Therapists’ perceived competence “My first client was a female who had not accepted herself as lesbian yet. At that time I knew nothing about the development of lesbian identity and it was very difficult for me to “forget” about familiar heterosexual stereotypes”. No one of the psychotherapists was well-grounded in the issues related to sexuality, and sure of that he was ready to create a positive and unprejudiced atmosphere, and feel comfortable discussing issues related to homosexuality. So, it became evident that all the psychotherapists experienced a lack of training which could help them to be prepared to decide relevant problems working with LGBT- clients. “My first client was a female who had not accepted herself as lesbian yet. At that time I knew nothing about the development of lesbian identity and it was very difficult for me to “forget” about familiar heterosexual stereotypes”. No one of the psychotherapists was well-grounded in the issues related to sexuality, and sure of that he was ready to create a positive and unprejudiced atmosphere, and feel comfortable discussing issues related to homosexuality. So, it became evident that all the psychotherapists experienced a lack of training which could help them to be prepared to decide relevant problems working with LGBT- clients.

Identified clients’ problems Psychotherapists outlined two groups of clients’ problems: 1) Among the problems of their LGBT-clients psychotherapists mentioned the problem of integration of the first homosexual experience in one’s identity scheme, coming-out in a new professional environment, coming-out in a new personal environment,. They pointed out that these problems were not prevailing but the most difficult ones for the psychotherapist. 2) More often gay and lesbian clients came to psychotherapist with the problems concerning interpersonal couple relationships at different stages of the development of couple relationships, stress, loneliness, self-concept, etc. Psychotherapists said that gay and lesbian psychological problems were similar to those of non-LGBT-clients, but had some peculiarities of the context of their social environment. Psychotherapists outlined two groups of clients’ problems: 1) Among the problems of their LGBT-clients psychotherapists mentioned the problem of integration of the first homosexual experience in one’s identity scheme, coming-out in a new professional environment, coming-out in a new personal environment,. They pointed out that these problems were not prevailing but the most difficult ones for the psychotherapist. 2) More often gay and lesbian clients came to psychotherapist with the problems concerning interpersonal couple relationships at different stages of the development of couple relationships, stress, loneliness, self-concept, etc. Psychotherapists said that gay and lesbian psychological problems were similar to those of non-LGBT-clients, but had some peculiarities of the context of their social environment.

Universality and specifics All of the respondents mentioned that they had surprisingly found out that from the very beginning they had almost all necessary knowledge and which was universal for the work with both heterosexual and homosexual clients. Individuals at the stage of the “identity synthesis” are often seen as not different from most clients we see in therapy. This fact is in correspondence with findings of L.Garnets et al. (2009), C.Heffner (2003). These clients “have accepted their sexuality, have developed relationships, and don’t see ‘gay’ as the issue, but rather as one of the many issues they deal with in an imperfect world”. And they prefer psychotherapist treat them as his usual client. All of the respondents mentioned that they had surprisingly found out that from the very beginning they had almost all necessary knowledge and which was universal for the work with both heterosexual and homosexual clients. Individuals at the stage of the “identity synthesis” are often seen as not different from most clients we see in therapy. This fact is in correspondence with findings of L.Garnets et al. (2009), C.Heffner (2003). These clients “have accepted their sexuality, have developed relationships, and don’t see ‘gay’ as the issue, but rather as one of the many issues they deal with in an imperfect world”. And they prefer psychotherapist treat them as his usual client.

Universality and specifics There also exist specific issues in LGBT- consulting. Among these are: nature and diversity of lesbian and gay male relationships which frames the methods of psychotherapeutic work; recognition of the possible synergistic effects of multiple social statuses experienced by ethnic minority gay male and lesbians, etc. There also exist specific issues in LGBT- consulting. Among these are: nature and diversity of lesbian and gay male relationships which frames the methods of psychotherapeutic work; recognition of the possible synergistic effects of multiple social statuses experienced by ethnic minority gay male and lesbians, etc.

Conclusion The results show that psychologists, regardless of their own sexual orientation, can provide appropriate and sensitive care to lesbians and gay male. But psychotherapists face definite difficulties starting their therapeutic work with their LGBT- clients. These difficulties are connected with the lack of relevant knowledge about LGBT- community and any specifics (or its absence) in LGBT-consulting and with therapists’ first-time facing their own homophobia.

Conclusion Psychotherapists face many problems in their work with LGBT-clients connected with poor relevant educational practices. In Altai territory there is no system of educating psychologists for LGBT-clients consulting. The results of the interview show that the development of educational materials and modeling of the curriculum for graduate and professional training which should include issues in LGBT-psychotherapy concerning the strategies of intervention, issues of LGBT- populations, etc. would be up-to-date.

Acknowledgements I wish to thank my colleagues Natasha Malysheva and Barys Paulau who have inspired me to develop this project. I appricaite the help of psychotherapists, who participated the interview and kindly shared their experiences. I wish to thank my colleagues Natasha Malysheva and Barys Paulau who have inspired me to develop this project. I appricaite the help of psychotherapists, who participated the interview and kindly shared their experiences.