by Kristin A. Hancock, PhD
January 20, 2006 — Most psychologists are likely to encounter a lesbian, gay or bisexual (LGB) client at some point in their practices (Garnets, Hancock, Cochran, Goodchilds, & Peplau, 1991). LGB individuals tend to seek psychotherapeutic services more frequently than their heterosexual counterparts (Bell & Weinberg, 1978; Jones & Gabriel, 1999).
It is important for practicing psychologists to acquire knowledge and skills in providing services to these clients. A therapist’s understanding of issues specific to LGB clients has been found to relate to client satisfaction (Liddle, 1996).
This article focuses on the APA’s “Guidelines for psychotherapy with lesbian, gay and bisexual clients,” beginning with a brief discussion of significant effects of stigma and “minority stress" on LGB individuals.
Stigma and “Minority Stress”
Although some progress has been made regarding the human rights of LGB people in the past 30 years, LGB individuals are still subject to prejudice, discrimination and violence. “Minority stress” is the term used by researchers such as DiPlacido (1998) and Meyer (2003) to describe the cumulative negative effects associated with the prejudice, discrimination, violence and other adverse social conditions experienced by individuals in stigmatized groups.
Indeed, there is evidence to suggest that LGB individuals may have higher rates of stress-related disorders than do their heterosexual counterparts (e.g., Cochran & Mays, 2000; Cochran, Sullivan, & Mays, 2003; Gilman, Cochran, Mays, Hughes, Ostrow, & Kessler, 2001; Mays, Cochran, & Roeder, 2003). Meyer (2003) found that people who felt more frequently stigmatized or discriminated against, who felt they needed to conceal their sexual orientation, or who were prevented from affiliating with other LGB people did tend to report more mental health concerns.
So it is important for providers to understand and appreciate the particular ways in which stigma and prejudice affect the mental health and well-being of LGB clients. Practitioners sometimes have a tendency to associate the increased mental health concerns of LGB clients with their nonheterosexual orientation, rather than considering the effects of stigma.