Dissertation/Thesis Abstract

Lesbian, gay, and bisexual client experiences and therapeutic practice with sexual minorities: An interpretive phenomenological analysis
by Goettsche, Rebecca Shepard, Ph.D., Pacifica Graduate Institute, 2015, 447; 3682372
Abstract (Summary)

Despite some indications that treatment experiences have been improving (Liddle, 1999), LGB clients still receive discriminatory treatment (Bieschke, Paul, & Blasko, 2007). Even clinicians who wish to offer affirmative therapy hold unconscious negative biases due to growing up within a heterosexist culture (Bieschke et al., 2007). Utilizing Interpretive Phenomenological Analysis (Smith, Flowers & Larkin, 2009), this qualitative study explored the therapeutic experiences of seven LGB individuals in order to inform competent treatment with this population. Participants provided accounts through semi-structured interviews, which were validated using participant review. Specifically, the research focused on cross-orientation dyads, although experiences in therapy with shared-orientation dyads were also examined.

The results of this study are presented within five domains. Self-Categorization contextualizes participant accounts by discussing chosen identity terminology, variations of visibility, and the impact of categorical conceptions of identity. Identifying Others, Identifying Allies notes ways in which participants identified the cultural competence of practitioners. Navigating Heterosexism discusses the pervasive influence of heterosexism on individual's expectations of therapeutic experiences. Additionally, participants reviewed situations wherein clinicians expressed judgment or lack of knowledge, which highlight how therapists can more effectively respond to cultural ruptures. Preferring Therapist Identities explores participants' therapeutic preferences and discusses benefits and challenges embedded within shared-orientation and cross-orientation therapeutic dyads. Finally, Understanding Therapeutic Practices identifies practices that support affirmative therapeutic work regardless of the clinician's sexual orientation. Underlying principles of competent cross-cultural therapy with LGB clients were proposed, which emphasize the importance of clinician self-reflection in order to provide nonjudgmental acceptance, discuss sexuality with ease, value different ways of approaching relationship, and decrease therapist defensiveness.

While this study found that several participants preferred sexual minority therapists, the results also suggest that there are significant benefits to working with culturally competent heterosexual clinicians. Participants described benefiting from the experience of acceptance from a member of the dominant culture, which provided a corrective experience to internalized heterosexism. These accounts indicate that, with training and self-reflection, heterosexual clinicians can provide uniquely supportive therapeutic experiences to LGB individuals. Recommendations are provided concerning cultural competent practice and ways to approach cultural misunderstanding.

Indexing (document details)
Advisor: Yakushko, Oksana
Commitee: Morrow, Susan L., Sharpe, Diana
School: Pacifica Graduate Institute
Department: Clinical Psychology
School Location: United States -- California
Source: DAI-B 76/07(E), Dissertation Abstracts International
Subjects: LGBTQ studies, Counseling Psychology, Clinical psychology
Keywords: Allies, Counseling, Heterosexism, Ipa, Multicultural competence, Psychotherapy
Publication Number: 3682372
ISBN: 978-1-321-55762-6
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