Come As You Are: A Look Inside LGBTQ+ Affirmative Counseling
“To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment.” — Ralph Waldo Emerson
As an LGBTQ+ affirmative therapist, I am often asked:
“What does that look like in respect to other forms of counseling?”
My answer is that it’s both the same and different. Let’s break this down, shall we?
How It’s the Same:
Gay, straight, trans, cis-gender…we’re all human. Joining with the client by getting to know their story (and doing everything you can to help them feel truly heard) doesn’t change. Identifying main concerns, current coping strategies and goals to tackle are still part of the therapeutic equation as well.
A common misconception when working with this population is that the focus of treatment will automatically be spotlighting one’s sexual orientation and/or gender identity. The truth is, LGBTQ+ individuals seek mental-health services for many of the same reasons other clients do.
Clinicians should remain open-minded and wait for clients to define what they are hoping to gain from the process. That is to say, let your client be the guide. Give your client the reigns to determine the roadmap that feels right to them. Maybe your client is hoping to address everyday life stressors, or pesky people-pleasing or an enigmatic relationship with their mother…The point is, counselors should not be at all surprised to encounter the same types of presenting concerns, such as anxiety, depression or trauma, found in their work with heterosexual and/or cis-gender clients.
At the end of the day, all clients are united by human experience, and no client can be defined by a single identity. According to the Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling taskforce, mental health professionals should “respect and attend to the entire individual.”
How It’s Different:
The main add-ons when it comes to ethically serving this population include:
Attending to the unjust and ever-evolving hurdles LGBTQ+ persons face just by product of being different
Walking alongside your client as they navigate said obstacles, and…
Helping your client move toward self-love and steadfast pride in their own truth
Creating a safe, empowering space to step into a more self-aware and self-accepting version of their story is also part of the package. This means being able to embrace them for exactly who they are, until they are ready to own that acceptance themselves.
In addition to mental-health concerns faced by all types of clients, regardless of sexual orientation or gender identity, individuals who live their lives under the LGBTQ+ umbrella confront a wide range of specific challenges, including externalized and internalized homophobia, biphobia and/or transphobia, gender dysphoria, minority stress, stigma and social rejection, harassment, bullying and violence, issues related to lack of social support from families of origin, navigating the complicated coming-out process, discrimination and prejudice at school, in the workplace, in healthcare settings and at the political level, denial of basic human rights guaranteed to dominant societal groups, etc. etc.
The list goes on and on, is ever-changing and cannot be applied as a general rule. Each client is an individual with their own worldview, their own needs and their own unique story to share. The more comfortable a clinician is with exploring these topics, the more likely the individual will be to engage in a meaningful dialogue.
A Special Focus on Self-of-the-Therapist:
Before working with this population, it is incredibly important for therapists to self-reflect and self-confront. A thoughtful unpacking and deconstructing concerning one’s upbringing, values, beliefs, assumptions, attitudes, biases, intersecting identities where privilege and oppression manifest synchronously and the influences and impact of living in a heteronormative, gender- binaristic society can add depth to client-therapist discussions, enhance credibility and help clinicians develop a more affirmative stance in their work with LGBTQ+ clients.
Assessing the Ally Role:
The final piece of the puzzle that is somewhat adapted when it comes to LGBTQ+ affirmative therapy is deciding how you would like to advocate for this population in and/or outside of therapy. Are you an activist fighting the good fight, marching alongside fellow change-agents, volunteering at local organizations and speaking to future generations at school functions? Or, are you more of the type to spark change through your work with clients, lead a supplementary support group and attend ongoing trainings to keep your interventions fresh and inspired? There is no right or wrong- just get involved in a way that feels good to you.
Tying it All Together:
To summarize, the basic recipe to LGBTQ+ affirmative therapy is as follows:
One pinch seeing the whole person and letting them direct their own journey;
One dash educating yourself on specific challenges faced by this community and helping clients work toward acceptance and authenticity;
One dollop of taking a good, hard look at your own intersecting identities and how they impact you both personally and professionally;
-- And a smidgen of intentional exploration into your own version of the ally role.
Visit our page here for more information spotlighting Resolve’s LGBTQ+ affirmative services.
Caitlyn Crawford, LMFT
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