HOW QUEER FOLKS CAN FIND LGBTQ+ SPECIALIZED THERAPIST
Along with all humans, psychotherapists participate in social and cultural systems and subsystems. Socially, most individuals participate in these systems unconsciously. So, often individuals, including therapists, are unaware when cultural systems like homo-bi-transphobia move through us. Without the specialized training to serve LGBTQ+ clients, therapists practicing within a standardized education to meet the standard of care are not equipped to address the psychological needs of this population.
The Psychotherapist’s Oath (American Psychotherapy Association, 2016), states that therapists must possess an awareness of their participation in socio-cultural systems and the degree to which they enact dominance over subordinate groups. Without this awareness, harming and retraumatizing of clients will occur in therapeutic relationships. To be a sexual and gender minority specialized therapist requires a strong clinical foundation working with LGBTQ+ clients. Additionally, therapists must maintain a dedicated commitment of continued cultural humility and self-education of affirming theories and perspectives.
What is LGBTQ+ Therapy?
Gay mental health expert, sexologist, and author Joe Kort (2008) produced a guide to support therapists in conducting specialized therapeutic relationships with LGBTQ+ clients. Kort noted, “Although the psychotherapy field has changed dramatically in its attitudes towards homosexuality over the past 50 years, homophobic therapists are still around, often treating patients while keeping their homophobia in the closet” (p. 2). Kort’s view highlights how the therapeutic field has made great advancements in reducing harm inflicted on LGBTQ+ clients, but still needs work. Kort’s writings outline steps that contemporary clinicians can take to reduce any unintentional harm and enhance their therapeutic practices with LGBTQ+ clients. Kort (2008) highlighted self-education as being paramount in a therapist’s pursuit of effective treatment. He wrote, having a healing, validating stance in therapy does help some of the distorted thinking that most clients bring in. But having an affirmative stance without being informed about specific issues that LGBTQ+ folks experience limits your clinical effectiveness. (p. 18)
Kort’s perspective highlights the unintentional harm that underprepared therapists can inflict when advertising a trained stance without proper education. Kort used the term “Homo-Avoidance” (p. 28) as a label for therapeutic microaggressions against LGBTQ+ clients from under informed therapists. He suggested that the avoidance of the topic of sexual orientation erases large portions of the client’s identity, reaffirming a negative self-image instilled by cultural heterocentrism.
A key contribution Kort provided to the contemporary psychotherapeutic field regarding LGBTQ+ concerns included his attention to speak to the unspoken. Through naming aloud in an empowering manner, the oppression experienced by many LGBTQ+ clients healing can unfold. Without attention to detail, unconscious personal biases, microaggressions, and enacting dominant-subordinate power dynamics in therapy can perpetuate oppression and the client’s symptomology.
What does effective LGBTQ+ Therapy Look Like?
LGBTQ+ Specialized Therapy can often feel more like a very engaged conversation. The traditional therapist role of neutrality, silence, and openness can often be harmful to clients who have been oppressed based on sexual orientation or gender identity. This approach leaves too much room for a client to project negative bias from the therapist. Effective LGBTQ+ therapists are engaged with clients and proactively demonstrate understanding, acceptance, and validation.
Psychoanalyst, feminist, and founder of relational-cultural therapy, Jean Baker Miller’s (1986) perspective stressed the importance of Proactive Interventions. Proactive Interventions are conceptualized through discussion of Miller’s (1986) approach to cultivating awareness of oppression and its subsequent psychological effects and externalizing efforts to reclaim autonomy. It is important for clinicians to know when they can successfully be affirmatively proactive or constructively challenging with a sexual minority client. A powerful intervention can be applied when a client shares an experience of discrimination, imposed heteronormativity, or rejection based on queerness. When clinicians can appropriately acknowledge these instances, they validate the client’s lived experience and greatly reduce shame. Likewise, this naming and labeling intervention will inform clients and support them in not internalizing discriminatory offenses in the future. Proactive interventions can also normalize shame, hurt, and anger associated with lived discrimination and counter clients internalized shame.
Searching for a LGBTQ+ Therapist
How do you find an effective LGBTQ+ therapist that will fit you and your goals for therapy? It can be hard to figure out who would match your needs and practices what they advertise. Here are a few tips to empower folks in finding a therapist who will fit what you are looking for. First and foremost, searching and filtering therapists is important. Knowing the difference between therapists who advertise themselves as LGBTQ+ Friendly, Affirming, or Specialized is key.
Friendly
LGBTQ+ friendly therapy raises my eyebrow the most. It is it suggests a sense of tolerance rather than understanding and empathy. Anyone can say that they’re LGBTQ friendly but that doesn’t mean they're truly informed on how you walk through the world. ‘Friendly’ could mean anything. For instance, a therapist could be someone who espouses right wing, evangelical or cis-het-patriarchal ideology, and doesn’t understand the conflict of interest with LGBTQ+ mental health. They could still advertise that they are LGBTQ+ ‘friendly’ for marketability and profitability. Unfortunately, this happens a lot.
Affirming
LGBTQ+ affirming therapy is a better bet in that ‘affirming’ typically means that the therapist has a shared experience within LGBTQ+ communities or possibly a strong sense of ally ship. Affirming therapy can also mean that therapist has a commitment to participating in social justice for LGBTQ+ folks.
Specialized
I recommend seeking a LGBTQ+ specialized therapist. Specialized means that the education and training was selected and completed for LGBTQ+ oriented mental health considerations. Antioch University in California offers is LGBTQ+ specialization within their master’s program which requires the consistent focus on LGBTQ+ considerations throughout the two-year program. Similarly, the Los Angeles LGBT CENTER provides a standardized 65-hour initial training on LGBTQ+ mental health considerations, interventions, and theory along with a year-long supervision program provided by LGBTQ+ experts. Other forms of specialization can be documented trainings, research, and consultations. Overall, ‘Specialized’ means the therapists career is dedicated to LGBTQ+ mental health.
Expert
Within the field of mental health if a therapist has worked within a specific population, theoretical orientation, or specific contexts for over five years, they are considered an expert. An expert is someone who has traceable experience and competence working within a specific field of psychology. Experts and those advertising LGBTQ+ therapy should have trackable documented proof of such experience. That proof can be accreditation, certification, or associations with reliable institutions.
Vet Them
Vet the hell out of a prospective therapist. Make sure to interview several therapists before picking one. Most therapist offer a free phone consultation. If they don’t, that could be a red flag. In a consultation, ask all your questions. It is a two-way interview. Also ask:
-Where their experience with LGBTQ+ mental health originates from?
-What LGBTQ+ education, certifications and trainings have they completed?
-What relationship do they have to the LGBTQ+ community?
-How do they identify?
-Why do they like working with LGBTQ+ clients?
Don’t be afraid to ask the questions that are important to you. A relationship with a therapist is important, vulnerable, and special. Treat it like dating before committing and make sure it is the right fit. Trust your internal instincts about this and really vet them well so you can fully commit to a therapeutic process that is right for you.
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References
Kort, J. (2008). Gay affirmative therapy for the straight clinician: The essential guide. New York, NY: Norton.
Miller, J. B. (1986). Toward a new psychology of women. Boston, MA: Beacon Press.
