PSYCHOLOGICAL TREATMENT OF LGB INDIVIDUALS: UNDERSTANDING PRACTICE GUIDELINES
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1 PSYCHOLOGICAL TREATMENT OF LGB INDIVIDUALS: UNDERSTANDING PRACTICE GUIDELINES Arlene Noriega, Ph.D. Rock Bridge Psychological Associates, LLC President-Elect, Div. 44 March 24, 2012
2 Guidelines for Psychological Practice With Lesbian, Gay, and Bisexual Clients Originally adopted in 2000 Current Revision Published in APA Monitor in January 2012 issue. Vol 67, No. 1, p Both the original and revision LGB Guidelines Task Force chaired by Kris Hancock, Ph.D. and Doug Haldeman, Ph.D. This presentation is based on this publication.
3 The LGB Practice Guidelines were of such high caliber that they were used as a template in APA for all other guidelines.
4 Why do we need guidelines? Provide a frame of reference for treatment. Provide basic information/ references in the various areas.
5 Guidelines assist psychologists conducting lesbian, gay, and bisexual affirmative practice, education, and research.
6 LGB Guidelines were developed in collaboration between Division 44 and the Committee on Lesbian, Gay, Bisexual, and Transgender Concerns (CLGBTC).
7 But, where is the T? Division 44 and APA recognize that there are idiosyncratic issues in working with transgendered individuals in psychotherapy and that these issues warrant their own guidelines. The Transgender Guidelines are currently being worked on. The Transgender Guidelines Task Force has met once in February of 2012 in Atlanta, GA. The Taskforce is chaired by lore dickey, Ph.D. and Anneliese Singh, Ph.D.
8 What are guidelines? Guidelines are: Pronoucements, statements, or declarations that suggest or recommend specific professional behavior, endeavors, or conduct for psychologists. Aspirational in intent. Facilitate the continued structured and systematic development of the profession. Guidelines are NOT: Mandatory/exhaustive. Definitive. Superseded by judgment of psychologist. Superseded by federal and state law.
9 Guidelines are to be consistent with APA Code of Ethics and Conduct.
10 What happened in 1975??
11 Did you know? In 1975, APA adopted a resolution stating that homosexuality per se implies NO impairment in judgment, stability, reliability, or general social or vocational capabilities AND urging all mental health professionals to take the lead in removing the stigma of mental illness that has long been associated with homosexual orientations. Conger, 1975
12 The sex of those to whom one is sexually and romantically attracted. Gay men/lesbians Heterosexuals Bisexuals Sexual orientation is not always in such neat, categories and instead is a continuum Sexual Orientation
13 So, what s the problem? Everything should be okay now, right???
14 NOPE! In 16 years following APA s 1975 resolution, there is documentation of a gap between policy and actual practice.
15 Did you know? In 2009, APA affirmed that same-sex sexual and romantic attractions, feelings, and behaviors are NORMAL and positive variations of human sexuality regardless of sexual orientation identity. APA, 2009
16 How do guidelines differ from standards??
17 Standards are mandatory and may be accompanied by an enforcement mechanism. You will be held to the STANDARDS of your profession in a court of law.
18 Terms
19 Sex Biological status. Typically categorized as male, female, or intersexed.
20 Gender Attitudes, feelings, & behaviors that a given culture associates with a person s biological sex. Gender Normative Behavior = cultural expectations Gender Nonconformity-- Behavior # cultural expectations
21 Gender Identity One s sense of oneself as male, female, or transgender (APA, 2006). When one s gender identity and biological sex are not congruent, the person may consider themselves transgender/ transsexual
22 Cisgender The opposite of transgendered Someone who is cisgendered has a gender identity that agrees with their socially recognized sex.
23 Way in which a person acts to communicate gender within a given culture. For ex., clothing, communicatio n patterns, interests, etc. APA, 2008 Gender Expression
24 Gender expression not consistent with socially prescribed gender roles
25 Queer Queer is an umbrella term to describe sexual orientation for sexual minorities that are not heterosexual, heteronormative, or gender-binary. Only identifier that does not specify the sex/gender of partner.
26 Coming Out The process in which one acknowledges and accepts one s own sexual orientation. Includes the process by which one discloses one s sexual orientation to others.
27 Levels of Coming Out Use of Bronfenbrenner s Socioecological Model to describe the varying levels of coming out. If different contexts influence development, could we influence various contexts??
28 Overview of Guidelines ATTITUDES TOWARDS HOMOSEXUALITY AND BISEXUALITY Guideline 1 through Guideline 6 RELATIONSHIPS AND FAMILIES Guideline 7 through Guideline 10 ISSUES OF DIVERSITY Guideline 11 through Guideline 16 ECONOMIC AND WORKPLACE ISSUES Guideline 17 through Guideline 18 EDUCATION AND TRAINING Guideline 19 through Guideline 20 RESEARCH Guideline 21
29 ATTITUDES TOWARDS HOMOSEXUALITY AND BISEXUALITY
30 Guideline 1 Psychologists strive to understand the effects of stigma and various contextual manifestations in the lives of LGB people.
31
32 More Terms
33 Social Stigma a negative social attitude or social disapproval directed toward a characteristic of a person that can lead to prejudice and discrimination. VandenBos, 2007
34 Heterosexism The ideological system that denies, denigrates, and stigmatizes any NONHETEROSEXIST form of behavior, identity, relationship, or community. Herek, 1995
35 Minority Stress The concept of minority stress is based on the premise that gay people in a heterosexist society are subjected to chronic stress related to their stigmatization.
36 Example of a Microaggression
37 Sexual Minority Term used to refer to people who are nonheterosexual particularly when comparing their experiences with those of ethnic minority individuals. (Dworkin, 2000).
38 LGB Affirmative The view that LGB people and issues are central and self-defining as opposed to marginal and defined by a heterosexual norm. Morrow, 2000
39 Guideline 2 Psychologists understand that lesbian, gay, and bisexual orientations are NOT mental illnesses
40 Practical Applications The practical application is that clients who have been exposed to notions of homosexuality and bisexuality as mental illnesses may present with internalized prejudicial attitudes. 1. Consider the effects of internalized stigma 2. Collaborate with client on establishing therapeutic goals 3. Disseminate accurate scientific and professional information about sexual orientation to counteract the bias.
41 Guideline 3 Psychologists understand that same-sex attractions, feelings, and behavior are normal variants of human sexuality and that efforts to change sexual orientation have not been shown to be effective or safe.
42 S-Sexual O-Orientation C-Change E-Efforts Therapeutic interventions intended to change, modify, or manage unwanted nonheterosexual orientations.
43 Guideline 4 Psychologists are encouraged to recognize how their attitudes and knowledge about LGB issues may be relevant to assessment and treatment and seek consultation or make appropriate referrals when indicated
44 Georgia Grad Student Sues University Over Gay Sensitivity Training By SARAH NETTER July 27, 2010 A Georgia student studying counseling says her university went too far in requiring her to change her Christian beliefs on homosexuality before she's allowed to graduate. Backed by the Alliance Defense Fund, Jennifer Keeton has filed suit against Augusta State University after, she said, school officials threatened to dismiss her from its counseling program when she refused to participate in a "remediation" plan to increase her tolerance of gays and lesbians after she made it known that she believed homosexuality was a personal choice. According to the lawsuit, filed earlier this month in the U.S. District Court for the Southern District of Georgia, school officials told Keeton that she was failing to conform to professional standards because of her views onlesbian, gay, bisexual and transgender issues.
45 Sexual Orientation Blindness This is also an ineffective approach. It is similar to Color Blindness. Ignores or denies the culturally unique life experiences of the lesbian, gay, and bisexual populations. Instead of eliminating heterosexist bias, it perpetuates heterosexism in a manner that is not helpful to clients.
46 Guideline 5 Psychologists strive to recognize the unique experiences of bisexual individuals.
47
48
49 Guideline 6 Psychologists strive to distinguish issues of sexual orientation from those of gender identity when working with LGB clients
50 The L Word
51 RELATIONSHIPS AND FAMILIES
52 Guideline 7 Psychologists strive to be knowledgeable about and respect the importance of lesbian, gay, and bisexual relationships.
53
54
55 Psychologists strive to understand the experiences and challenges faced by lesbian, gay, and bisexual parents. Guideline 8
56
57
58 Guideline 9 Psychologists recognize that the families of LGB people may include people who are not legally or biologically related.
59 Guideline 10 Psychologists strive to understand the ways in which a person s LGB orientation may have an impact on his/her family of origin and the relationship with that family of origin
60
61
62
63 What influences the lives of LGB people?
64 Guideline 11 Psychologists strive to recognize the challenges related to multiple and often conflicting norms, values, and beliefs faced by LGB members of racial and ethnic minority groups.
65 Psychologists are encouraged to consider the influences of religion and spirituality in the lives of LGB persons. Guideline 12
66 Psychologists strive to recognize cohort and age differences among LGB individuals. Guideline 13
67 Psychologists strive to understand the unique problems and risks that exist for LGB youth. Guideline 14
68
69 Opt for broad terms like Queer or reject them altogether. Youth reject labels
70 Social Support is Crucial Importance of GSAs
71 Psychologists are encouraged to recognize the particular challenges that LGB individuals with physical, sensory, and cognitiveemotional disabilities experience. Guideline 15
72 Guideline 16 Psychologists strive to understand the impact of HIV/AIDS on the lives of LGB individuals and communities.
73 ECONOMIC AND WORKPLACE ISSUES
74 Guideline 17 Psychologists are encouraged to consider the impact of socioeconomic status on the psychological well-being of LGB clients.
75 Guideline 18 Psychologists strive to understand the unique workplace issues that exist for LGB individuals.
76
77 EDUCATION AND TRAINING
78 Guideline 19 Psychologists strive to include LGB issues in professional education and training.
79 Guideline 20 Psychologists are encouraged to increase their knowledge and understanding of homosexuality and bisexuality through continuing education, training, supervision, and consultation.
80 RESEARCH
81 Guideline 21 In the use and dissemination of research on sexual orientation & related issues, psychologists strive to represent results fully & accurately & to be mindful of the potential misuse or misrepresentation of research findings.
82
83
84 Thank You! Contact Information: Arlene Noriega, Ph.D. Rock Bridge Psychological Associates, LLC 5440 Lawrenceville Hwy. Lilburn, GA Office: ext. 103
85 Become a member/student member of Division 44
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