MFT TRAINING IN SEXUAL MINORITY ISSUES: A CORE FACULTY PERSPECTIVE

MFT TRAINING IN SEXUAL MINORITY ISSUES: A CORE FACULTY PERSPECTIVE LIND S A Y L. EDW A R DS, M S UNI V ER S ITY O F CO NNE C TI CU T JANET R O BE RTSO N, M S & PA ULA S MITH, MDI V. MA A NTI OC H UNI V ER S ITY NEW EN G L A ND N ICO LE O' BRIEN, MA LMFT FAIRFIELD UNI V ER S ITY

BACKGROUND Large numbers of MFTs report working with gay and lesbian clients (80% 1 and 95% 2 ) MFTs are in a unique position to provide valuable therapeutic services COAMFTE has yet to establish standards for training students to work with LGB clients Less than 25% of family therapists had more than 2 hrs of training on LGB topics 3 Slightly less than 50% not encouraged to explore heterobias3 Only 39.5% of MFT students received some training on affirmative therapy practices 4

METHOD Descriptive and exploratory by design 57-item online survey given to MFT core faculty Short answers 5-point Likert Scale 1 - "strongly disagree" to 5 - "strongly agree" Questions derived from suggestions in literature 5-6 Addressed 5 broad areas: Affirmative integration at the program level Integration of LGB identities into curriculum Integration of LGB identities in on- and off-campus clinical work Self-evaluation of supervision abilities Evaluation of training program in its entirety

PARTICIPANT DEMOGRAPHICS Demographic Characteristics of Participants: 84(28.6%) faculty started survey and 57 ( 19.4%) completed survey Characteristics n % Characteristics n % Gender Program Structure Female 30 53.6 Masters level only 36 64.3 Male 26 46.4 Both Masters level and PhD 17 30.4 Transgender 0 0 PhD only 3 5.4 Race/Ethnicity Spirituality Caucasian/ European-American 48 87.3 Some form of Christianity 24 African American/Black: 2 3.6 Spiritual in-general 9 Na tive American I Native Alaskan 2 3.6 Buddhism or Buddhist principles 4 Asian/ Asian American 1.8 Jewish 3 Latino(a)/ Chicano(a)/ Hispanic 1.8 Non-practicing 3 Biracial I multiethnic: 1.8 Interconnection of people 3 Sexuality Unitarian Universalists 2 Heterosexual 53 94.6 Science of the Mind 2 Bisexual 1.8 Mindfulness/meditation/yoga 2 Gay /Lesbian 1.8 Atheist Other 1.8 Intercultural Position Senior level 28 49. 1 Time in field post masters degree in years Mid level 19 33.3 M(SD): 20.85(1 0.22) Junior level 10 17.5

PARTICIPANT BELIEFS Heterosexism has Heterosexism has historically permeated the current day implications mental health profession for clinical work Must be mindful of heterosexism when working with clients 27 36 45 Strongly Agree Agree Neutral Disagree

Strongly Strongly Disagree Neutral Agree Survey Item Disagree Agree n {%} n {%} n {%} n {%} n {%} Policies beyond standard nondiscrimination 7 (11.5) 18 (29.9) 6 (9.8) 22 {36.1 ) 8(13.1) Enforces non-discrimination policies 2 (3.3) 6 (9.8) 6 (9.8) 28 (45.9) 19 (31.1) Recruits LGB students for program 7(11.3) 1 18 (29.0) 12 (19.4) 12 (19.4) 13(21.0) Affirming environment for LGB students Recruits LGB faculty or instructors for program Affirming environment for LGB faculty in program Language in program application not heterobiased Affiliated with LGB affirming community organizations Plans community events focusing on LGB topics Plans continuing education focusing on LGB topics Multiculturalism/diversity in mission statement Sexua l orientation in mission statement 1 ( 1.6) 2 (3.2) 9(14.5) 24(38.7) 26{41.9) 11 ( 17.7) 13 (21.0) l 19 (30.6) I 7 ( 11.3) 12 (19.4) 4 (6.5) 1 ( 1.6) 10 ( 16.1) 28 (45.2) 1 19 (30.6) 1 ( 1.6) 8(12.9) 10 (16.1) 19 (30.6) 24 {38.7) 4 (6.6) 10 (16.4) 9 (14.8) 16 (26.2) 22 {36.1) 8 (12.9) 19 (30.6) 8(12.9) 16(25.8) 11 (17.7) 6 (9.7) 22 (35.5) 10(16.1) 19(30.6) 5(8.1) 0 (0) 7 ( 11.3) 0 (0) 16 (25.8) 39 (62.9) 3 (4.8) 14 (22.6) 6 (9.7) 12 (19.4) 27 {43.5) I! M SD 3.10 1.29 3.92 1.05 3.10 1.34 4. 16 0.91 2.94 1.35 3.92 1.06 3.92 1.12 3.69 1.30 3.04 1.35 2.92 1.18 4.40 0.96 3.74 1.35 Findings for Program Environment Items Frequencies, Means, and Standard Deviations

Survey Item Strongly Strongly Disagree Neutral Agree Disagree Agree n (%} n (%} n (%} n (%} n (%} Discuss diversity of human sexual experiences 0 (0) 1 (1.6) 4 (6.5) 16 (25.8) 41 (66.1) Discuss fluidity of human sexuality 2 (3.2) 2 (3.2) 11 ( 17.7) 13 (21.0) 34 (54.8) Discuss social construction of sexual orientation 1 (1.6) 2 (3.2) 8(12.9) 20 (32.3) 3 1 (50.0) Use films/ movies with LGB persons 2 (3.2) 4 (6.5) 11 ( 17.7) 19 (30.6) 26 (41.9) Use role plays/case studies with LGB clients 0 (0) 2 (3.2) 5 (8.1) 23(37.1) 32 (51.6) Incorporate LGB guest speakers 1 (1.6) 4 (6.5) 13 (21.0) 15 (24.2) 29 (46.8) M SD 4.56 0.69 4.21 1.06 4.26 0.92 4.02 1.08 4.37 0.77 4.08 1.04 Findings for Curriculum Items Frequencies, Means, and Standard Deviations

Strongly Strongly Disagree Neutral Agre e Survey Item Disagree Agree M n (%) n (%) n (%) n (%) n (%) Use diverse relationship options in p a p erwork "Other" gender option in c linical paperwork Images of LGB families in clinic brochures and publications Decorate c linic so that they are LGB affirming Recruit LGB clients for on-campus clinic Students have referral sources for LGB clients Books on LGB topics in c linic library Placements have same non-discrimination policies Place students in internships w ith LGB clients Students at internship have LGB resources Solicit student feedback that placement affirming - 1 (1.9) 5 (9.3) 5 (9.3) 19 (35.2) 5 (9.4) 17 (32.1) 2 (3.6) 20 (36.4) 1 (1.9) 10 (18.5) 2 (3.6) 7 (12.7) 1 ( 1.8) 5 (9.1 ) 3 (5.6) 4 (7.4) 3 (5. 1) 4 (6.8) 3 (5. 1) 4 (6.8) 3 (5.2) 3 {5.2) 2 {3.4) 3 {5.1 ),, 8 (15.1 ) 12 (2 1.8) 24 (44.4) J 4.11 11 {20.8) 12 {22.6) 1 0 { 18.2) 11 {20.0) 8 (14.8) 25 (46.3) 10 {18.5)...----,'--------' 17 (30.9) 14 {25.5) 15 {27.3) 7 (12.7) 15 {27.3) 27 (49.1) J 9 (16.7) 23 (42.6) 15 {27.8) 15 (25.4) 22 (37.3) 15 {25.4) 20 (33.9) 23 (39.0) 9 {15.3) 16 {27.6) 20 (34.5) 16 {27.6) 9 {15.3) 23 (39.0) 22 {37.3) 3.15 3.14 3.6 1 3.60 4.13 3.80 3.71 3.53 3.74 4.02 SD 1.04 1.35 1.22 1.05 1. 13 1.07 1. 12 1.08 1.01 1.09 1.03 Findings for Clinical Component Items Frequencies, Means, and Standard Deviations

Survey Item Strongly Strongly Disagree Neutral Agree Disagree Agree n (%) n (%) n (%) n (%) n (%) Prepared to supervise students working with LGB clients 0 (0) 0 (0) 2 (3.4) 21 (33.9) 36 (61.0) Supervisees can do case presentation for LGB clients 0 (0) 3 (5. 1) 5 (8.5) 27 (45.8) 24 (40.7) Knowledgeable about issues faced by LGB persons 0 (0) 1 ( 1.7) 6 (10.2) 27 (45.8) 25 (42.4) Access continuing education on issues faced b y LGB clients 0 (0) 2 (3.4) 2 (3.4) 24 (4 1.4) 30 (51.7) Number of students supervised during career M(SD): 41.69(35.76) M SD 4.58 0.56 4.22 0.81 4.29 0.72 4.41 0.73 Findings for Self- Assessment of Supervision Ability Items Frequencies, Means, and Standard Deviations

Program does a good job training students to work with LGB clients Satisfied with how Program needs changes program trains students in how it trains students to to work with LGB clients work with LGB clients 22 31 37 Strongly Agree/ Agree Neutral Strongly Disagree/ Disagree Findings for Evaluation of Training Program items

CORRELATIONAL ANALYSIS Person Correlations performed to test relationships among subscales and the individual evaluation of training program items Program environment subscale Curriculum subscale Clinical component subscale Supervision abilities subscale Satisfied with training Feel they do a good job Do not need to make changes

1 2 3 4 5 6 7 1. Program Environment Subscale 2. Curriculum Subscale.758** 3. C linical Subscale.776**.619** 4. Supervision Abilities Subscale.338**.299*.366** 5. Good Job.733**.731**.689**.186 6. Satisfied.531**.554**.482**.070.788** 7. Needs Changes -.415** -.321* -.375**.053-571** -.725** **p < 0.01 *p < 0.05 Correlation Matrix with Program Environment, Curriculum, Clinical Component, and Evaluation of Training Variables

CORRELATIONAL ANALYSIS Faculty in more affirming programs more likely to indicate: They teach the variable nature of sexuality within their curriculum They represent LGB identities within their instruction Their programs' clinical components are more inclusive of LGB identities They have a greater level of expressed ability as supervisors Faculty more likely to feel they do a good job, be satisfied with training and feel they do not need to make changes to program if they are in programs that: Are inclusive and affirming Emphasize the diversity of human sexual experiences in instruction Represent LGB identities within their instruction Has inclusive representation of LGB identities in their clinical components

QUALITATIVE FINDINGS Changes faculty would like in program (n = 23): More overt, proactive, visible integration of LGB identities ( 6 faculty) Program-wide commitment to prioritize the integration of LGB identities (5 faculty) More connections with LGB community organizations (4 faculty) Classes focused specifically on this topic (3 faculty) Increase education, in-general (3 faculty) Program to draw more on external resources (3 faculty) Actively recruit LGB students (2 faculty) Actively recruit LGB faculty (2 faculty) Faculty training on LGB needs and experiences (2 faculty) More comprehensive integration of LGB identities into their curriculum (2 faculty) Actively recruit LGB clients ( 1 faculty) Do better job addressing subtle homophobic behaviors (1 faculty)

QUALITATIVE FINDINGS Comments on current status of program (n = 21): Reaffirmed they are doing good job (6 faculty) Mentioned bias of colleagues (5 faculty) Listed challenge of being in a religiously affiliated university when addressing this issue (3 faculty) Highlighted challenge of fitting everything into a masters program (3 faculty) Unhappy with programs' efforts (2 faculty) Recently solicited student feedback on this issue (2 faculty) Current efforts too slow (2 faculty) Proud of program's outreach to transgender community(1 faculty) Program only addresses blatant discrimination (1 faculty) Described program environment as neither safe nor affirming for LGB individuals ( 1 faculty)

QUALITATIVE FINDINGS How they address student who are averse to working with LGB clients (n=sl): Offered some action they take (34 faculty) Through supervision during program { 15 faculty) Gate-keeping during admission process {13 faculty) Help students explore bias in their course work ( 13 faculty) Address concerns directly with student in private meeting ( 1 0 faculty) Through their affirmative program climate, in-general {9 faculty) Through a specific remediation plan, ending with counseling out (8 faculty) Emphasize diversity in a general sense {7 faculty) Require additional education {5 faculty) Expose students to people from different backgrounds {5 faculty) Reference AAMFT code of ethics (5 faculty) Encourage students to work with groups they do not want to (4 faculty) Provide students with current research {2 faculty) Currently no plan ( 11 faculty) Do not have students who are averse ( 4 faculty) In the process of establishing policy (2 faculty) Unsure (2 faculty)

DISCUSSION Many of the suggestions in literature instituted 5-6... But! Still need changes to make MFT programs safe and affirming environments that sufficiently train students for work with LGB clients Increase visibility of LGB identities in program Actively recruit LGB students and faculty Include images of LGB families in clinic brochures /publications Active outreach to local LGB community Clear policies for addressing students who are averse to working with LGB clients Experiences of LGB persons interacting with MFT programs dependent on the faculty members in charge

LIMITATIONS Multiple faculty members from the same institution responded to this survey balanced the need for privacy with our wish to make conclusions about the programs directly Respondents of survey predominately from an affirming disposition

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