Gay, Lesbian, and Bisexual Clients
For individuals in the U.S. & U.S. territories
In Gay, Lesbian, and Bisexual Clients, Dr. Ruperto M. Perez demonstrates and discusses his approach to working with lesbian, gay, or bisexual individuals. Therapy and counseling with this population is similar in many ways to working with members of the heterosexual population, except that the therapist must keep in mind issues of homophobia, the coming out process, and the multiple social roles that lesbian, gay, or bisexual clients may play.
In this session, Dr. Perez illustrates his affirmative approach to therapy with a client named Denise, a woman who in the past year has divorced her husband of 26 years, come out to friends and family as a lesbian, and entered a new relationship with a woman. Dr. Perez works with Denise on the complications of having a fuller relationship with her partner while acknowledging the needs of her children as well as her fears of coming out at work and in the broader community.
Affirming therapy with gay, lesbian, and bisexual clients involves acknowledging where a client stands in his or her development and encouraging healthy growth. Affirming does not simply mean acceptance—challenging the client may be part of the therapy—but is rather a validation of the client's experiences and lesbian, gay, or bisexual identity.
Research has shown that one of the most important aspects of therapy with lesbian, gay, and bisexual clients is the therapist's attitude, and an affirming approach has been shown to result in successful therapy.
Dr. Perez outlines two key aspects to his approach to working with lesbian, gay, and bisexual clients in the coming-out process: learning the client's story and discerning a support system. Listening to the client's story involves learning about his or her experiences of life, coming out, and any current concerns. Next, the therapist helps the client discern his or her support system: friends and family who support and accept the client.
If the client does not have a support system, the therapist should offer ways to develop a network of support. This might involve counseling on communication skills or recommending involvement in lesbian, gay, and bisexual organizations or groups.
An overriding issue in therapy with gay, lesbian, and bisexual clients is the effect of homophobia and heterosexism on the client. Therapists should learn as much as they can about these phenomena, as experiences of stigma and prejudice will very often be central to the concerns of the client.
In addition, a client may or may not be out (i.e., having revealed his or her true sexual orientation to those around them) or may be partially out (may have come out to some close friends or family). A client's social roles will be determined in part by the extent to which they have come out.
Most therapists will work with lesbian, gay, and bisexual clients during their careers. Dr. Perez recommends reading the literature on affirming therapy and working in general with lesbian, gay, and bisexual clients. He also recommends obtaining supervision and consultation on working with this population.
Ruperto (Toti) M. Perez, PhD, is assistant director for clinical services and clinical assistant professor at the University of Florida Counseling Center. Dr. Perez received his PhD in counseling psychology from the University of Missouri—Columbia. He served as counseling services coordinator and internship training director at the University of Georgia from 1993–2002 as well as adjunct assistant professor.
Dr. Perez is a fellow of the American Psychological Association's (APA's) Division 17 (Society of Counseling Psychology) in which he served as chair for the Section on Ethnic and Racial Diversity and as vice president for Diversity and Public Interest. Dr. Perez presently serves as special interest groups coordinator. He has also served as the Division 17 liaison to the APA Board for the Advancement of Psychology in the Public Interest (BAPPI) and is a current member of BAPPI.
In addition, Dr. Perez is a member of the American College Personnel Association Commission for Counseling and Psychological Services (CCAPS) and has served as directorate body member, commission chair, and CCAPS liaison to APA Division 17.
Dr. Perez's areas of professional interest include counseling issues related to diversity and multiculturalism; gender issues; lesbian, gay, bisexual, and transgendered concerns; outreach and consultation; and supervision and mentoring.
He is coeditor of the Handbook of Counseling and Psychotherapy With Lesbian, Gay, and Bisexual Clients (with K. J. Bieschke & K. A. DeBord; APA, 2000).
- American Psychological Association (2000). Guidelines for psychotherapy with lesbian, gay,and bisexual clients. American Psychologist, 55, 1440–1151.
- Bieschke, K. J, Perez, R. M., & DeBord, K. A. (Eds.). (in press). Handbook of counseling and psychotherapy with lesbian, gay, bisexual, and transgender clients (2nd ed.). Washington, DC: American Psychological Association.
- Croteau, J. M., Bieschke, K. J., Phillips, J. C., & Lark, J. S. (1998). Moving beyond pioneering: Empirical and theoretical perspectives on lesbian, gay, and affirmative training. The Counseling Psychologist, 26, 707–711.
- Croteau, J. M., Lark, J. S., Lidderdale, M. A., & Chung. Y. B. (2005). Deconstructing heterosexism in the counseling professions: A narrative approach. Thousand Oaks, CA: Sage.
- Fassinger, R. E. (2000). Gender and sexuality in human development: Implications for prevention and advocacy in counseling psychology. In S. D. Brown & R. W. Lent (Eds.), Handbook of counseling psychology (3rd ed., pp. 346–378). Hoboken, NJ: Wiley.
- Firestein, B. A. (1996). Bisexuality: The psychology and politics of an invisible minority. Thousand Oaks, CA: Sage.
- Garnets, L. D. (2002). Sexual orientations in perspective. Cultural Diversity and Ethnic Minority Psychology, 8 (2), 115-129.
- Pachankis, J. E., & Goldfried, M. R. (2004). Clinical issues in working with lesbian, gay, and bisexual clients. Psychotherapy: Theory, Research, Practice, Training, 41, 227–246.
- Perez, R. M., DeBord, K. A., & Bieschke, K. J. (Eds.). (2000). Handbook of counseling and psychotherapy with lesbian, gay, and bisexual clients. Washington, DC: American Psychological Association.
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- Client-Directed Outcome-Focused Psychotherapy
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- Feminist Therapy
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- Working With Gay Male Clients
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- Handbook of Counseling and Psychotherapy with Lesbian, Gay, Bisexual, and Transgender Clients, Second Edition
Edited by Kathleen J. Bieschke, Ruperto M. Perez, and Kurt A. Debord
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- Mom, Dad. I'm Gay. How Families Negotiate Coming Out
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- Sexual Orientation and Mental Health: Examining Identity and Development in Lesbian, Gay, and Bisexual People
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