This study examined couple and family therapy (CFT) students' beliefs about sexual orientation, their self-reported competency working with lesbian, gay, and bisexual (LGB) clients, and the level of affirmative training students received in their CFT programs. One hundred and ninety students from accredited CFT programs completed the study. While participants reported feeling only somewhat competent to work with LGB clients and less than half reported receiving any training on affirmative therapy, the majority of the participants did appear to hold positive attitudes toward LGB clients. The results support the literature arguing for CFT programs to include specific training on affirmative therapy practices, as the level of affirmative training was directly related to participants' self-reported clinical competency working with LGB clients.

The purpose of this article is to propose a three-step model to help heterosexual therapists become more aware of the influence of their own heteronormative assumptions, heterosexual privileges, and heterosexual identities on the therapy process. This article also provides definitions of concepts central to the practice of affirmative therapy with lesbian, gay, and bisexual clients and strategies that therapists and clients can use to deconstruct heterosexism in the context of therapy.

This study established the validity and factor structure of the Affirmative Training Inventory (ATI; T. S. Carlson, C. R. McGeorge & M. Rock, unpublished) as a measure of lesbian, gay, and bisexual (LGB) affirmative clinical training. Additionally, this study examined the latent associations among the subscales of the ATI and the Sexual Orientation Counselor Competency Scale (Bidell, 2005) utilizing a sample of 248 master’s and doctoral couple and family therapy students. The findings from this study provide empirical support for the relationship between specific classroom‐related content associated with LGB affirmative therapy and students’ perceptions of their own ability to work competently with LGB clients. This study also found a positive association between the degree to which couple and family therapy programs adopt a LGB‐affirmative stance and students’ beliefs, knowledge, and skills associated with competent therapy with LGB clients.