This paper seeks to review the history of discussions about lesbian and gay male sexuality in family therapy theory and practice. It examines whether homophobic and heterosexist attitudes are present in family therapy thinking. Possible connections are explored between attitudes towards lesbian and gay issues and the professional backgrounds of family therapists, wider debates on homosexuality within society, and conceptualizations of the family life cycle. The question of why relatively little has been written on the issues raised by lesbians, bisexuals and gay men in therapy is discussed. The implications of this oversight on practice are addressed and suggestions made for future work.In recent years there has been an adjustment within family therapy theory and practice to incorporate a diversity of family forms within the concept of family. However, family therapy in general has been slow to consider sexuality as an influence on family life, and in particular to address the issues raised by families led by a lesbian or gay parent or a lesbian or gay couple. Much more work has been done on considering factors such as divorce, gender and ethnicity, both that of our clients and of ourselves as therapists (see, among others, Carter and McGoldrick, 1989;Goldner, 1985Goldner, , 1988Lau, 1984;McGoldrick et al., 1982;Walters et al., 1988) but much less attention has been paid to sexuality, the topic of this paper. It should be made clear at this point that we are not discussing sexual activity within relationships, a territory reviewed by family therapists such as Skynner (1976), but what is often described as sexual orientation.It is, of course, entirely appropriate that ethnicity and gender should be a focus of attention in order to fully engage with the cultural perspectives that influence the family, but attention also

This paper discusses a questionnaire survey done with a sample of 130 systemic family therapists, which investigated their training in, and experience of, working with lesbian and gay male clients and attitudes towards lesbians and gay men using the Index of Attitudes to Homosexuals. The findings indicate that the majority of respondents had received relatively little training in working with this client group within their systemic training. It also indicated that their attitudes towards lesbians and gay men generally may have been influenced by the degree of social, professional or familial contact that they had with them.

Lesbians and gay men are more likely to use psychotherapy services than are heterosexual men and women, yet little is known of the aspects of psychotherapy that lesbians and gay men find helpful. A postal survey with a community sample of lesbians and gay men in the UK who had used counselling or psychotherapy services examined this issue. Content analysis of the responses that lesbians and gay men (n = 365) gave to a series of open-ended questions on what was helpful or unhelpful in psychotherapy revealed that issues related to sexual identity were important in addition to generic qualities of the therapeutic relationship. Lesbians and gay men also listed friends, family of choice, and family of origin, and complementary or "alternative" therapies as important sources of support aside from psychotherapy. This study has implications for counselling and psychotherapy training, for counsellors and psychotherapists working with lesbians and gay men, and for lesbians and gay men who use psychotherapy.

Systemic therapy is considered as a modality which may be well-suited to therapeutic work with lesbian and gay male populations, whether as individuals, couples or families of choice. Issues within systemic therapy and practice are discussed with reference to working with these populations.

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