This article explores the unique issues and concerns facing lesbian women in our culture. Theoretical issues and effective therapeutic interventions in counseling lesbians are examined. Specific content areas highlighted include lesbian identity development and management, interpersonal and couple issues, and specific problems such as substance abuse, domestic violence, and sexual abuse. The article concludes with recommendations for treatment and suggestions for research.

Gender identity: a person's sense of being male or female, believed to develop by 3 years of age (Wishik & Pierce, 1995).Sex roles: culturally and socially defined behaviors for men and women (Wishik & Pierce, 1995).Sexual minorities: people who are nonheterosexual. In this chapter, the term refers to gays, lesbians, and bisexuals. Polyamory : referring to people whose relationships are non-

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In this study, we investigated the effects of three counseling interventions on women's body image and self-concept. The interventions used were cognitive therapy techniques, cognitive behavior therapy techniques, and reflective therapy techniques. Women experiencing body image problems (N = 79) completed Secord and Jourard's (1953) Body-Cathexis and Self-Cathexis Scales and were classified into either moderate or severe body image disturbance groups. Participants were randomly assigned to a therapy or the control group. Those assigned to the therapies participated in three structured interviews and did homework. Cognitive techniques emphasized changing self-statements, and reflective techniques explored feelings. A double repeated measures multivariate analysis of variance was performed on pre-and postscores on the Body-Cathexis and Self-Cathexis Scales, which had been found to be correlated. All participants improved in body image and self-concept. Therapy was better than no therapy. Cognitive therapy techniques were most effective for body image, and cognitive therapy techniques and cognitive behavior therapy techniques were most effective for self-concept. Participants in both classifications improved significantly on body image.

Therapists, having recently come to terms with treating gay and lesbian clients, now must consider the issues that bisexual clients face. This article reviews the literature on what it means to identify as bisexual in a world where sexual identity is viewed as dichotomous, heterosexual at one end and gay or lesbian at the other end. The article explores sexual identity and its biological versus social origins, internalized biphobia, coming out, relationship patterns, and therapist issues. Two cases illustrate issues that might arise when a therapist is treating a bisexual client. The first case is a 17-year-old young woman who is accepting of her bisexual identity, and the second case is a 56-year-old woman, heterosexually identified and married, who suddenly fell in love with a woman. Concluding remarks focus on some future directions for research and work with bisexual clients.