Conceptual and ethical issues in therapy for the psychological problems of gay men, lesbians, and bisexuals

Abstract

Reviewed here are a number of conceptual and ethical issues surrounding the study and treatment of gay men, lesbians, and bisexuals (GLB), with particular emphasis on the frequently overlooked political and ethical dimensions of what therapists choose to treat, indeed, on the goals patients themselves want to work towards. Several issues are discussed, including the relevance and irrelevance of sexual orientation and the role of therapist biases in assessment and treatment planning, the need for better understanding of how the problems of GLB patients are construed and the associated dangers of stereotyping, the challenges of coming out and the ways therapists can help patients make the decision and how to implement it, the extra effort required to be a GLB person in terms of the formation of an unconventional social and sexual identity, the trust issues that can arise when one partner in a committed relationship requests protected sex, the challenges and rewards of parents "coming out" as family members of a gay son or daughter, the social invisibility of lesbians and the deleterious effects this can have on them, social support issues for GLB youth, and the need for professionals to take a broad, institutional community psychology perspective to their study and treatment of GLB individuals.

Compulsivity, Substance Use, and Loneliness: The Loneliness and Sexual Risk Model (LSRM)

“…For example, the issue of identity is complex and for bisexual men it may be particularly difficult because it is common for bisexuality to not be validated by the gay community. This is mainly because it is not perceived by many as a defined identity and is often thought of as a transitional phase towards gay identity (Davidson, 2001).…”

“…Generally, therapists interpret patient problems, direct the therapeutic process towards a specific definition of the problems, and then facilitate the development of goals to address these problems (Davidson, 2001). Therefore, therapists should be aware of their own biases and develop cultural competence with the populations they are working with so that the definitions of problems are accurate and the subsequent goals set are appropriate (Davidson, 2001).…”

If I Am Not Straight or Gay, Who Am I?

“…As shown by other research, invisibility and silence work to hinder homosexuals from fully extending and integrating aspects of their identities (Saari 2001). According to Davison (2001), a major ethical issue in therapy is related to seeing the problems of lesbians and gays as a direct consequence of oppression in society due to a lack of recognition for their love. When conducting research among women attracted to other women, it is imperative that these and related aspects are taken into consideration in selecting a sample.…”

Family Counseling and Referral with Gay, Lesbian, Bisexual, and Transgendered Clients: Ethical Considerations

“…Family issues might involve Marc's parents'"coming-out" process as the parents of a gay son, altered expectations, and potential feelings of loss, grief, and personal responsibility (Davison, 2001).…”