Family and couples therapy with gay and lesbian clients: acknowledging the forgotten minority

Abstract

Family and couples therapy in; the main concentrates on heterosexual clients, and has thus been described as limited in its outlook, or discriminatory. It is argued that family and couples therapy is at present not offered to gay and lesbian clients because of an absence of appropriate referrals, the inability of therapists to recognize the sexual orientation of their clients, a belief that skills held by therapists are not appropriate for this client group, or because of the homophobia of the therapist. It is suggested that family and couples therapy should be more readily available for gay and lesbian clients, and a number of different issues which these families might face are discussed. This includes problems associated with the gay adolescent and the gay or lesbian parent, as well as the gay or lesbian couple. It is concluded that established forms of intervention are effective with gay clients, provided that the specific needs and prolblems of the gay and lesbian community are addressed by the therapist. IntroductionJudging by the dearth of information on the gay and lesbian client in the family therapy literature, it would seem that family and couples therapists at present have little to s,ay about, or offer to, the gay and lesbian community; they are thus open to the accusation that they are limited in their outlook and operate discriminatory practices (Stein, 1988). It has been argued by some critics that the very terms 'family' and 'marital' or 'couple' therapy in themselves appear to exclude the gay and lesbian client (MacKinnon and Miller, 1984) -the terms tend to assume a man and a woman as the 'couple', with the 'family' usually conceived of as containing children.One argument in defence of family therapists is that many have little knowledge or experience of the homosexual community, and are unsure as to the applicability of farnily-based interventions with gay or lesbian couples or families. In this review, I will present a case to demonstrate that couples and family therapy is both needed and of * Psychology Division, University of Sussex, Falmer, Brighton, BN1 9QN, UK. 132Jane M. Ussher benefit within the gay and lesbian community. In order to address the issue that homosexual family work is somehow different, I will outline some of the issues which need to be considered by therapists working in this area, in order to provide positive suggestions for future developments for the practice of family and couples therapy with gay and lesbian clients. 'All my clients are straight': Reasons for heterosexual biases in family and couple therapyOne of the most common reasons which therapists put forward for their concentration on heterosexual clients is that homosexual clients are not referred to them, implying that this section of the population is not in need of couple or family therapy, or at the very least that they are not presenting with their problems to any referral agencies (Ussher, 19896;Wyers, 1987). There may be some truth in the latter assumption, but it could be argued that referrers or the...

Object relations couples therapy with Lesbians

“…An object relations couples approach can add to the growing need for more readily available family and couples models for work with lesbians (Usher, 1991), who increasingly present themselves for treatment. It is an appropriate approach for the lesbian couple interested in understanding the intrapsychic, interpersonal, and environmental forces which are responsible for their difficulties.…”

“…Homophobia displays itself culturally when oppression is legitimized. Usher (1991) discusses the impact on the lesbian of being "out" in a homophobic society; lesbians, for example, may be subject to and fearful of loss of employment, housing, and even of their own children, for no other reason than their sexual orientation. Some have even been subjected to violent attack (Pharr, 1988).…”

“…However, in work with lesbian couples, it is essential that the social context not be neglected (Usher, 1991). A major focus needs to be placed on the couple-insituation.…”

Therapeutic Experiences of Lesbian Couples

“…With the "one size fits all therapy" style that has occurred within our culture, some therapists may attempt to provide services for those who will not benefit from them. Professionals who grapple with their own issues of homophobia are responsible for restricting the development of family and couples therapy with their gay and lesbian clients (Ussher, 1991). Couple B commented on how a therapist can potentially do more harm than good when faced with a homosexual individual or couple that challenges their personal belief system.…”

“…Because there is little information regarding therapeutic experiences from lesbian couples' perspective, interviews were conducted with each member of five lesbian couples to explore variables that might appear to influence their levels of relationship satisfaction and how the experience of therapy mediated this satisfaction. Ussher (1991) reports that one issue of concern for therapists is the lack of normative data on family issues, relationship difficulties, or sexual problems within the gay and lesbian community because epidemiological studies have historically concentrated primarily on the heterosexual population and often do not inquire about the sexual orientation of the participant. The issues lesbian couples face, while similar in some respects to those faced by heterosexual couples, have long been treated either with reduced importance, pathologized, or evaluated on heterosexual scales of normalcy.…”