Counseling 5670 Dr. Cyndi Matthews

1. Counseling 5670Dr. Cyndi Matthews http://www.upworthy.com/the-only-thing-unnatural-about-gay-marriage-is-that-there-aren-t-enough-ads-out?c=ufb1 Sexual Orientation Gender Identity

2. What Do These Things Have in Common? Lost files of a reported stalking incident Broken Beer Bottle Chipped Tooth Bag of dog poop

3. Self-Reflection • When was the first time you remember knowing there is a sexual orientation other than heterosexual and what do you remember learning about LGBT people? • What representations of LGBT people do you see today? • Are they positive or negative? • What is one LGBT topic you are interested in learning more about and what are ways to seek out information?

4. Why do we need to become informed about LGBT issues and concerns? •What if you don’t want to counsel an LGBT individual? • What does the Hermann/Herlihy article tell us? • What about ACA/APA ethical guidelines?

5. Some PercentagesFrom GLSEN 2003 National School Climate survey • 28 % students drop out of school because they feel unsupported • 80% of anti-gay violence goes unreported • 5x more likely to commit suicide • 7x more likely to be a victim of a hate crime • 90% report being bullied during school/college • 40% report being physically harassed because of their sexual orientation

6. More Numbers • 26x a day LGBTQ hear anti-gay slurs • 82% reported faculty/staff never intervened when slurs were made • 75% of people committing hate crimes are under 30 – majority are in school/college environment • GPA for LGBTQ students who can identify supportive staff/faculty: 3.1 • GPA for LGBTQ students who cannot identify supportive staff/faculty: 2.8

7. •What do these numbers mean?• What does this mean for us as counselors?

8. Suicide 47% have attempted 27% have attempted more than once 37% have seriously thought about suicide in last 12 months Youth First Texas 2008 Survey of LGB Youth • Sexual Behavior • 16% have survival sex • 43% have been forced to have sex • 50% do not use protection • 40% have never been tested for STDs (10% know have STD) • Family Life • 85% have come out to family • 19% do not feel safe coming out to family • 42% abused by family member • 26% kicked out due to sexual identity • Coping Methods • 35% smoke 38% start fights • 90% use alcohol 36% cutting • 29% use pot 43% eating disord. • 30% use cocaine 53% therapy • 22% use heroine -for depression • 17% been to rehab & anxiety

9. APA Guidelines Attitudes Towards clients 6 Guidelines

10. Guideline 1LGBT not indicative of mental illness • Previous beliefs in the profession about sexuality and mental illness • Few differences in LGBT persons and heterosexual persons in matters of psychological functioning. • What differences were found were attributed to social stigma of sexuality as opposed to intrinsic qualities of said persons. • Seek consultation and training if indicated. • Key issues to receive training in: • Understanding of human sexuality • The “Coming Out’ Process and it’s effect on clients • Same Sex Relationship Dynamics • Family of Origin Issues • Spirituality issues that interact with sexuality decisions. • Career Issues/Discrimination • Coping Strategies for Healthy Living Guideline 2Recognize personal attitudes and knowledge may affect assessment & treatment

11. Guideline 3Understand social stigmatization against LGBT • Realize prejudice, discrimination, violence poses risks to mental health • Sexual Minority Orientation in a heteronormative society can cause persons to be at risk for greater stress from daily stresses and major events related to sexual orientation. • Negative attitudes about sexual orientation may have been internalized. • It is recommended that psychotherapists take an accurate and complete history to assesses for past victimization that may be related to sexual orientation. Guideline 4 Understand stereotypes may affect client’s presentation in treatment • Psychotherapist must base treatment on accurate understanding of issues related to sexual orientation. • (e.g. a psychotherapist providing information about sexual orientation & mental health; a psychotherapist debunking myths regarding heteronormativity and reparation therapy)

12. Guideline 5Respectful & Knowledgeable about LGBT Relationships • Related to Romantic Partners • communication • difficulties, sexual problems • dual-career issues, household chores • commitment decisions, marriage discrimination, family • Parenting • Child custody • LGBT parents (myths)

13. Guideline 6: Relationships and Families • Guideline 6: Psychologists strive to understand the particular circumstances and challenges faced by lesbian, gay, and bisexual parents. • Legal/Social Welfare institutions have discriminated against LGBT parents and raised concern about their influence on a child's gender identity, gender role conformity, and sexual orientation. • Currently no data exists that supports differences in children on LGBT parents and children of heterosexual parents in regard to gender identity, gender role conformity, or sexual orientation. • Marriage rights/Hospital rights/Insurance

14. How Does Bias Against LGBTQ People Affect Us ALL? • Rigid gender-based roles - unhealthier • Limits relationships with members of one’s own gender • Disrupts family relationships and communication • Inhibits some LGBT people from developing an authentic self-identity, causing undue stress • Pressure to be heterosexually active to prove they are normal

15. Bias against LGBTQ PeopleAffects us ALL • Stigmatizes and targets people who are perceived to be LGBT • Denies the benefits and gifts LGBT have to offer • Diverts energy away from more constructive endeavors • Encourages bias for everyone • Discourages diversity

16. Terminology • Sexual Orientation • LGBTQQIAAP • Gender Identity/Gender Expression • Transgender, Transvestite, Transsexual Please write YOUR definition of the word(s) your group has been given. We will then discuss as a group and come to shared definitions.

17. What is Sexual Identity/Orientation? • Sexual orientation is a pattern of emotional, romantic, and/or sexual attractions to men, women, or both sexes. • Recent data and research estimates indicate that 3.5% - 10% of the population identifies as lesbian, gay, bisexual, or transgender. • The visibility of LGBTQ individuals as a group is higher than ever.

18. A Little Background • Biological Sex (genitals, hormones, chromosomes) Male Intersex Female (Hermaphrodite) • Sexual Orientation (Kinsey Scale) 0 3 6 Straight Bisexual Gay/Lesbian (others include: Asexual, pansexual) • Gender (socially constructed) and Gender Expression Masculine Androgynous Feminine

19. More Terms • What is Heterosexual Privilege? Examples? • Heterosexual Questions - Microaggressions • Heterosexual Privilege • What is homophobia? Biphobia? Transphobia • What is internalized homophobia?

20. What Do These Phobias Look Like? • Thinking of an LGBTQ’s sexuality or gender identity rather than seeing them as a whole person • Assuming a bisexual person is experimenting with a gay or lesbian relationship • Changing your seat in a meeting if LGBTQ person sits next to you • Thinking you can “spot one” • Worrying about the effect LGBTQ person might have on your work environment or school

21. What do These Phobias Look Like? • Thinking that if a LGBTQ person touches you – they are making an advance • Stereotyping lesbians as man-haters and gay men as sissies • Feeling repulsed by displays of affection between LGBTQ individuals • Wondering which one in the pair is the “man” or “woman” • Assuming everyone you meet is probably heterosexual • Being outspoken about queer rights, but making sure everyone knows you are straight

22. Professional Organizations Nature/Heredity Environmental Factors Does it Matter? The American Psychiatric Association classified “homosexuality” as a mental illness until 1973. The American Psychological Association took “homosexuality” out of the Diagnostic Statistician’s Manual (DSM) in 1973 The American Psychiatric Association, The American Psychological Association, and the American Counseling Association deem it unethical to practice “reparative” therapy (increased depression, suicide) ACA code of ethics states what?

23. Is It a Choice? • http://www.youtube.com/watch?v=MfBOGXFkC8c • There are differing opinions on the causes of being LGBT – most theories support Nature/Heredity • Book: Is It a Choice? • Heterosexual Questionnaire Nature/Heredity Environmental Factors Does it Matter?

24. What is Coming Out? • Lifelong process – stages of development (Cass, 1979) 1. Identity Confusion (feeling different) 2 Identity Comparison 3. Identity Tolerance (find support groups) 4. Identity Acceptance (Coming Out) 4. Pride Development 5. Synthesis • Ongoing – not always one direction • Different for different people • Fear of being “outed” • Why do people stay “in the closet?” • What can you do if someone comes out to you? • What might one say in each stage?

25. What is Homophobia? • Homophobia • Biphobia • Transphobia • How can phobias be internalized?

26. What do these Phobias Look Like? • Thinking of an LGBTQ’s sexuality or gender identity rather than seeing them as a whole person • Assuming a bisexual person is experimenting with a gay or lesbian relationship • Changing your seat in a meeting if LGBTQ person sits next to you • Thinking you can “spot one” • Worrying about the effect LGBTQ person might have on your work environment or school

27. What Do These Phobias Look Like? • Thinking that if a LGBTQ person touches you – they are making an advance • Stereotyping lesbians as man-haters and gay men as sissies • Feeling repulsed by displays of affection between LGBTQ individuals • Wondering which one in the pair is the “man” or “woman” • Assuming everyone you meet is probably heterosexual • Being outspoken about queer rights, but making sure everyone knows you are straight

28. Homophobic Levels of Attitude • Repulsion • Pity • Tolerance • Acceptance

29. Positive Levels of Attitude • Support • Admiration • Appreciation • Nurturance

30. Basic Rights - Respect • Fill out the form first for yourself under “YOU” for things which you deserve • Now fill it out for what you think everyone else deserves • Is there a difference?

31. Underlying it ALL!! Ethics Counseling • Non-maleficence • Do no harm • Beneficence • Do Good • Respect for Autonomy • Individual Rights • Justice: Fairness • Fidelity: Keep your word • Veracity: Truth • Unconditional Positive Regard • Respect • Not judging • Empathy (not sympathy) • Genuineness & Congruence

32. General Systems Model INPUTS P R O C E S S E S OUTPUTS FEEDBACK

33. An Integrative Model for Counselors Helping LGB Youth Through the Coming-Out Process Counselor Strategies and Interventions Addressing Personal Homophobia Openly Accepting and Being Supportive of LGB youth Getting Training re: LGB Issues; i.e., knowing stages of development Working With Parents As Needed – educating, conflict management, etc. Addressing family issues, peer issues, school environment, Addressing religious issues/beliefs Addressing issues of race/culture Addressing previous counseling exp. Providing Resources (i.e., literature and support groups) Specific Techniques: Role Playing, Reframing issues Social Advocacy/Policy Changes Client Inputs Client Outputs Internal Factors: Sexual-Identity Stage Internalized Feelings of Homophobia Self Esteem/Acceptance Mental Health Behaviors External Factors Family Environment School/Peer Environment Access to LGB Support Network Race/Culture Religion Previous Counseling Experience Self Esteem/ Self Acceptance Mental Health Behaviors Family Support Peer Support LGB Community Support Institution Support Religion/Schools Gender Identity Acceptance/Integration Coming Out Process Continued Support as Needed

34. Client Inputs: Client’s World Helps Counselor Determine Interventions/Strategies Religion Sexual-Identity Stage *Identity Confusion *Identity Comparison *Identity Tolerance *Identity Acceptance (disc) *Identity Pride *Identity Synthesis *Cass (1984) Race/Culture Access to LGB Support Network School/Peer Environment Internalized Feelings of Homophobia Family Environment Self Esteem & Acceptance Previous Counseling Experience Key: Mental Health Behaviors Internal Factors External Factors

35. Counselor Strategies and Interventions: Getting Training re: LGB Issues; i.e., knowing stages of development Addressing Personal Homophobia Openly Accepting and Being Supportive of LGB youth Working With Parents As Needed – educating, conflict management, etc. Addressing family issues, peer issues, school environment, Addressing religious issues/beliefs Addressing issues of race/culture Addressing previous counseling experience Providing Resources (i.e., literature and support groups) Specific Techniques: Role Playing, Reframing issues Social Advocacy/ Policy Changes

36. Client Outputs Self Esteem/ Self Acceptance Mental Health Behaviors Family Support Peer Support LGB Community Support Institution Support Religion/Schools Gender Identity Acceptance/Integration Coming Out Process Continued Support as Needed

37. Jerry: A Case Study • 17 year old • Hispanic • Catholic • Gay Male • Working 3 part time jobs • Quit school at 16 due to being bullied • Attends a weekly GLBT youth support group • Referred to counseling for depression and anger issues • Previous Counseling experience (x2)

38. Client Inputs: Client’s World Helps Counselor Determine Interventions/Strategies Religion Sexual-Identity Stage *Identity Confusion *Identity Comparison *Identity Tolerance *Identity Acceptance (disc) *Identity Pride *Identity Synthesis *Cass (1984) Race/Culture Access to LGB Support Network School/Peer Environment Internalized Feelings of Homophobia Family Environment Self Esteem & Acceptance Previous Counseling Experience Key: Mental Health Behaviors Internal Factors External Factors

39. Internal Factors External Factors Religion *raised Catholic *told he is evil *Wicca Sexual-Identity Stage *Identity Tolerance/Identity Acceptance Race/Culture *Hispanic *looked down upon Access to GLBT Support Network *GLBT youth group weekly meetings *Family meetings Has Internalized Feelings of Homophobia/Anger Previous Counseling Experience *2 different counselors *”Reparative therapy” Self Esteem & Acceptance Low Mental Health Behaviors *cutting *suicide attempts *drug & alcohol attempts *journalizing *meditation Family Environment *Feels mother, brother and sister-in-law won’t be supportive because of religious beliefs

40. Counselor Strategies and Interventions Psycho-educational regarding stages – Normalizing Feelings Addressing Personal Homophobia Addressing religious issues/beliefs – finding common church for family/himself Wicca practices Specific Techniques: Role Playing, Reframing issues (e.g. anger management) Openly Accepting and Being Supportive of GLBT youth Working With Parents As Needed – educating, conflict management, etc. Addressing issues of race/culture Mental Health Behaviors: meditation, music, journaling Coming Out Process Continued Support as Needed

41. Counselor Strategies and Interventions: Getting Training re: LGB Issues; i.e., knowing stages of development Addressing Personal Homophobia Openly Accepting and Being Supportive of LGB youth Working With Parents As Needed – educating, conflict management, etc. Addressing family issues, peer issues, school environment, Addressing religious issues/beliefs Addressing issues of race/culture Addressing previous counseling experience Providing Resources (i.e., literature and support groups) Specific Techniques: Role Playing, Reframing issues Social Advocacy/ Policy Changes

42. In Groups Discuss: • What are some potential biases a counselor needs to be aware of within her or himself when working with a LGBT client? • Identify inappropriate reactions a counselor may have when finding that his or her client is a sexual minority. • Drawing from the Matthews/Salazar article, what are some key issues faced by LGBT individuals? • What can counselors do to alleviate some of these issues faced by sexual minorities?

43. Resources for Counselors • PFLAG • www.pflag.org • Gay/Straight alliances (GSA’s) – High School • www.gsanetwork.org • GLSEN: Gay, lesbian and straight education network • www.glsen.org • Safe Zone/Safe Spaces) - Universities • ALGBTIC; TALGBTIC through ACA and TCA • www.algbtic.org • www.txca.org/tca/TALGBTIC_Home.asp • Churches/Church Leaders (Cathedral of Hope)

44. Case Studies • Lenses Book • Chapter 9 Sarah P. 277 • What are the issues to be considered? • How would you work with Sarah? • Chapter 10 Jeff P. 310 • What factors would you take into consideration? • How would you work with Jeff?