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Article 2

Needs Assessment for Counseling GLBT Clients

Rebecca Gardner, Joshua Adkins, Whitney Gillespie, and Cristen Wathen

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There are many issues that face gay, lesbian, bisexual, and transgender (GLBT) individuals that their heterosexual peers do not encounter, such as coming-out stressors, marginalization, discrimination, and identity development issues (Vaughan & Waehler, 2010; Weststrate & McLean, 2010; Zubernis & Snyder, 2007). Meyer (2003) has shown that GLB individuals have a higher rate of mental disorders than do heterosexual individuals. The author describes a conceptual framework of minority stress as the major contributor to his conclusions (Meyer, 2003). Due to the significant stress and mental health repercussions that this population faces, counselors and counselor educators must be aware of and have an understanding of the potential struggles and stresses that often occur. This literature review will look at specific aspects of issues of GLBT individuals, including an emphasis on college students. It will also discuss ways that counselors and counselor educators can successfully address these issues when working with GLBT individuals or teaching future counselors.

Stressors and Developmental Issues

GLBT college students face the same stressors as their heterosexual peers, and have additional stressors because of the stigma associated with their GLBT identity (Zubernis & Snyder, 2007). College students typically go through a process of questioning their identity. One important factor in identity development is having an assumed support system, which many GLBT individuals think they do not have when they begin to question their sexual identity. According to Zubernis and Snyder (2007), a heterosexual student’s assumed support systems are social institutions, religious communities, their friends, and family. However, GLBT students often lack these assumed support systems when questioning their sexual identity. They cannot assume these groups’ support because they may be rejected for being GLBT—many times, they are left to undergo these developmental milestones alone.

Many GLBT individuals have difficulty with identity development because their stories are silenced by the dominant cultural-historical story of heterosexuals (Westsrate & McLean, 2010). GLBT students may also have problems making life, educational, and career choices because they are worried about the negative attitudes society has towards individuals who are GLBT. Career domains that may be off limits in the decision making process are commonly found in the military, in teaching, and in religious studies (Zubernis & Snyder, 2007). GLBT individuals face many other difficulties including housing discrimination, miscommunications, and obtaining quality health care (Lennon & Mistler, 2010).

In an article by LePeau (2007), a study regarding religion and homosexuality was conducted in the structure and form of a college class. Students participated by listening to a religious speaker, engaging in conversations about the speaker’s topic, and journaling about their reactions to this process. The topics always included religion and homosexuality. The heterosexual students’ reactions were typically defensive modes in the form of “denial, deflection, and principium” (LePeau, 2007, p. 188). According to LePeau, heterosexual individuals’ reactions to the discussions in class about GLBT individuals fit into one of those three categories: denial, deflection, and principium. In the denial category, heterosexual individuals deny that GLBT individuals would be oppressed by religion. Deflection was that students had never thought about GLBT issues in a religious or spiritual context. Principium illustrated that students viewed GLBT lifestyle as a sin, and thus, would not consider thinking about GLBT issues beyond that. The perceptions of these heterosexual students provide insight into the difficulties GLBT students may experience in a classroom or other social setting (LePeau, 2007).

When GLBT students internalize society’s destructive attitudes about being GLBT, it can result in a negative self-concept and lower self-esteem (Vaughan & Waehler, 2010; Zubernis & Snyder, 2007). GLBT students may also feel like outsiders and that they are not accepted in society. Psychosocial identity development models perceive these stressors as a challenge in an adolescent’s identity development stage. Being in this confused state of identity can lead to feelings of isolation: GLBT students have to hide who they are, while their peers are learning communication skills to express their identity (Zubernis & Snyder, 2007).

Developing an integrated sexual identity with overall identity is an important step for college students (and other GLBT individuals) to undergo (Westsrate & McLean, 2010; Zubernis & Snyder, 2007). GLBT students are challenged to progress through this stage because of society’s stigma of being GLBT. Internalized homophobia leads to self- hatred and students become reluctant to label themselves as GLBT. Labeling oneself is an important process of identity development. When GLBT students label themselves GLBT internally, but present themselves as heterosexual, they create patterns of deception, which create difficulties in forming intimate relationships (Zubernis &Snyder, 2007).

Coming Out and Stress Related Growth

There is much current research that looks at the coming out process of gay and lesbian individuals, particularly the coming out growth (COG) and the stress-related growth (SRG) that follows. In Erikson’s developmental theory, he stressed that “developmental tasks (crises) must be navigated successfully in order to form a healthy personality” (Vaughan & Waehler, 2010, p. 94). Working through a crisis can lead to personal growth and development and a greater understanding of life’s purpose. GLBT individuals who are more out tend to have less stress and fewer symptoms of depression and anxiety (Jordan & Deluty, 1998).

Given this information, Vaughan and Waehler (2010) sought to “advance the understanding of COG through the development and validation of a measure specifically designed for this purpose” (p. 96). The researchers found moderate to high levels of self- reported growth during the coming out process. The “results of this study provided broad support for the concept that lesbians and gay men experience high levels of stress-related growth from coming out” (Vaughan & Waehler, 2010, p. 101). Overall high levels of growth from the participants show that sexual minorities can take the stress of the coming out process and utilize it in other dimensions of growth. The research results also show that coming out to other people has two overlapping benefits: “improvement in how individuals perceive or experience themselves, and improvements in how they perceive their GLBT peers and their relationships with these peers” (Vaughan & Waehler, 2010, p. 101). The participants also noted that accepting other members and themselves as part of the GLBT group was easier when coming out was done at a young age.

Vaughan and Waehler (2010) explained that while their research showed growth related to coming out; more extensive research needs to be done. The majority of the participants had higher levels of educations (bachelor’s degree and higher), and only 12% of the participants declared themselves to be a racial or ethnic minority. Vaughan and Waehler’s research (2010) could also be expanded to include the coming out growth period for other sexual minorities, such as bisexuals and transgender.

Identity

Part of this identity process is expressing identity through stories. Gay identity is an evolving entity and has been throughout history (Westsrate & McLean, 2010). There are differences in identity development in older cohorts, as Westrate and McLean (2010) term generational groups, and younger ones. Older cohorts base more of their identity in social events while younger ones base it on a personal process (i.e., coming out). This study is based on a narrative approach and uses the idea of “voice and silence.” Cohorts which have their voices heard are usually the majority and culturally accepted. Stories and identities which are silenced are usually resisting the stories that are voiced and considered the majority. Although the term “gay” is used throughout Westsrate and McLean’s article, the authors shared that the term is used to include male and female homosexuals. This study looked at the ways different cohorts identify themselves based on cultural and historical contexts. Narrative theory was used because of the unique way that telling one’s story can also develop an individual’s sense of identity. When these stories are silenced it affects the individual’s identity development. These stories are influenced by cultural and historical factors such as world events and personal experiences. According to Hammock (2008, as cited in Westsrate & McLean, 2010), “the personal meaning of the story is only understood in the particular cultural-historical context within which it is constructed” (p. 227).

Westsrate and McLean (2010) also hypothesized that older generational groups (or cohorts) would have more cultural events associated with their identity development and younger cohorts would have fewer cultural events related. Older cohorts would have been more silenced due to the time in which they lived and younger cohorts have more of a voice because of political and social changes. Since older cohorts had more cultural events to relate to their identity, they had more of a master narrative (relating to more gay individuals in the time period with shared meaning), and they would have less personal meaning making involved than younger cohorts (Westsrate & McLean, 2010). The younger cohorts are trying to integrate personal experiences into an identity and have less shared cultural experiences associated with their identity.

Participating in this Westrate and McLean (2010) study were 251 individuals who shared their description of a cultural or historical event that had an impact on their identity and also a personal experience that was defining in terms of their sexuality. They found gender differences between men and women, with women more likely to identify relational events and men more likely to identify sex-related events. There was also a significant difference between older and younger cohorts. The “older cohort members had clearer cultural events that are tied to their identities” and were “more likely to report actual cultural events (events of which many people would be aware)” (p. 231). Younger cohorts’ narratives were based more on personal events, like coming out or school experiences. The only cultural event that younger cohorts identified was dealing with government and legislation (Westsrate & McLean, 2010).

Westsrate and McLean (2010) discussed how different eras had different foci in their personal experiences. For example, in the 1960s cohort, the personal experiences were based around sexual experiences, while the 1990s cohort’s experiences were around the self and self-exploration. It was interesting to note that the millennial cohort “embody an individualized identity, with almost all events being similarly represented” (p. 233). With this variety among younger cohorts, the focus is not on standing out distinctly among the majority as much as finding themselves among a larger population and being accepted by social norms. Because of the changes in cultural events, Westsrate and McLean ask the following question: “What significance will the transition from having a revolutionary identity to being just like everybody else hold for gay people?” (p. 237). They suggest that with the majority or “norm” of heterosexuality silences the other various narratives of millennial gays because they don’t have a “revolutionary identity” (Westsrate & McLean, 2010, p. 237) based around cultural events as did older cohorts. According to the authors, this individualized narrative identity among gays today signals that individual narratives are being silenced by the majority narrative. This silencing will affect the identity development of other gays and could result in a lack of a cohesive identity (Westsrate & McLean, 2010).

Because there are generational differences among the GLBT population (Westsrate & McLean, 2010), the issues facing GLBT students can be different than older GLBT individuals. For many GLBT people (including students), self-image is severely compromised by a world where they are in constant defense against physical violence, ridicule, verbal harassment, and rejection from others in society. This compromised self-image results in more GLBT students engaging in self-destructive behavior, such as substance abuse and sabotaging relationships to failure (Zubernis & Snyder, 2007).

Support

When GLBT students find support, they can cope with the specific challenges they face more easily (D’Augelli, 2006). Having accurate information about being GLBT, feeling accepted, and having positive role models can contribute to GLBT students succeeding through these developmental stages and being successful as students and in their careers. A positive self-image also leads to happiness (Zubernis & Snyder, 2007).

Establishing this cohesive identity and a positive self-image could be facilitated by social and community support. D’Augelli (2006) described the struggles of a professor coming out in his rural university community and the ramifications of that decision. He found that he struggled to establish this identity and experienced what many other individuals experience upon coming out—feeling feeling vulnerable and afraid. He turned to the community for support; however, this was difficult as he found that there was a lack of resources in the area for gays, lesbians, and bisexuals (D’Augelli, 2006). After working to establish resources in the community, D’Augelli (2006) saw the next challenge as decreasing homophobia on the university campus where he worked and providing resources for GLB students, faculty, and staff.

In attempting to have the university change its policies and practices, D’Augelli (2006) was met with much difficulty and resistance. He felt that the university was the major power in the town and because of this, D’Augelli thought that the administrators did not see any need to change. D’Augelli became the leader of the GLBT group on campus. Students reported that they did not feel safe to live in university housing if they had come out, so many stayed closeted for fear of harassment. D’Augelli reported the harassment and difficulties the GLBT students were having to the administration, but nothing was done to change the non-discrimination policy on campus. Although it was difficult at times, D’Augelli remained the faculty advisor because he was tenured and so he wasn’t worried about losing his job, as were other faculty and staff.

D’Augelli (2006) used his influence to create change in the university. It took years and many personal difficulties for D’Augelli, but he realized the importance of having a support system for GLBT individuals and worked towards that, at great personal sacrifice. He stated “the personal and professional risks I took were outweighed by the importance of encouraging changes in my town and my university that met my needs as well as others’ needs” (p. 210). Counselors working in university settings should be aware of the available support and resources for GLBT people and they should also be advocating for this population.

Training Considerations for Counselors

As shared previously, GLBT youth are at higher risk for attempting suicide than heterosexual youth (Walker & Prince, 2010). These authors wrote that homosexual individuals having a high external locus of control, local political climates (red and blue states), and religious institutions, all create an environment that makes it difficult for GLBT individuals to come out. Staying “closeted” can “cause confusion, depression, and anxiety; coming out can prompt rejection, verbal and physical abuse, and expulsion from one’s family’s home, and even death” (Walker & Prince, 2010, pg. 3). GLBT individuals also experience ridicule, physical assault, and workplace sabotage when they come out in non-supportive environments.

Most counselors have never received adequate training in how to effectively work with GLBT clients (Walker & Prince, 2010). Many counseling students do not feel adequately prepared to effectively work with GLBT clients. “Counseling students should advocate for increased training standards that reflect skill acquisition with GLBT individuals” (Walker & Prince, 2010, p. 6). According to Walker and Prince (2010), if a student is having difficulty with GLBT clients because of their own religious based homophobia, they can be assigned to read books or articles and read the Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling competencies (ACA, 2009). This is for the purpose of increasing the student’s level of awareness about the pervasiveness of homophobia and other issues GLBT individuals’ face (Walker & Prince, 2010).

The Cass model of sexual identity development (1979) is limited because it is linear and does not encompass a wide enough range of GLBT experiences, and is not sensitive to a diversity of cultures (Degges-White, Rice, & Myers, 2000). Van de Meerendonk and Probst (2004) suggests an identity development model that has two stages. Issues for counselors to explore with clients are existential in nature: hope, optimism, and a sense of purpose in life. The coming out process creates existential issues like, freedom, fear of isolation, meaning making, and searching for authenticity (Walker & Prince, 2010).

Counselors can help normalize GLBT clients who are coming out by providing additional resources like clubs, Web sites, and books, so they can become more accepting of themselves. When a GLBT client wants to come out to family and friends, the counselor can help the client review a pros and cons list of making this decision— particularly based in the context of religion, ethnicity, and political influence (Walker & Prince, 2010). Confronting negative self-talk and thoughts, and validating positive self- talk and thoughts, as well as groups based on coming out and confronting internalized homophobia are other interventions that can be used to help GLBT individuals through the coming out process in counseling (Walker & Prince, 2010). The counselor should encourage the client to come out at their own pace within his/her levels of comfort. Also, being mindful of sexist attitudes is an important consideration to make when working with lesbian clients (Walker & Prince, 2010).

Bisexual individuals do not typically identify as lesbian, gay or heterosexual. Counselors should use terms that encompass a wider range of acceptance (same-sex, same-gender, other-sex, and other-gender; Walker & Prince, 2010). Because bisexual individuals feel isolated from these groups, counselors should help them to normalize their attraction to both genders. This normalization can happen in the form of joining clubs and Internet organizations for bisexuals and seeking out positive bisexual role models (Walker & Prince, 2010).

Walker and Prince (2010) addressed how transgender clients have their own unique set of considerations for counselors. He and she talk should be eliminated from discussion; if the counselor doesn’t know how to address a transgender client, he/she should ask. Transgender clients considering surgery and hormone therapy should be encouraged to explore all the options, procedures, benefits, and challenges of such decisions. Information for counselors is very limited when working with transgender clients and advocacy for this population is recommended on an institutional level (Walker & Prince, 2010).

Counselor educators could invite experts to speak about GLBT issues in their classes. Counselor educators should encourage counseling students to work with GLBT individuals, while they provide supervision to the student dealing specifically with GLBT issues (Walker & Prince, 2010). Overall, counselor educators need to work toward increasing their counseling students’ knowledge, skills, and awareness in working with GLBT individuals.

Practical implications of a study by LePeau (2007) for counselors and counselor educators who plan on facilitating dialogue between GLBT clients/students and heterosexual students on the topic of sexual identity and spirituality included: exploring one’s own privilege and how it can affect dialogue; creating a safe place for dialogue; allowing for non-verbal expression, such as journaling; validating both GLBT and heterosexual student’s feelings; and utilizing guest speakers. According to Lennon and Mistler (2010), it is imperative that university counselors be aware of racial issues and be comfortable enough to bring those up with GLBT students. For example, an African American transgender student may feel uneasy talking to a male Caucasian counselor. Discussing these issues towards the beginning of the counseling session will help ease the tension and awkwardness for both counselor and student in future sessions (Lennon & Mistler, 2010).

GLBT individuals show higher rates of depression than their peers (Ross, Doctor, Dimito, Kuehl, & Armstrong, 2006). Even though this is the case, many GLBT individuals do not seek out services because they fear the stigmatization or discrimination they may face. There have been few studies that have focused on interventions specifically for this concern of depression among GLBT people (Ross et al., 2006).

Ross et al. (2006) conducted a study in which they incorporated the issue of oppression and internalized homophobia into their treatment of depression. They found that after 14 weeks, the individuals who participated in a modified cognitive-behavioral therapy group reported that depression decreased and self-esteem increased due to the therapy. Even though in the session the counselors addressed internalized homophobia and oppression, the participants did not show a statistically significant decrease in levels of internalized homophobia (Ross et al., 2006). This study speaks to the fact that there are interventions that have been researched as being effective, but there are still many issues that are internalized for GLBT individuals that can be difficult to overcome.

Counselor Education

Counselor educators and counselors-in-training face a growing dilemma in addressing issues related to GLBT groups. Many graduating counselors feel incompetent to work with minority issues, particularly GLBT clients. Though the American Counseling Association urges all counseling educator programs to cover multiculturalism in all classes; Sherry, Whilde, and Patton, (2005) found that only 17% of programs researched incorporated GLBT issues into course evaluations (Frank & Cannon, 2010).

One possible explanation as to why counselor educator programs do not widen the learning spectrum with GLBT issues could be due to the fact that some do not see GLBT’s fitting into multiculturalism (Frank & Cannon, 2010). Some counselor educators may have a religious belief that does not condone homosexuality. Incorporating a broader view of multiculturalism must first begin with the educator’s awareness of his/her perceived values system (Frank & Cannon, 2010).

Counselor educators may not be aware of their faulty assumptions that could lead to negative or harsh feelings towards GLBT groups. Eliason (2000) found that 44% of surveyed substance abuse counselors had ambivalent or negative attitudes towards GLBTs. These negative attitudes can be detected from both clients and counselors-in- training (Frank & Cannon, 2010). Because counselors are placed in a hierarchical role, multicultural clients such as GLBTs may feel unheard and dissatisfied with counselors who are culturally unaware. They may feel that the counselor does not understand their issues, or that they do not have sufficient knowledge pertaining to GLBT clients (Frank & Cannon, 2010).

Counselors-in-training may also be affected due to a supervisor or counselor educator’s viewpoints on GLBTs. If faculty are not committed to furthering student development towards GLBTs, students may feel that it is unimportant to learn and research possible counseling issues regarding GLBT clients (Frank & Cannon, 2010).

Incorporating queer theory into multiculturalism may help students gain a better insight on GLBT issues and development (Frank & Cannon, 2010). Frank and Cannon (2010) believe that queer theory “requires rethinking traditional concepts and definitions such as identity, psychopathology, gender, and sexuality” (p. 23). Queer theory looks to educate students on the rewards associated with being a socially accepted heterosexual. The theory also allows for counselors-in-training to view how power is held between the client and counselor (Frank & Cannon, 2010). Integrating queer theory (an approach that rejects traditional gender roles and sexuality) into the classroom will allow for a new generation of thought in counselors. It may help counselors-in-training identify misconceptions about GLBT individuals. Counselors-in-training may also feel safer discussing GLBT questions in class, as well as gaining a greater depth of knowledge about current GLBT issues (Frank & Cannon, 2010).

Implications

As the research shows, there are many issues facing GLBTs that counselors are not prepared to address, such as stress related to coming out, support uses, and identity development. This literature review examined research that has been done in these areas, as well as training considerations for counselors and considerations for counselor educators. There are specific needs that GLBT individuals have and counselors can facilitate wellness in their GLBT clients by being aware of and addressing these needs. The article discussed related research that has been done and yet these issues are still pervasive and are affecting the quality of life for many GLBT individuals. Counselors and counselor educators should take an active role in advocating for their clients and students in this area and teaching others about GLBT issues. By increasing awareness during training, counselor educators provide some of the tools needed to help future counselors assist GLBT individuals in navigating their issues and leading more fulfilled lives.