Self-Perceived Competence with Lesbian, Gay, and Bisexual Clients: A Qualitative Study with Heterosexual Early Career Psychologists and Advanced Trainees
Open Access
- Author:
- Dendy, Anna Katherine
- Graduate Program:
- Counseling Psychology
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- September 02, 2010
- Committee Members:
- Kathleen Bieschke, Dissertation Advisor/Co-Advisor
Kathleen Bieschke, Committee Chair/Co-Chair
Joyce Karen Illfelder Kaye, Committee Member
Keith B Wilson, Committee Member
Theresa K Vescio, Committee Member - Keywords:
- gay
bisexual
LGB clients
counseling competence
lesbian
psychotherapy competence
grounded theory
qualitative study - Abstract:
- The field of psychology is generally—though not uniformly—LGB-affirmative. Yet many trainees enter doctoral programs with LGB-negative beliefs based on strong religious convictions and/or cultural traditions. This study used the qualitative research methodology of grounded theory (Glaser, 1992) to explore the doctoral LGB-training experiences of 29 heterosexual early-career psychologists and advanced psychology trainees who did not hold LGB-affirmative views upon entering their graduate programs. Some participants had developed LGB-affirmative values while in their programs and some had not, but all considered themselves currently competent to work with LGB clients. The goal of this research was to develop a substantive theory of how our participants engaged with LGB training in their programs, and how they believed they gained competence with LGB clients. The core category that emerged in our study was Dissonance. When participants entered doctoral training, they experienced cognitive dissonance provoked by the differences between their own LGB beliefs and those of others. Participants adopted distinct strategies to reduce their dissonance and adapt to their programs: Assimilation, Separation, and Integration. Participants who used the Assimilation strategy typically rapidly adopted LGB-affirmative beliefs. Conversely, participants who used the Separation strategy held to their own LGB-negative beliefs and dismissed the affirmative values of psychology and people in their programs. Participants who used the Integration strategy, however, were continually engaged in a process of examining their own values and attempting to resolve their dissonance, which was the most successful strategy for developing competence with LGB clients. Participants said that exposure to and positive, meaningful contact with LGB people allowed them to develop increasing comfort with and empathy for LGB people, which participants cited as the most important factors for increasing their competence with LGB clients. Frequently cited barriers to LGB competence were discomfort, anxiety and avoidance of LGB material, particularly LGB relationships and sexuality and LGB clients’ own conflicts regarding religion and sexual orientation. Participants without LGB-affirmative values particularly struggled with these issues, and evaluated themselves as less competent when confronted with them. However, some non-affirmative participants used their religious beliefs to connect with their LGB clients’ humanity and to develop empathy for them, thereby increasing their competence. We found that conservatively religious participants felt unwelcome in secular programs, and believed their religious identities were stigmatized. They did not discuss their religious and LGB values with faculty for fear of negative evaluation. Some participants did discuss their values conflicts in clinical supervision, which they cited as the most helpful aspect of their LGB training. LGB training must addresses LGB awareness, knowledge, and skills. In addition, programs must attend more to assisting trainees in resolving conflicts between their personal LGB values and their professional roles with LGB clients. We agree with the position of the Counseling Psychology Model Training Values Statement Addressing Diversity (CCPTP, ACCTA, & SCP, 2009), which stated that training programs cannot mandate trainees’ beliefs, but can require trainees to learn to provide competent services to minority populations. Our participants’ experiences made clear that resolving values conflicts is an essential task in developing competence in working with LGB clients.