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Current attitudes of counselling practitioners towards sexual and gender differences raise the possibility that minority clients may experience re-traumatisation due to in-session expressions of therapist homophobia. This paper explores these issues through a qualitative study that examines client and counsellor narratives on homophobia in counselling. The results describe specific examples of homophobic behaviour by counsellors. While individual examples might appear mundane on the surface, the frameworks they invoke and their pervasiveness constitutes a considerable threat to the counselling relationship. The paper argues that homophobia in counselling practice is a significant issue that requires sensitive, critical and applied analysis that redirects therapeutic efforts in the future.
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International Journal for the Advancement of Counselling, Vol. 27, No. 3, September 2005 ( C2005)
DOI: 10.1007/s10447-005-8207-7
Homophobia in Counselling Practice
Randolph Bowers,1,2David Plummer,1and Victor Minichiello1
Current attitudes of counselling practitioners towards sexual and gender differ-
ences raise the possibility that minority clients may experience re-traumatisation
due to in-session expressions of therapist homophobia. This paper explores these
issues through a qualitative study that examines client and counsellor narratives
on homophobia in counselling. The results describe specific examples of homopho-
bic behaviour by counsellors. While individual examples might appear mundane
on the surface, the frameworks they invoke and their pervasiveness constitutes a
considerable threat to the counselling relationship. The paper argues that homo-
phobia in counselling practice is a significant issue that requires sensitive, critical
and applied analysis that redirects therapeutic efforts in the future.
KEY WORDS: counselling; homophobia; difference; prejudice; bias.
Counselling literature since the 1980s has attempted to address the specific
needs of sexual and gender minority clients in therapy. The literature acknowl-
edges that, while there are many similar issues facing minority people, there are
also unique issues that counsellors need to develop awareness of (Appleby &
Anastas, 1998). Gay, lesbian, bisexual and transgendered people come from all
parts of society. When stereotypes are highlighted at the expense of acknowledg-
ing individuality, retraumatization will result from the insidious effects of social
shame and homophobia (Kaufman & Raphael, 1996).
Across the literature, the term, “homosexuality” is said to inspire strong
internal and behavioural responses. For instance, Schwanberg (1990) surveyed at-
titudes towards homosexuality by reviewing American healthcare literature during
the 1980s. The author concluded that prejudice is common among practitioners,
and that the AIDS crisis, at least in the early days of the epidemic, increased
1School of Health, University of New England.
2Correspondence should be directed to Randolph Bowers, PhD. School of Health, University of New
England, Armidale, New South Wales, Australia 2351; e-mail:
0165-0653/05/0900-0469/0 C
2005 Springer Science+Business Media, Inc.
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470 Bowers, Plummer, and Minichiello
negative attitudes and prejudice towards gay, lesbian and bisexual clients. A Report
of the Gay and Lesbian Medical Association in America (American Counseling
Association, 2001, p. 1) states that the medical and psychological impact of ho-
mophobia is extensive across various age groups, and can negatively influence the
development of self-esteem. The report defined homophobia as “the socialisation
of heterosexuals against homosexuals and concomitant conditioning of gays and
lesbians against themselves.” According to the Medical Association, homopho-
bia “is a legitimate health hazard.” Despite the health consequences, addressing
homophobic attitudes and practices continues to be a challenge that faces the
therapeutic professions.
The literature distinguishes between the attitudes of men versus women to-
ward male or female homosexuality (Kemph & Kasser, 1996; LaMar & Kite,
1998). Heterosexual men tend to be more negative toward male homosexuality
than heterosexual women, and heterosexual women find lesbian women more
discomforting than gay men. Other studies examine the homophobic function of
stereotypical attitudes and the social stigma associated with HIV/AIDS, reinforc-
ing the notion that these problems are of great social concern (Luchetta, 1999;
Pugh, 1998). Davenport-Hines (1991) suggests that gaining knowledge about the
sociohistorical origins of homophobia is a necessary beginning in challenging
prejudicial frameworks.
Smith and Gordon (1998) propose that people appear to need a cognitive
map that brackets and/or stereotypes gay and lesbian sexualities. Moreover, main-
taining cognitive maps may ‘protect’ counselling practitioners by validating their
position and reinforcing familiar frameworks that may be inherently prejudicial.
Homophobic constructs that underpin stereotypical attitudes may not necessarily
be in the counsellor’s conscious awareness. Others challenge this view and argue
that many conscious attitudes towards homosexuality are sanctioned by everyday
mainstream discourse and rendered invisible to the counsellor’s analysis by virtue
of being so commonplace, and, therefore, normalized (Plummer, 1999). For in-
stance, when looking at attitudes towards homosexuality, De Cecco (1990) and
Coleman (1990) suggest that, in mainstream (heterosexual) culture, homosexuality
tends to define the gay or lesbian person to the exclusion of other factors. In coun-
selling, when a client discloses sexual orientation, practitioners may foreground
sexuality inappropriately, losing a balanced or holistic perspective. The counsel-
lor’s countertransference regarding homosexuality, gender and/or sexuality may,
during these moments, influence the therapeutic process.
Pardie and Luchetta (1999) propose that heterosexism, like gender bias and
racism, is an ideological construct that encodes a person’s attitudes along nar-
row lines. Whether because of fear-based needs for structure, because of learned
prejudice, or because of unacknowledged same-sex desire, ideological constructs
bind a person’s development by disallowing certain perspectives while sanction-
ing others. Markowitz (1992) suggests that much work needs to be done to raise
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Homophobia in Counselling Practice 471
awareness among counselling professionals on issues associated with homopho-
bia. For example, countertransference has been explored in relationship to a ther-
apist’s bias towards lesbian clients (Gelso, Fassinger, et al., 1995). It is thought
that internalised homophobic scripts along with the gender of the counsellor may
be important variables in understanding countertransference issues. Mair (2003)
explored the narratives of gay men, and suggested that homophobia is a significant
problem in clients and their counsellors.
Despite a growing literature on homophobic attitudes, few studies have ex-
plored the phenomenological importance of homophobia in counselling practice.
The current study aims to address this gap in the literature through conducting
in-depth interviews with minority people on their experiences of counselling, and
with counsellors on their experiences of working with people who are gay, lesbian,
bisexual, and transgendered.
This study utilized an interpretative and social constructivist approach that
sought to explore how participants located their experience of counselling in rela-
tion to issues associated with minority identity. From this theoretical perspective
the authors began with the premise that people both experience reality and shape
reality according to the way meaning is constructed around that reality. For these
reasons, the study gathered data in order to better understand the construction of
these issues from the perspective of participants.
Within this design, the researchers acknowledge that interpretation of social
interactions and data is a necessary component of the research process. Our ap-
proach to studying homophobia was fluid and a source of rigorous debate, and
began as only a tentative proposition and with great scepticism amongst some of
the research team during the first half of this study. However, as evidence from the
data continued to emerge throughout the study, a logical and systematic analysis
suggested that homophobia was a phenomenon that best described experiences of
bias, prejudice and discrimination in everyday life and in counselling.
To further ensure a rigorous design, interviews were structured in a way that
information relating to homophobia was unsolicited and the term ‘homophobia’
was not used by the researchers and was not contained in the Participant Infor-
mation Sheet where the project was simply entitled, ‘Constructing Counselling
Awareness.’ If and when the term ‘homophobia’ was used by participants, the
interviewer inquired by asking open-ended questions that encouraged the partici-
pant to describe their experiences further. However, in many instances participants
did not specifically label their experiences as ‘homophobic.’ Rather, many partic-
ipants described social interactions that appeared directly linked to their sexual
and/or gender identity and that were in some manner difficult, traumatic, and that
appeared to increase their sense of social isolation. While the topic of homophobia
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472 Bowers, Plummer, and Minichiello
was researched in the literature throughout this study, these themes were largely
‘suspended’ when it came to gathering data from participants on their experiences
of counselling. The intention was to offer participants a forum to discuss any
issues related to their past counselling interactions. Following on the strength of
homophobia as the predominant theme in the data, we have come to affirm that,
like sexism, racism, and other ‘isms,’ homophobia deserves greater pubic attention
in published literature and in research.
The project used theoretical sampling, and began with a sampling frame that
identified only that participants would be adults 18 or over, from rural and urban
areas, clients and counsellors, and that they would be (in the case of clients and
possibly counsellors) gay male, lesbian female, bisexual,transgender, and (in the
case of counsellors, likely) heterosexual.
Thirty-four adult participants were interviewed, consisting of 18 clients and
16 counsellors. Client’s experiences of counselling varied from single sessions to
lengthy therapeutic relationships that spanned several years. Counsellor status var-
ied from new practitioners to senior practitioners, and spanned from professionals
with specialization in sexual and gender minority issues to counsellors who had
very little experience in the area. Several people had overlapping client/counsellor
identities. Interview duration was between one and three hours and total recorded
interviewed time is estimated at 56 hours. Interviews were audiotaped. The three
open-ended funnel questions used in all interviews were: (i) Can you tell me a bit
about yourself and how you came to be where you are now? (ii) Tell me a bit about
your experiences of (a) counselling, or (b) working with gay, lesbian, bisexual and
transgendered clients and, (iii) If you could speak directly to counsellors, what
would you tell them that you most want them to know about working with gay and
lesbian clients? The interviewer then asked probing questions to follow up lines
of inquiry arising from the participants’ responses.
The participants were recruited through three methods: by snowball referrals;
by posting requests for volunteers on community e-mail list servers; and by con-
tacting counsellors through the telephone directory. Client participants comprised
four gay, six lesbian, four bisexual and four transgender participants.
Several counsellor participants identified as gay male and bisexual female.
No lesbian counsellors were accessed during the study, though one client who
identified as lesbian was a social worker and another who identified as bisexual
and ‘polyamorous’ worked in sexual health. When the project began, counsellors
were chosen based on their expertise in sexual and gender counselling. It was felt
that hearing their perspectives may help the project focus on relevant issues. Later,
counsellors who had no experience in the field were sought out to offer a con-
trast. The counselling practitioners included psychologists, clinical psychologists,
clinical social workers, health workers who also worked as counsellors, private
practitioners, ministers of religion, alternative practitioners, and counsellors in
several fields including individual, couple and family work.
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Homophobia in Counselling Practice 473
Interview data were transcribed and coded according to whatever content was
apparent in the text. From this simple coding process, each interview was sorted,
and each self-apparent code was built upon, and over 800 codes were sorted. This
laborious process was facilitated by using a qualitative data analysis programme
(Qualitative Research Solutions, 1997). When one code logically combined with
another code, a category was developed. Each stage of the process was documented
by analytical memos that expressed the rationale for grouping together persistent
codes into categories that were identified by a dominant idea.
As categories were clarified throughout the coding process, they were sub-
sumed into larger thematic groups. Client and counsellor data were coded ac-
cording to themes that emerged across the complete sample, with an emphasis
on client-initiated themes. Themes related to homophobia that were documented
fell into three areas of experience: (i) family, school, community and religious,
(ii) healing from homophobia, and (iii) counselling. Several themes were excluded
because of resource limitations; for instance, medical and psychological issues as-
sociated with gender reassignment. The following section discusses themes related
to homophobia in counselling.
A Subtle and Complex Landscape
It might be thought that ‘homophobia’ is expressed by overt and even violent
behaviour, such as gay bashing. While this may be true, the data below suggest
a much more subtle and complex landscape of social interactions is taking place
between counsellors and clients. This landscape appears to involve the subtle and
varied ways that counsellors’ perspectives (which may include lack of knowledge,
assumptions, bias, and/or prejudice) and their approach to therapy (which may
include a range of ‘inappropriate’ behaviours and responses for the client’s partic-
ular situation) impact on the client and are read as unhelpful and/or homophobic.
More often, different types of inadequacies will overlap so that, for instance, a
certain lack of knowledge and awareness may be combined with a degree of as-
sumptions, which may or may not include (upon further self reflection) layers of
prejudice (that may in many cases be related to past socialization into the gender
and sexuality belief systems of one’s family of origin and its social milieu).
The following data, whilst not demonstrating all of these points in each
instance, collectively demonstrates the logic of the arguments developed. As well,
the intention of this section is to introduce and not overshadow the voices of the
participants. This reflects closely the data analysis methodology, which sought
to reduce subjective interpretation of people’s words and allow the interviews in
some way to speak for themselves.
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474 Bowers, Plummer, and Minichiello
The data presentation begins with the case of ‘Stephen,’ a rural based hetero-
sexual counsellor, who works in a school setting. His case illustrates an apparent
subtle and complex overlapping of lack of knowledge, assumptions, and perhaps
even some level of unacknowledged countertransference and/or prejudice towards
minority clients. During the interview Stephen mentioned that it took one of his
clients six months to disclose that she was a lesbian. This made the interviewer
curious and when asked why it took six months, Stephen said:
It might have been because they weren’t. . . it might have been because they didn’t think it
was relevant. It might have been because they wanted to get to know me better . . . I think
the most common answer to that would be, it was just not relevant to the matter that brought
them to counselling in the first place. And a lot of people do separate their study or their
The interviewer remained silent and the participant continued. It was noticed
that his reasons may not account adequately for how his half of the therapeutic
relationship influences the level of comfort of sexual and gender minority clients:
I have no doubt that some clients would make the immediate assumption that I am a fairly
traditional, conservative sort of ‘normal.’ I hate the word but . . . that I’m just an average
sort of person and that if they raise a fairly controversial issue with me . . . they’re not going
to quite know how I’m going to react or what I’m going to do with them.
The counsellor appeared to construct where he stood in relation to ‘traditional’
versus ‘controversial’ issues. There is nothing inherently problematic about this
framework save that it was curious how his construction appeared to overlook the
needs of the client. It may not seem unusual that it would take six months for
a client to disclose their sexual orientation to a counsellor, because perhaps her
presenting issues were not related to her sexuality. But the discussion of the case
suggested that the counsellor missed something during the six month period. Their
relationship included discussion of issues related to the student’s rural community
and family issues, and it seemed evident that the self-presentation of the therapist
was somehow involved in not establishing enough trust for the client to disclose a
central and important part of her identity when he said:
I have things like these posters up here because I have a certain identity and. . . I want
people to try to get to know me as quickly as possible . . . but I’m not going to change. I
don’t feel that I need to try and adapt myself to each individual client. I’ve got to be myself
and I’ve got to be comfortable and I’ve got to help the clients to get to know me and get
comfortable with me.
The posters he mentioned were related to his interests in mainstream rock
music, and his office looked like any office you may expect to find in a community
school or college, except that some counselling offices may or may not display
posters about multicultural issues, health issues, or gay and lesbian issues. In
these offices the posters may serve to proactively suggest to clients that it is
OK to disclose about their identity and issues. His comment that he was not
going to change was perhaps his most powerful statement. This combined with
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Homophobia in Counselling Practice 475
his assumption that there is no need to adapt to individual clients seems an odd
approach for a counsellor to take in a field that demands flexible interpersonal
styles and in a practice where he sees a wide range of clientele. The interview that
followed reinforced a sense that he assumed and expected that his clients would
(or should?) adapt to him. In many ways Stephen seemed to miss the mark with
this particular client by uncritically acting on assumptions.
Missing the Mark: Assumptions and Stereotypes
Jane, a rural based lesbian social worker discussed working as a client with
a heterosexual male counselor who identified as heterosexual. Jane was happy he
was honest enough to disclose his ignorance of certain issues. Other parts of their
relationship greatly troubled Jane:
He said, ‘well you’ll be getting a lot of support because you’re with a female,’ and I said,
‘well no.’ And he said, ‘well you’d have a lot of trouble with your family then, you know,
here you are stressed and everything and they’re not accepting you as in a homosexual
relationship.’ And I said, ‘well no, they are, because I’m still their mum and we always had
the grounding, the bonding and everything there.
Jane was forced to confront his assumptions at every turn and this was
He assumed too that within the dynamics of the culture, I was part of . . . . . . lesbians would
go and protect you. And I said, ‘no, we’re all individuals and we’re all professionals . . . And
when they get home they are just dog-tired as well, so you haven’t got this flock of women
nurturing you.’
Jane concluded:
He sort of had no insight about gay lifestyle and then rather than doing reflective listening
and things like that, he made a lot of assumptions that were totally incorrect. I didn’t feel
as bad as what I had with [my previous] counsellor, but I hadn’t moved on very far either
because I was dealing with sexuality issues rather than my fears because of the assumptions
that he had made. So I was dealing with [his] assumptions and not [my] issues.
The word ‘assumptions’ in such situations can often be read as ‘stereotypes,
and if counsellors relate to stereotypes of a person they are not relating to the
person. This identifies an underlying mechanism of homophobia in counseling—
that it is possible for a counsellor’s unexamined stereotypes of gay and lesbian
clients (which are generated in the larger social climate much like sexism and
racism) to block effective therapeutic interaction.
Charlie’s story shows how counsellors can change these dynamics by facing
personal issues through education. He is a heterosexual rural counsellor who came
to the discipline later in life. While he candidly disclosed parts of his sexual history
during the interview and showed an openness to change, he expressed that gay
issues were an area of learning for him. Charlie spoke about how society had
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476 Bowers, Plummer, and Minichiello
changed, and that if he just accepted his lack of training in the area he may not
work effectively with minority people. So he and his partner (also a counsellor)
made a concerted effort to learn about the issues:
We went along to various seminars run by a chap in [rural Australia] who is homosexual—
his partner died of AIDS and actually they used to come into our shop back in the
1980s . . . Now he does lectures about homosexuality and all the rest of it. . . so we’ve
made the effort to get the additional education.
During the interview Charlie’s ease with the discussion and genuine interest in
learning contrasted considerably with Stephen’s interview. Cases were discussed
where it was assumed the client felt comfortable disclosing their identity, and
the counsellor encouraged disclosures through expressing openness, interest, and
basic knowledge of the issues.
How Does Homophobia Intrude on Therapy
Bert, a bisexual male, recalled seeing several counsellors, one of whom
identified as lesbian, others appeared to be heterosexual. Bert stated that his
heterosexual counsellors would:
. . . not necessarily be able to relate to the specifics but will give you some general diatribe
about what you should do . . . with all the intentions in the world of helping . . . just not
being able to see the unique perspective of the person.
Bert ‘spoke’ to the heterosexual, middle-aged women, family counsellors he
had seen:
I know that you are meaning well and I know you have got a lot of things to say [but] you
certainly don’t have a certain empathy about [my experience].
While his words were direct and perhaps confronting, he raised an important
issue related to many professional counsellors not having enough knowledge,
experience, or ability to relate to sexual and gender minority clients. His use of the
phrase to be ‘well meaning’ opened a lengthy reflection that was echoed across
the data. In a broad sense, when counsellors ‘mean well’ they may be overlooking
significant information and may even cause minority clients significant discomfort.
From a socially critical perspective, ‘meaning well’ can translate into a veiled
attempt to obscure countertransference that may be based in unacknowledged
homophobia. To illustrate, Bert stated:
I didn’t expect her to be able to relate at all. Maybe . . . get a vague outline but that really
wasn’t what I needed . . . I certainly didn’t begrudge that. . . they are the most relevant to
have to serve the vast majority of the population. . . they certainly listen and they certainly
give advice and they have the best intentions in the world . . .
The question could be asked whether ‘having the best intentions in the world’
might be a way of excusing what may translate into homophobia in counselling
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Homophobia in Counselling Practice 477
practice? Consider two levels of homophobia emerging from this analysis. The first
is subtle and covert practice (which may be by degrees conscious or unconscious).
This is illustrated when counsellors ‘mean well’ but are ill equipped, misinformed
and may unintentionally harm clients. Having ‘good intentions’ and ‘meaning
well’ not adequate excuses for prejudiced practice (countertransference), even
when prejudice ‘simply’ reflects omissions such as ignorance, unpreparedness and
use of stereotypes. The second level is more obvious and overt prejudice (which
may also be by degrees conscious or unconscious). The problem here is that
few people will admit to being prejudiced, but when they do, they often attempt
to justify their practices by appealing to homophobic traditions (Noel, 1994;
Plummer, 1999, 2000). The next difficulty is deciding what practices ought to be
put under ‘well intentioned’ versus ‘overt prejudice’ and how relevant are these
categories in any case? Particularly in social climates where ‘political correctness’
prescribes self-censorship of homophobic beliefs and values, the landscape of
analysis is more subtle and demanding.
One example of ‘well meaning’ homophobic practice is when a counsellor
engages in a protracted assessment, and takes several sessions to get the client’s
story in relation to understanding their sexuality or gender identity. Jane offered
an example of a prolonged assessment:
I couldn’t move on very quick because the first three sessions, they were nearly two-hour
sessions, was dealing with assumptions of sexuality . . .I felt like I was dealing with his
issues and I couldn’t deal with mine.
Claire sought help from many people within various helping professions.
She found that no one had the skills and insight to help her in her crisis, and for
whatever reasons they all tended to disregard the issues most important to her. She
I went to a lot of people for help . . . [but] did not get it from anybody. Everybody I went
to . . . didn’t identify any of my problems. they all treated me like I was just an over
imaginative teenager . . . I didn’t need to be given panaceas and . . . some of them were ‘well
meaning’ people but they were really dopes . . .
The practitioners that Claire encountered seemed to have certain traits in
common. They were not able to demonstrate empathy or insight and so could not
identify her issues. Though Claire’s past issues were many and confounded the
difficulty of her case, none should have prevented a skilled therapist from building
a strong therapeutic alliance with her. Twenty years later she was able to forge a
positive relationship with a rural based heterosexual female counsellor. Though
she defined this relationship as helpful and constructive, the therapist allegedly
exhibited degrees of homophobic behaviour. Claire stated:
She tries very hard to accept that lesbian relationships are equally valid with ‘het’ relation-
ships. But because it is not a . .. let’s set up house and have kids, type of variety, she has
a bit of difficulty with that . . . so she tends to not place the same kind of value on it. She
doesn’t think about it as a relationship, like a sexual, personal, emotional relationship . . .
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478 Bowers, Plummer, and Minichiello
For Claire’s counsellor, lesbian relationships were not as valid, legitimate or
normal. Again, the counsellor engaged in stereotypes of gender relationships and
in the process, devalued the client’s experience. Claire knew this dynamic was
happening because of the words her counsellor used and did not use:
She has said, ‘you two are best friends,’ and she would talk about it, ‘Oh, when you have a
friend.’ But when she was talking to me about other clients, she talks about their husband
or their wives as their lovers. She doesn’t use that terminology with me. Even though she
might be talking about my lover, she talks about my ‘friend.
In spite of the counsellor engaging in euphemistic talk, Claire found a basis
for respect in the therapeutic alliance:
I now know that this kind of therapeutic relationship is possible . . .The point is that I’ve
met someone who is prepared to treat me in a way that is meaningful to me . . . It has given
me a bit more faith in the whole process.
Claire described her counsellor’s approach:
My counsellor hasn’t insisted on making all the decisions. She has gone through the process
with me . . . and when we haven’t had the results that she expected she hasn’t blamed me
for that, she’s looked for another way to get results. . . I felt that there isn’t something that
I have to do right to be able to come back next week, and I haven’t had to look after her
particularly, to be careful about her feelings. . .
Jack, a transgendered person, expressed the relational aspect of therapy in
the following way:
Maybe it’s about approach or maybe it’s about counselling style . . . but I would prefer if
this counsellor would not just listen to what I would say, but actually heard it and tried
to understand it, and admitted when she didn’t know the answer. That she would allow me
to work through some of this stuff . . . to talk about whatever was going on and to allow
me to direct the counselling.
When commenting about the approach of therapists, we acknowledge that
poor counselling skills may be a precipitating factor in homophobic practice. This
could be the case for beginning or senior counsellors, as higher levels of training
do not necessarily correlate with greater sensitivity and/or awareness of minority
issues. Jack’s comments suggest that regardless of the qualities of the therapist
and client, expectations for therapy need to be negotiated.
Acceptance Verses Homophobic Rhetoric
Jake warns that counsellors may believe they possess acceptance and respect
for clients but in reality, communicating those qualities is another matter:
Any course about counselling talks about not being judgmental and respecting other people
and blah, blah, blah .. . There’s one thing to be taught that and to believe that you are that,
and there’s another thing to really be that, to really respect people, to really accept people’s
choices in life.
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Homophobia in Counselling Practice 479
There appears to be a gap between the use of rhetoric and the implementation
of inclusive practice. The next case further illustrates this point. Lilliana, a bisexual
women, works in sexual health. Homophobic practice is seen by Lilliana as a much
more organized system of values held by practitioners. She stated quite clearly
There is a very strong culture of heterosexual dominance . . . and there’s this systemic
idea that we don’t need to learn how to work with gay and lesbian people because there
aren’t enough of them here, and we’ve got much more important things to do than worry
about poofters and dykes. But that whole thing of heterosexual dominance is . . . seeing
heterosexuality as the only expression of sexuality.
The social dynamic she discusses appears to subordinate and overlook al-
ternative lifestyles. Regarding the idea that we don’t need to learn how to work
with minority people because there aren’t enough of them, Alex, an urban based
heterosexual female counsellor specialising in transgender issues, made this com-
In the Netherlands, it’s [cases of transgender clients] like 1 in 11,000 but in the States it’s
like 1 in 35,000. You wonder if there was acceptance . . . the others speak up, because they
need to hide or they may even suicide . . . Does 1 in 30,000 justify people knowing about
it? I think so. I mean doctors deal with the rare diseases there are one in many thousands,
so I don’t see why this is not taken seriously.
Alex went on to speak about ‘gender dysphoria’ being a diagnostic category
in the DSM IV and she felt that so many practitioners are still ignorant of its
dimensions (American Psychiatric Association, 1994). As Alex stated:
[The transgender experience] can’t be forgotten by using anti-depressants or any other band
aid treatment . . . It is documented that they must change the body to suit the mind, they
can’t change their mind to suit the body. It’s the only way they can be healthy, functioning
individuals . . .
Transgender experiences require further research and attention. Unfortu-
nately many of the issues raised by transgender participants that were unrelated to
homophobia were outside the focus of this study.
The Myth of Neutrality
Edwina, a heterosexual counsellor, works in a rural setting. She was in her late
fifties at the time of the interview. The discussion of her beliefs and values helped
to clarify certain ethical boundaries counsellors will face when their beliefs clash
with their client’s way of life. Though Edwina used the rhetoric of ‘bracketing’
bias, in reality she could not hold her beliefs outside of the counselling process.
She began by relating the models that inspired her during her basic training:
I don’t think I had definite attitudes . .. that perhaps made it very easy for me to. . . get very
interested in Carl Rogers’ . . . qualities of unconditional positive regard, genuineness and
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480 Bowers, Plummer, and Minichiello
those sorts of counsellor qualities . . . I had to learn how to hold back and not say things and
how to ask vetted questions . . .Another influence helping me was the phenomenological
approach . . . the idea of presuppositionlessness . . . to hold in abeyance . . . to let the things
themselves present themselves to you and to hold your preconceptions in abeyance . . . some
people may think I don’t have enough strong opinions myself . . .
It seemed unlikely that Edwina had no strong opinions—she was a senior
practitioner and articulated well-developed arguments. Though her statements
denied any ‘definite attitudes’ she aligned herself with the liberal traditions of
Carl Rogers and the phenomenological tradition.
As analysis progressed, the participant’s belief in a counsellor’s ability to
bracket homophobic bias became implausible, and to the contrary, suggested
that an elaborate intellectual rationalisation of bias and prejudicial practice was
operating. For example, when Edwina implied that she held her preconceptions
‘in abeyance,’ in response to the question ‘what preconceptions?,’ she said those
that limit acceptance of difference and may increase the likelihood of homophobic
practice. On the one hand, it is not unreasonable that counsellors may ‘hold
in abeyance’ their preconceptions, as they are expected to do as professionals
(American Counselling Association, 1995; Canadian Counselling Association,
1999). On the other hand, though, Edwina’s statements might suggest that by
rationalising away her inability to withhold homophobic beliefs and by denying
her strong opinions, a quite complex mental and/or social ‘game’ was being played
When the interviewer inquired, Edwina admitted her strong opinions: “All
right, if you press me, I would say I do have a position. But I don’t put it forward.
She withheld her position, but continued to counsel people if they chose to come to
her. Edwina’s overt position to her clients was that she was accepting, Rogerian and
phenomenological. Her covert position to her clients was that she only ‘tolerated’
sexual difference and did not offer acceptance. She said:
The position is that in our society today, I think it’s important to tolerate diversity of gender
preference and racial origin or whatever . . . tolerance is highest on my list.
It appeared from analysis of several narratives that the nature of ‘tolerance’
is to present a rhetoric of acceptance with underlying and hidden qualifications.
Edwina’s statements below indicated that tolerance was not actually first on her
list of priorities. Put together, the clues suggest a covert and unintended admission
of prejudice:
But if I’m upholding values to my children, I will uphold . . . the value of heterosexual
family life . . . I would still uphold family life. I think if it’s your choice to . . . be in a same-
sex relationship and sort of have a family life that way, that is okay. But I think we need
as a community . . . I think we need to, not to promote it, but to tolerate it but not to do
things . . .
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Homophobia in Counselling Practice 481
Family Rhetoric and Homophobia
In Edwina’s case, family rhetoric is illustrated. In her framework, offering
tolerance to homosexuals is done, ostensibly, to protect the ‘institution of the
family.’ She also implies that gays and lesbians are anti-family, a position that
cannot be supported by reason and research (Benkov, 1994; Green, 1996). In
certain cases, prejudice and homophobia appear to be somewhat irrational and
based on false assumptions, emotional reactions and stereotypes. From her point
of view, supporting lesbian and gay people will undermine the institution of the
family. She said:
I can’t . . . you’ll have to help me . . . I don’t want to be seen . . . I don’t want to sound as
though I think one is better than the other. It’s like an individual choice. But I think like, I
think it’s still important somehow to prize. . . the heterosexual family somehow. Does that
make sense?
‘Prizing the heterosexual family’ sounds like a reasonable proposition. Soci-
ety can prize many things within a framework of liberal citizenship and equality
under the law. But Edwina suggests something more than this. For her, the hetero-
sexual family, itself a label riddled with stereotypes and problematic assumptions,
ought to be prized above any other lifestyle and protected as the ideal under the
law and through social policy. The key to this argument is that using ‘the family’ as
a counterpoint is a false and illogical binary. When the polarisation of ‘gay versus
family’ is shed, there is less ammunition and typical views on sexual and gender
difference are exposed for what they are—illogical and unfounded prejudice. As
a result of her philosophy, Edwina would vote against giving lesbians access to
in-vitro fertilisation:
I’m just thinking in terms of how I might vote if I had to choose on these issues in the
public arena. What would I choose in relation to certain procedures . . . like facilitating the
pregnancy of a woman in a lesbian relationship? I think if put to the test, but I’d have to
think hard about it, I may well vote against that.
Edwina then spoke of a female client who was seeking counselling around
pregnancy issues, she
. . . wanted to have a child herself without a [male] partner. . . I think I just asked questions.
I asked questions relating to the rights of the child to have perhaps a father. I would have
asked in a very gentle way. But I’m aware that somehow in me, there are these . . . as you
say, there are some views there. . . there are some things I wouldn’t actively advocate. I
wouldn’t go around saying that it’s okay for same-sex couples to be funded from the public
purse for facilitating children.
Effectively, the underlying message to her client is that she denies support
for the client’s need to explore having a child because the women did not have a
male partner.
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482 Bowers, Plummer, and Minichiello
Counsellor and Client Discomfort
Many client and counsellor participants suggested that counsellors may not
be comfortable in some areas. Alex is a female and bisexual counsellor who
worked with transgender clients:
[It is about] being open to hearing anything that they may want to say, especially in areas
of intimacy and sexuality and gruelling details you know. I mean, ‘he inserted his penis in
my new vagina . . . this happened’ you know. Stuff like that. I’m fine with all of that stuff.
I’m not embarrassed about it.
Hlony, a lesbian, found it difficult to speak frankly with her heterosexual
I used to find myself that I couldn’t tell her a lot of things because I just feel embarrassed.
So I wasn’t also open about a lot of things because I felt really embarrassed because she
was straight. But when I talk to someone who is gay, they can really help me because I’m
open, I can just talk about my issues.
Regardless of their sexual or gender identity, counsellors will often be re-
quired to ‘take the first step’ in demonstrating comfort. As Hlony said:
Sometimes you need to go down to the nitty gritty of the thing . . . Because everybody has
to be comfortable, both the counsellor and the patient. They’ve got to both be comfortable.
Jack, a heterosexual therapist, echoed this theme when he said:
For the counsellor, the most important thing is to be comfortable with their own sexuality.
I can remember dealing with this guy who . . .was beginning to come to terms with his
sexuality . . . and he fell in love with me . . . what I expressed was that I could hear what he
was saying . . . I could appreciate where he was coming from.
Jack shared that to be open to working with gay men, he needed to first
explore his socially learned aversion to homosexuality:
Like the guy who said he loved me, I needed to be able to explore with him what that meant
for him and what he was really saying was that ‘you’ve accepted me.’ That then meant that
I could understand what he meant.
Jack was able to acknowledge the client’s feelings and used his interpersonal
skills to create an accepting environment where the underlying meanings could be
Homophobia Effects Everyone—we all Lose
Jack, a heterosexual male counsellor expressed well an obvious point that
came from this research:
In some ways both become victims. Homophobia can affect gay people with discrimination,
judgements, a whole range of things can occur within the workplace, the social environment,
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Homophobia in Counselling Practice 483
the church, and the community. And they are victims of that prejudice. But similarly, the
person who is prejudiced is a person who lives in a narrow framework and that has an
impact on them and so they become victims from a different perspective. . .
Using unexamined stereotypes limits our capacity to relate to others. Jack
suggests we need to become self-aware:
A friend of mine I’ve always seen as being very controlled, and a good psychologist in a
fairly senior position, and he’s come out. But he’s jumped . .. 180 degrees literally with the
explosion. My mind boggles actually, that here’s this guy who had had so much suppression
for most of his life, he wasn’t aware of it. . . he was blind as a bat until, I don’t know how
or why . . . His father died, and that gave him the freedom to be himself . . . If we suppress
things within ourselves, it inhibits our capacity to play and enjoy life.
If we suppress things within ourselves it also likely inhibits our capacity
to counsel. So then, homophobia may also include internalized fear surround-
ing same-sex relationships, suppressed feelings, and unexplored potential in the
counsellor (Berkman & Zinberg, 1997). As the case above illustrates, therapists
may be carrying a range of issues stemming from family of origin interactions.
Cultural and/or familial assumptions that go unquestioned may also influence a
counsellor’s values and practice.
As the quotes above suggest, homophobia may be present in many social
interactions and may influence the work of counselling practitioners of all sex-
ual and gender identities. Homophobia in counselling is a subtle and complex
landscape that may include lack of knowledge, assumptions, bias, and prejudice.
Counsellor expressions of homophobic practice in the study have included a wide
range of behaviours. These are highlighted in Table I.
From the analysis of data emerged many positive and proactive ways that
counsellors can work in this area. Table II pulls suggestions and insights from the
interviews discussed above.
Based on our understandings of these insights for improving practice, it is
also helpful to establish a basic framework for examining counsellor homophobia.
Table III provides key insights from this research that can assist in this endeavour.
While the evidence suggests that homophobia manifests in professionals’
attitudes and relationships, the way forward also needs careful consideration.
Plummer (1999) encourages the practice of reflexivity when approaching issues
around homophobia. Engaging in reflexivity includes being continually open to
new experiences and self-awareness. This may be a crucial factor in therapist
development when facing issues of homophobia, as reflexivity includes the ability
to correct one’s perspective through ongoing self-critical analysis.
Though many of the counsellor behaviours that suggest homophobia is
present in therapeutic interactions can be addressed by simply doing the opposite,
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484 Bowers, Plummer, and Minichiello
Tab l e I. Counsellor Expressions of Homophobia
Engaging in ‘well meaning’ behaviours that attempt to conceal prejudicial values
Using stereotypes
Selective use of language
Using clients to learn about minority experience
Inappropriately protracted assessment
Discounting client’s experiences
Attempting to change sexual orientation
Supporting systemic attitudes that promote homophobia
Acting out of incorrect understandings
Having limiting views of minority people’s lives
Choosing to avoid minorities
Remaining inflexible in counselling style
Controlling the course of therapy to suit therapist needs
Pushing one’s assumptions on clients
Trying to prove broad-mindedness
Using a rhetoric of tolerance, compassion, and acceptance to mask homophobic values
Leaving unconscious beliefs unchallenged
Rationalizing and intellectualizing homophobic beliefs and practices so they appear
acceptable and reasonable
Being uncomfortable with sex talk and sexual feelings in therapy
Inappropriate boundaries and lacking in personal awareness
Table II. Insights on Addressing Homophobia in Counselling
Provide support by staying flexible and open to learning
Establish an environment of safety and comfort for clients
Attend to assumptions and stereotypes as these create distance and prevent working with
real people and their issues
Generally engage with listening skills, open-ended questions, allowing the client to share
their story
Seek out education on these issues, attend workshops and seminars
See the unique perspectives of the person
Demonstrate clearly both empathy and understanding
Look beyond mainstream culture, and become aware of minority culture, issues, and
Do not use clients to learn—take responsibility for education on these issues
Be aware of ‘subtle’ uses of language, and realize it is not subtle for many clients
Be collaborative in exploring mutual goals
Admit not having answers and/or being ignorant of an issue
Do not ‘tolerate’ difference, accept and affirm difference—and communicate support and
encouragement to clients
Explore personal cultural traditions and assumptions
Know yourself—so you can work honestly, transparently, and effectively
Examine prejudicial beliefs around ‘family’ and ask—what am I afraid of? Why am I
getting defensive? What do I have to gain from this stance?
Acknowledge the social and political landscape
Be aware of professional and ethical responsibilities to equitable care and consideration
Be comfortable—find a place of ‘restless acceptance,’ or reflexivity, around personal
issues, roles, and responsibilities and the client’s issues
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Homophobia in Counselling Practice 485
Table III. Framework for Examining Counsellor Homophobia
Key insights
‘Bias’ against sexual and gender difference surfaces in words or actions a counsellor may
see as subtle but the client experiences as blatant.
Clients (and counsellors) describe negative experiences of counselling that are related to
homophobia, and homophobic experiences in counselling are pervasive.
Both clients and counsellors tend to minimize prejudice by framing it as bias, but clients
tend to be more sensitized to homophobic prejudice even when they form rationalizations
that minimize its emotional impact.
Professionals sustain unconscious and conscious cognitive frameworks that strategically
isolate prejudiced practice into cloaked categories.
Counsellors cannot ‘suspend their bias’ (bracket homophobic prejudice) and still work
with minority clients without their values coming forward and negatively impacting the
counselling process.
Counsellor education programs could benefit by inclusion of research and discussion of
minority issues at all curricular levels, along with schools of counselling establishing
specializations in this area including the support of research chairs in sexual and gender
minority studies
Counsellors should be encouraged to re-educate themselves by attending lectures,
workshops, and seminars on these issues
Professional associations ought to establish professional interest groups within the
associations for peer education, research, and dissemination of information
Greater attention needs to be drawn to homophobia as a serious problem in counselling
and other allied health disciplines
Future research needs to be encouraged that continues to investigate the social, personal,
and interpersonal phenomena of homophobia
Like sexism, gender bias, racism, men’s identity issues, women’s identity issues,
homophobia is an area that will continue to demand extensive social interest and
awareness because of its far reaching implications in our understanding of the
construction of human gender, sexuality and interpersonal identity
how each person responds in any given situation is far more complex. Rather
than addressing specific behaviours, which may be an endless process of elim-
ination, educational programs may be better suited to assisting counsellors to
deconstruct a range of attitudes in order to facilitate reflection on underlying be-
liefs, values, and early experiences of socialization into gender and sexuality roles.
Educational programs can benefit by modeling reflexive practices that encourage
self-awareness and critical social consciousness. Because the need for awareness
of self-in-relation to minority concerns actually precedes the effective use of core
conditions and basic counselling skills and because the use of such skills cannot
be applied uncritically in a minority context, counselling curriculum requires ex-
tensive revision that accounts for issues associated with the social construction of
all sexual and gender identities (and cultures) in largely multicultural and complex
Counsellor education programs will benefit by addressing homophobia along
with sexual and gender issues from beginning to advanced curricula (Hill, 1998).
Counsellor supervision ought to account for the many countertransference is-
sues that arise when approaching practitioners’ often unrecognized homophobic
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486 Bowers, Plummer, and Minichiello
behaviours (Long, 1996; Russell & Greenhouse, 1997). Supervisors will, there-
fore, require education around these issues, and sensitization to their own biases
and prejudice. Counselling associations need to encourage higher standards for
practice, along with higher expectations for educational qualifications. These stan-
dards need to address the prevention of homophobia in counselling.
The authors acknowledge the helpful contribution of Dr. Margot Schofield in
the design of this study, and funding received from the University of New England
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This chapter examines the complex interplay of ethical and clinical considerations in psychotherapy, research, and supervision with sexual and gender minority (SGM) clients. Using ethical codes and “best practices” documents from mental health organizations throughout the Anglophone world, the authors explore topics such as clinical competence, nonmaleficence, non-discrimination, confidentiality, multiple relationships, using and conducting research, financial matters, advertising, assessment and diagnosis, and supervision through a feminist, queer lens. Ethical considerations are illuminated through brief vignettes grounded in affirmative clinical practices and a cultural humility approach.
... Во истражувања направени пред околу две децении, со загриженост се констатира дека 10% од социјалните работници во САД изразиле предрасуди кон хомосексуалноста (Berkman & Zinberg, 1997). Во терапевтската практика, отвореното искажување на негативните ставови кон сексуалните малцинства е крајно ретко, но затоа, не се исклучени полатентни форми на неприфаќање, кои варираат од предлози за промена на ориентацијата, до користење реторика зад која се прикрива хетеронормативниот став, или поставување крути граници кон клиентите со нехетеросексуална ориентација (Bowers, Plummer & Minichiello, 2005). ...
... Sexual minorities report experiencing discrimination and stigma related to their sexuality and/or mental health within healthcare settings (Ash and Mackereth 2013;Pilling et al. 2017;Romanelli and Hudson 2017). Subtle forms of prejudice or 'microaggression' in counselling settings (e.g. a counsellor assuming one is heterosexual) are deterrents to accessing care (Bowers, Plummer, and Minichiello 2005;Shelton and Delgado-Romero 2011). ...
Compared to the general population, sexual minority men report poorer mental health outcomes and higher mental healthcare utilisation. However, they also report more unmet mental health needs. To better understand this phenomenon, we conducted qualitative interviews with 24 sexual minority men to explore the structural factors shaping their encounters with mental healthcare in Toronto, Canada. Interviews were analysed using grounded theory. Many participants struggled to access mental healthcare and felt more marginalised and distressed because of two interrelated sets of barriers. The first were general barriers, hurdles to mental healthcare not exclusive to sexual minorities. These included financial and logistical obstacles, the prominence of psychiatry and the biomedical model, and unsatisfactory provider encounters. The second were sexual minority barriers, obstacles explicitly rooted in heterosexism and homophobia sometimes intersecting with other forms of marginality. These included experiencing discrimination and distrust, and limited sexual minority affirming options. Discussions of general barriers outweighed those of sexual minority barriers, demonstrating the health consequences of structural harms in the absence of overt structural stigma. Healthcare inaccessibility, income insecurity and the high cost of living are fostering poor mental health among sexual minority men. Research must consider the upstream policy changes necessary to counteract these harms.
... These ways of working are deeply political, even when we work unaware. Practitioners actively engage in the politics of identity, culture and difference even when they deny and overlook these dynamics (Bowers, Plummer, & Minichiello, 2005a). Bowers' (2005a) research suggests that bias and prejudice are common among education and healthcare professionals precisely because issues like racism and homophobia are inherent within cultural ways of knowing. ...
Identity and embodiment are central issues facing Aboriginal people. These issues are explored as sites of multiple meanings and associations related to prejudice and healing. Examples are chosen in the forms of racism and homophobia. Healing of identity is explored from the perspective of indigenous practice in wholistic and traditional Aboriginal medicine. Also, education and counselling are used as sites of inter-cultural dialogue. Models of healing in identity are proposed that rely on prior research, cultural awareness, and professional practice in counselling and education.
A substantial body of research documents high rates of mental health problems in rainbow communities, however little is known about the experiences of rainbow young people who access mental health support in New Zealand. Here, we present analysis of quantitative survey data from 955 rainbow and takatāpui rangatahi (aged 14–24) collected in collaboration with rainbow community organisations. We find that rainbow rangatahi report mixed experiences in mental health settings and commonly worry about discrimination and lack of knowledge on the part of mental health professionals. We also report significant differences in mental health support experiences based on a range of demographic variables, including gender, intersex status, age, location, and ethnicity. Finally, we consider a range of actions mental health professionals can take to improve service provision, and how these findings can improve the quality of mental health support for Aotearoa’s rainbow rangatahi.
Through a field experiment set among licensed therapists (N = 425), we found nuanced evidence of heterosexist discrimination at the entry point of mental health services for a fictitious White, presumably gay man seeking counseling. We called therapists in LGB-affirming and LGB-hostile states and left voicemails requesting services. To manipulate perceived sexual orientation, a confederate using the name “Jon” recorded one of three conditions (a) heterosexual-presenting Jon, (b) gay-presenting Jon, and (c) gay-sounding Jon. Analyzes comparing the rate of returned calls for each condition within LGB-affirming versus LGB-hostile states against our referent group, gay-presenting Jon calling mental health professionals in an LGB-affirming region, revealed a number of significant effects. Notably, being perceived as gay in LGB-hostile states significantly decreased the rate of returned calls, with the reverse being true in an LGB-affirming state. The use of “gay-sounding” voice, however, did not appreciably affect these relationships.
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Monografia rozpracováva problematiku homosexuality a homofóbie v kontexte sociálnej práce a je členená do piatich kapitol, ktoré sú venované jednotlivým oblastiam týchto javov. Autori v úvode popisujú fenomén homosexuality nielen v súčasnom ponímaní, ale zameriavajú sa aj na historický kontext postavenia homosexuálov v spoločnosti. Neoddeliteľnou súčasťou identity každého človeka je sexualita a sexuálna orientácia, ktorej definovanie je pre pochopenie formovania neheterosexuálnej identity, aj v prostredí sociálnej práce v praxi s LGBT+ jedincami a komunitou, kľúčové. Proces coming outu (vnútorného i vonkajšieho) je v živote homosexuálnych jedincov často sprevádzaný krízovými situáciami a sociálno-patologickými javmi, preto autori sumarizujú jeho najčastejšie teoretické modely. Samostatná kapitola je venovaná konceptom heteronormativity a heterosexizmu v sociálnych súvislostiach. Okrem iného sa zaoberá aj formovaním postojov z hľadiska náboženstva a maskulinity, ako dvoch výrazných faktorov sexuálnych predsudkov. Dôsledkom heteronormativity, negatívnych stereotypov, predsudkov a iracionálnych postojov je homofóbia, ktorá má negatívny dopad na životy neheterosexuálnych jedincov. V poslednej kapitole autori predkladajú vybrané teórie kritickej sociálnej práce, načrtávajú prístupy k LGBT+ klientom a ponúkajú podnety k eliminácii homofóbie v prostredí sociálnej práce.
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One of the Boys: Masculinity, Homophobia, and Modern Manhood takes a fresh look at the formation of modern male sexual identities. You will find that homophobia is not only widespread, but that it takes diverse forms and has far-reaching behavioral and social consequences. The new concept of “homophobic passage,” which is part of the development of all young men, will enlighten you as to the proposed “causes” of homosexuality and heterosexuality. One of the Boys will help you discover how the passage of young males from childhood to adulthood plays an important role in formation of the modern adult male self in gay and straight men. As a result, this knowledge will allow you to offer relevant services to clients who are struggling with societal stereotypes and identity issues. From this informative book, you will discover how homophobia plays a role in the increase in violence experienced by gay men and lesbians in our culture today. To help you offer improved services, One of the Boys discusses why homophobia is widespread, takes diverse forms, and has far-reaching behavioral and social consequences by: examining the school playground and its many effects on children’s peer groups to discover how profoundly names like “crybaby” and “poofter” can impact a child’s development learning that children often cannot escape harmful labels and stereotypes at home and realizing how it impacts a child’s developing sense of self discovering the media’s influence on role models and realizing the important role television and magazines play in providing information about homosexuality and homophobia realizing the heavy pressure homophobia exerts on men and how it shapes their relationships with women and other men, how emotionally close they allow themselves to get to people, how affectionate they are, and with whom they have sexual relations Through One of the Boys, you will gain valuable insight into the masculinity of the men interviewed and how it was shaped in order for you to develop a greater understanding of men and the many influences of society as a whole. This unique study investigates the development of homophobia and the meanings and significances people associate with it to help you understand how and where homophobia originates in our society.
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We addressed four components of attitudes toward gay men and lesbians: condemnation/tolerance, morality, contact, and stereotypes. We hypothesized that attitudes would vary by component and by the sex of the person being rated. Results indicated that men (n = 137) held more negative attitudes toward homosexuals than did women (n = 133) on all factors except stereotypes, and that attitudes toward gay men were more negative than were attitudes toward lesbians on all factors. On all subscales except stereotypes, men rated gay men more negatively than lesbians. Women rated gay men and lesbians similarly on the condemnation/tolerance subscale and the morality subscale, but rated lesbians more negatively on the contact subscale. The results confirm that to understand sex differences in attitudes toward homosexuality fully, researchers must consider both attitude component and the sex of the person being rated.
This study examined the nature of therapist–client interactions within and across seven psychotherapy cases (a) to test whether therapeutic outcome is a function of a transition from relational incongruence to relational congruence (S. Strong, 1982), and (b) to investigate the relation of relational congruence and control to qualitative aspects of the therapy relationship and to therapy outcome. Measures of therapist and client response patterning served as indices of relational congruence and of relational control. Relationship quality was assessed in terms of therapist and client ratings of their working alliance and of therapy session depth and smoothness. Outcome was operationalized in terms of symptom reduction. Results showed limited support for a relationship between relational congruence and therapy outcome and suggested that relational control is not a significant factor in client or therapist evaluations of relationship quality or therapy outcome.
A 3-dimensional model of therapeutic control was hypothesized and examined. The model posited that control indices can be adequately described by 3 independent dimensions: intrapersonal definitions vs interpersonal definitions, form definitions vs effect definitions, and behavior vs perceptions. Meetings of 26 clients with 1 of 14 therapists were audio recorded, and each participant was requested to fill out control questionnaires after a middle session of therapy. The audiotapes were rated with 5 different control-coding schemes, and the resulting sequential ratings were aggregated with 3 different methods, yielding 15 different behavioral-control indices. The correlation matrices of these 15 behavioral-control indices and 3 perceived-control indices were subjected to multidimensional scaling and cluster analysis. The results are supportive of the hypothesized model and the relative independence of behavioral and perception definitions of control. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
This study examined (a) male and female counselors' countertransference (CT) reactions to lesbian and heterosexual client actresses and (b) the role of counselor homophobia and CT management ability in CT reactions. Sixty-seven counselors viewed a videotaped client actress in 1 of 2 conditions: lesbian or heterosexual. The client discussed sexual problems within a stable relationship. Counselors responded to the taped client at 8 points. CT, the dependent variable, was assessed at behavioral, affective, and cognitive levels. Contrary to prediction, counselors did not exhibit more CT with a lesbian client. As hypothesized, (a) counselor homophobia correlated with counselor avoidance behavior in the lesbian condition and (b) female counselors had greater recall problems than male counselors with the lesbian client, whereas male and female counselors had equivalent recall with the heterosexual client. CT management ability was uncorrelated with CT reactions in all but a few instances.
Research examining therapists' sexual feelings toward their clients is limited, and there is minimal information on graduate training regarding how to cope with such feelings when they arise. We examined the training practices of counseling psychology programs, with regard to preparing students to deal with sexual feelings toward clients. We also examined the perceived adequacy of this training by practicing graduates of these programs. Results show that although most programs report addressing this issue (generally in practicum), only about half the practicing graduates of these programs report receiving such training; and of those, only 60% report it as adequate. Implications for training are discussed.