LGBTQ Clients in Today's World: Treatment Strategies for Gender & Sexual Identity Issues

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Aaron Testard, LMFT, LPCC Related seminars and products

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Aaron Testard, LMFT, LPCC, is a psychotherapist in private practice in Berkeley, California with nearly 20 years of experience. For 7 years, he served as Director of Clinical Programs at the Pacific Center for Human Growth, an LGBTQ counseling and support center where he designed and implemented psychotherapy services for individuals, couples, and families, 24 adult peer support groups, and an after-school youth program.

He also has trained and supervised numerous interns over the years, and has been an LGBTQ community mental health consultant for local clinics and organizations. Aaron has spent the majority of his career as an LGBTQ specialist, including time as an addiction counselor, a high school counselor, and a consultant for a felon re-entry program. In his current practice, he focuses on sexual and gender identity, working with adults, adolescents, and couples.

Aaron received his MA in Counseling Psychology from the California Institute of Integral Studies. He is a trained drama therapist, sensorimotor therapist, and practitioner of the Gottman couples method, EMDR, and DBT-informed client work. To learn more about Aaron, visit https://www.aarontestard.net/

Speaker Disclosure:

Financial: Aaron Testard maintains a private practice. He receives a speaking honorarium from PESI, Inc.

Non-financial: Aaron Testard is a member of the American Association for Marriage and Family Therapy; Gaylesta; World Professional Association of Transgender Health (WPATH); and Bay Area Open Minds

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Objectives

1. Appraise current trends and perspectives in the LGBTQ community, and the implications for clinical work.
2. Build safety and trust effectively with LGBTQ clients in clinical practice.
3. Analyze the main factors impacting treatment and the identity development process of LGBTQ clients.
4. Analyze the phases of identity development for LGBTQ clients to better inform treatment planning.
5. Integrate LGBTQ history and knowledge into the clinical session.
6. Determine treatment strategies to help clients in each phase of LGBTQ identity development.

Outline

Current Trends in LGBTQ Clinical Work

• Increased family and community acceptance: What this means for our work
• Sexuality and gender: separate but connected
• Polyamory and open relationships
• Conversion therapy debunked
• Online dating and hook-up culture

Establish Safety with LGBTQ Clients

• Terminology to include in website, business profiles, and client registration forms
• Avoid the most common mistakes by therapists that break safety and trust
• Build rapport quickly and effectively
• Talk about sex with openness and comfort
• Incorporate gender talk and knowledge into your vocabulary

The Factors That Impact LGBTQ Mental Health Treatment

• How being LGBTQ is connected to depression, anxiety, and addiction … and how it is not
• How developmental trauma affects identity development
• Particular traumas:
  • Bullying
  • Bashing
  • Institutional Oppression
  • Conversion Treatment History
• Family mirroring and acceptance
• Religious and cultural barriers
• Sexual health and wellness
• Alcohol and substance use

Help Clients at Each Phase of LGBTQ Identify Development

• Phase 1: Pre-Coming Out
  • Denial about sexual orientation or gender
  • When sexual behaviour doesn’t match sexual identity
  • Differentiate between feelings, behaviour, and identity
  • The importance of continued sexual health assessment and education
• Phase 2: Comparison and Consideration
  • When clients start to think they might be LGBTQ (or at least different)
  • Client cues that are openings to explore further
  • Questions to elicit more open discussion
  • How to inquire without pushing beyond client readiness
• Phase 3: Tolerance and Exploration
  • When clients are exploring sexuality and gender but have not claimed an identity
  • Use different models of sexuality and gender with clients
  • Track for integration: Is this helpful for the client?
  • Address shame and internalized homophobia/transphobia
  • Identify educational resources
• Phase 4: Acceptance
  • When clients start to integrate their sexual and gender identity into the world
  • Connect clients with community support
  • Facilitate grief for lost time and lost dreams
  • Develop a coming-out plan and process
  • Start talking about gender transition
  • Tools to navigate the conflicting worlds of family, identity, and cultures
• Phase 5: Pride
  • Address client rage about oppression and past injuries (even when it’s directed toward you)
  • Support clients in celebrating their “adolescence”: validation and safety
  • Attend to the particular challenges of bisexuals
• Phase 6: Synthesis and Integration
  • When being LGBTQ is hardly an issue for the client
  • Effectively integrate LGBTQ history and knowledge into the clinical session

Target Audience

• Counselors
• Social Workers
• Psychologists
• Psychotherapists
• Case Managers
• Marriage & Family Therapists
• Addiction Counselors
• Educators
• Nurses
• Other Mental Health Professionals

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