Twenty Years and Still in the Dark? Content Analysis of Articles Pertaining to Gay, Lesbian, and Bisexual Issues in Marriage and Family Therapy Journals
Clark, Wanda M., Serovich, Julianne M., Journal of Marital and Family Therapy
To what extent do marriage and family therapy journals address gay, lesbian, and bisexual issues and how does this coverage compare to allied fields? To answer these questions, a content analysis was conducted on articles published in the marriage and family therapy literature from 1975 to 1995. Of the 13,217 articles examined in 17 journals, only 77 (.006%) focused on gay, lesbian, and/or bisexual issues or used sexual orientation as a variable. Findings support the contention that gay, lesbian, and bisexual issues are ignored by marriage and family therapy researchers and scholars.
Homosexuality began to be depathologized by the American Psychiatric Association in 1973 when they officially removed this classification from their list of mental disorders (Bayer, 1981). The American Psychological Association followed suit in 1975 and adopted a resolution not to discriminate against gay, lesbian, and bisexual people. Interestingly, the American Association for Marriage and Family Therapy (AAMFT) has been one of the last mental health organizations to address sexual orientation. Not until 1991 did AAMFT include sexual orientation in the code of ethics: "Marriage and family therapists do not discriminate against or refuse professional service to anyone on the basis of race, gender, religion, national origin, or sexual orientation" (p. 2). Furthermore, just this year (1997) the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) included sexual orientation in its antidiscrimination clause. If the precedent of the accrediting organizations is any indication, this suggests that as a profession, marriage and family therapy may be sluggish in responding to and including gay, lesbian, and bisexual people both as therapists and as clients.
The omission of sexual orientation by the field of marriage and family therapy is disconcerting for many reasons. First, many members of AAMFT are gay, lesbian, or bisexual and are often isolated from one another. Typically, professional organizations are looked to by isolated groups as a means for support or information sharing. Hence AAMFT may be missing an opportunity to play a significant role in helping to bring gay/lesbian/bisexual marriage and family therapists together. Secondly, as professionals, marriage and family therapists are in an ideal position to respond to clinical issues of gay/lesbian/bisexual clients. Relevant concerns for these individuals include but are not limited to dyadic relationship issues, disclosure of sexual orientation to families of origin, parenting issues, and development of community and social support networks (Carl, 1990; Falco, 1991; Greene, 1994). Unfortunately, as Markowitz (1991) recently suggested, although gays, lesbians, and bisexuals are out of the closet, family therapists may indeed still be very much "in the dark" (p. 27).
The percentage of gay, lesbian, and bisexual people who seek mental health services ranges from 25% to 73%, rates which are two to four times higher than those for heterosexuals (Bell & Weinberg, 1978; Morgan, 1992; Rudolph, 1988). Chance alone would suggest that some of these people are seeking services from marriage and family therapists, and certainly those gay/lesbian/bisexual people interested in improving their relationships may seek services from marriage and family therapists. In a recent study by Green and Bobele (1994), a random sample of 457 clinical members of AAMFT indicated that 72% of the respondents reported that approximately one 10th of their practice involved gays and/or lesbians. Overall, 80% of the participants in this study treat gay and lesbian people. Additionally, Doherty and Simmons (1996) reported that only a little over 50% of the clinicians surveyed (N = 526, national random sample of AAMFT clinical members) felt competent to treat gay and lesbian clients. Taken together, these two studies indicate that marriage and family therapists do treat substantial numbers of gay and lesbian (and presumably bisexual as well, though this was not assessed in the above studies) clients, but at least half of the clinicians surveyed do not feel competent treating these populations. …