This article offers suggestions and resources for infusing information about working with gay, lesbian, and bisexual clients into a counselor education curriculum or for use in one's professional development as a counselor. Information is provided for core counseling areas and clinical instruction.
The literature has consistently shown that graduate counseling programs are not adequately preparing students to work with gay, lesbian, and bisexual clients (e.g., Buhrke, 1989; Glenn & Russell, 1986; Graham, Rawlings, Halpern, & Hermes, 1984; Thompson & Fishburn, 1977). More recently, Phillips and Fischer (1998) found that most of the advanced-level students whom they surveyed reported that their programs had not prepared them to work with gay and lesbian clients and had prepared them even less well to work with bisexual clients.
Unfortunately, this lack of training is not benign. Glenn and Russell (1986) found that 83% of the counselor trainees whom they examined exhibited bias by responding to an ambiguous client simulation with the assumption that the client was heterosexual even though no information about sexual orientation was provided. In another analogue study, participants made a greater number of recall errors when processing information about gay or lesbian clients than when processing information about heterosexual clients (Casas, Brady, & Ponterotto, 1983). Hayes and his colleagues (Hayes & Erkis, 2000; Hayes & Gelso, 1993) found that, overall, therapists had rather low levels of homophobia; however, when homophobia was present, it predicted negative responses toward clients in analogue situations. Wisch and Mahalik (1999) found that male therapists high in gender role conflict reacted negatively to angry gay clients, whereas male therapists low in gender role conflict reacted positively to gay clients in response to randomly assigned vignettes.
In a review of programmatic research on therapeutic outcomes with lesbian, gay, and bisexual clients, Bieschke, McClanahan, Tozer, Grzegorek, and Park (2000) concluded that, although counselors tend to report lower levels of homophobia than the general public, heterosexist attitudes do interfere with their clinical behavior with this population. This may be reflective of the mixed attitudes Rudolph (1988) discussed in his earlier review. He suggested that counselors seem to be influenced both by the generally affirmative stance of the counseling profession and by the more biased attitudes of society in general. He speculated that counselors who believe they are open and affirmative, yet are still influenced by heterosexist societal norms, may lead to a potentially more dangerous situation than overt homophobia, for which clients can more easily screen when seeking counseling. In their evaluation of a seminar course on counseling gay, lesbian, and bisexual clients, Matthews and Selvidge (2002) reported significant positive changes in counseling competence with this population among students who took the course. These changes did not occur with students enrolled in a general multicultural counseling course or an advanced clinical techniques course. This suggests that conscious and deliberate training in working with this population can be beneficial. At the same time, it is not always practical for programs to offer an entire course devoted to this topic. The multicultural literature indicates that infusion of multicultural material into courses throughout a curriculum can be an effective and important way to train students in this critical area (e.g., Bowman, 1996; Ponterotto, Alexander, & Grieger, 1995). The purpose of this article is to encourage infusion of material regarding gay, lesbian, and bisexual issues into core counseling courses in a counselor education curriculum by providing information and resources for doing so. This material might also be useful for practicing counselors seeking professional development in working with this population. …