Course Spotlight: Interventions When Working With LGBTQIA+ People and Their Families

Over the summer, an impressive turnout for COUCN632—Interventions When Working With LGBTQIA+ People and Their Families reassured Sarah VanMattson, PhD that mental health clinicians-in-training understand this population has unique needs and crave the expertise to adequately meet them. Given the growing need for mental health leaders who can create, direct, and deliver high-quality services—in an effort to eliminate social disparities that exist in relation to access and quality of mental health care—this course is more timely than ever. 

“As clinicians, we have a huge responsibility to hold space for LGBTQIA+ folks who are currently worried about their ability to exist in the world,” says VanMattson, Assistant Professor in the Clinical Psychology Department, pointing to a very real fear that a rising percent of folks are experiencing at this particular moment in history. 

One in a trio required for those enrolled in the college-wide LGBTQIA+ Studies concentration, VanMattson’s course attracts a mix of students from the MA in Clinical Mental Health Counseling and PsyD in Clinical Psychology programs which makes for a collaborative and inclusive environment.

WHAT TO EXPECT

This course hinges on specific therapeutic approaches when working with members of the LGBTQIA+ community and their families. VanMattson begins with a broad discussion of treatment issues when working with this population, from disaffirming therapy and evidence-based professional practice to affirmative counseling. Subsequent class sessions delve into best practices for working with subgroups within the LGBTQIA+ population (e.g., gay men, lesbians, bisexual & pansexual people, transgender and gender non-conforming people, among others).

“Over time, we see generational differences when discussing the particular issues queer and trans people experience,” says VanMattson, emphasizing the shift required in working with them. Older queer folks who were forced to be largely invisible within communities several decades ago have different lived experiences than those who suffered prolonged loss and rejection during the AIDS epidemic, for instance.

When discussing  the bisexual umbrella, for instance, VanMattson begins with the specific issues and mental health struggles that bisexual folks might experience—from stigmatization and oppression to representation or lack thereof. A discussion of therapeutic lenses, including evidence-based practices that have been utilized in working with this subgroup, are also discussed. The family aspect is integrated into each class session.

“We try to focus on family from a bio and a found family lens, given the latter is so important for folks in the LGBTQIA+ community,” says VanMattson, of conversation that includes what it means to be affirming and how that fosters well being. Topics including self harm and suicidal ideation eventually arise as does the fact that both dramatically decrease when there's at least one person in the home who is supportive. Students also have a chance to explore what family therapy might mean for a given individual.

Two entire class periods are devoted to working with families. Issues range from what it means to come out to family to what it means to be a parent who is queer or trans. This year, VanMattson recentered the course around issues of social justice and understanding minority stress in an effort to shed light on the many ways folks who identify as LGBTQIA+ are being impacted by the current political climate. 

 The course culminates in each student creating a resource for use in the therapeutic space. Ideas run the gamut from training providers to work with folks experiencing marginalization based on sexual orientation as well as racial identity to revamping intake paperwork to help clinics be more inclusive. Recent student projects include a brochure for folks questioning their affectional orientation with education on asexuality and the vastness of that umbrella; a website for Muslim individuals who identify with the LGBTQIA+ community including tips on finding safe spaces and forging connection; and a parent-to-parent resource aimed at supporting kids’ gender identity development. 

“These hands-on, real-world projects help students dive into issues with which they were previously unfamiliar and want to understand better as well as those that reflect their own lived experience,” says VanMattson. Among students, only half of whom are enrolled in the concentration, class discussions build an environment of compassion and create a safe space for exploration.

CELEBRATING THE WINS

“There has been a long period of progress as far as being ‘out’ goes,” says VanMattson, pointing to the legalization of marriage equality rights in Massachusetts (2004) and nationwide (2015) which sparked a wave of LGBTQIA+ folks gaining visibility and finding community. National Coming Out Day is one such win.

Observed annually on October 11, #NationalComingOutDay was established in 1988 on the first anniversary of the National March on Washington for Lesbian and Gay Rights. This opportunity to support those individuals who identify as LGBTQIA+ and choose to live openly and authentically is a perennial reminder that for many folks, doing so is not always safe or easy.

“We understand now in the scope of minority stress that there’s still a whole lot of discrimination and rejection that queer and trans folks experience, within families and their communities at large, which ultimately impacts their well-being,” says VanMattson in a nod to what clinicians already know: Research consistently reveals that queer and trans folks experience some of the worst mental health outcomes within marginalized groups.

For VanMattson, who identifies as queer, a core component of working with the LGBTQIA+ population lies in creating a safe space to explore issues related to gender and/or sexual identity without assuming these issues alone led the individual to seek therapeutic support. As such, following the language of clients—and asking what their identity means to them—is key. 

LOOKING AHEAD

VanMattson remains certain that this course has been, and will continue to be, necessary in providing mental health professionals with the language, cultural sensitivity, and clinical competence required to deliver high-quality care to LGBTQIA+ populations. 

“As clinicians in the United States, we aren't required to receive any kind of training on LGBTQ issues in order to become licensed or to work with members of the population,” she says, pointing to the repercussions of folks being socialized and educated in a society that’s largely heteronormative.

“Research continuously tells us that therapists are failing their LGBTQ clients by not understanding who they are, what they need, and the uniqueness of their perspective,” says VanMattson, underscoring another important factor: Among LGBTQIA+ folks in families who are the sole individual to hold a particular identity, the stakes are even higher for alienation and misunderstanding. 

 These sobering truths have slowly given rise to a resounding question among VanMattson’s students: Why isn’t this training required? 

 From VanMattson’s perspective, goodwill only goes so far; what’s needed, she says, is a liberation lens.

“Our work must extend beyond the finite spaces in which we see clients,” says VanMattson, outlining ways in which all mental health practitioners can be therapeutically mindful. They include: advocating for LGBTQIA+ folks in the community at large; using one’s power and privilege to change the oppressive landscape for the populations we work with; and finding ways to empower those who sit with us, especially those who often lack power in the world around them.

“Without training, we fall into blind spots that can cause harm to the very individuals we are seeking to help.”

• Tags:
• Around Campus