Diversity Issues in Marriage and Family Therapy

Table of Contents

Professional interaction with clients is a priority concern for a practicing counselor (Lyons, 2010). Competency creates an ease in the way a therapist interacts and builds a professional relationship with a client. Cultural diversity of the clientele may pose a challenge to counselors and put the competency of therapists to test ((Adams, Jaques, & May, 2004). Therefore, therapists must gain exposure and knowledge of diverse cultures and subcultures, in order to take pressure off their practice and be competent counselors. The complex nature of the issue of cultural diversity is more notable in no culture than the gay community. In the recent past, the world was an environment in which a homosexual tag constituted a psychological diagnosis.

Gays and lesbians in such environments are a social anomaly.Psychologists and marriage counselors must remain cognizant of the complex and unique needs of gays, lesbians, and bisexuals (Davison, 2001). The atmosphere of stigma and alienation eased a bit in 1975 when the American Psychological Association made a declaration that homosexuality does not constitute an impairment of stability, judgment, reliability, or social capabilities (Conger, 1975). The American Psychological Association urged therapists in dissociating homosexual orientations from mental illness (Ibid). In this paper, I address cultural diversity concerns with a focus on the ethical issues relevant to the application of marriage and family therapy in cases that involve gay men.

Relationships and Families.

The ethical concerns surrounding gay individuals have a basis in both the professional context and foundation of social action (Adams, Jaques, & May, 2004). However, the issues are crucial in the effects on the individuals themselves and their friends and families. It is a concern that therapists neglect to address these challenges. Therapists should promote the open acceptance of homosexuality among friends, parents, and families. In this regard, therapists should avoid changing the sexual orientation of clients. Gay men who seek a conversion therapy do so because of the desire to escape from discrimination, hostility, and self hate coming from homophobic pressures in society (Lyons, 2010). Mental health professional strengthens societal stigma and bias against same-sex sexual orientation by condoning or providing sexual conversion therapy. There is a negative relationship psychological distress and low self-esteem among persons presenting with homosexual orientation. Low self-esteem results from internalization of discrimination and societal bias due sexual preference.

Stigmatization

It is a guideline of the American Psychological Association that social stigmatization is a risk to the well-being and mental health of gay clients (Hein & Matthews, 2010). Gay men face stigmatization in the form of social violence, discrimination, and prejudice. Living in a society that is heterosexist precipitates a significant level of stress for gay men, lesbians, and bisexual people. Basic forms of stigmatization based on sexual minority status include hassles such as exposure to anti-gay jokes (Lyons, 2010). However, others take the form of serious, negative life events such as loss of home, employment, and custody of children; anti-gay violence; and discrimination due to same sex preference (Ibid). In relation to research information, gay men are likely to develop emotional distress and mental health problems as a direct outcome of social, negative experiences. Gay men lack legal rights and protection during medical emergencies (Davison, 2001). They also lack acknowledgement of couple’s relationships especially in case of a loss of a partner. These factors promote the feeling of depression, helplessness, isolation, and vulnerability. These are social stress factors that promote substance abuse, prostitution, academic problems, and suicide (Hein & Matthews, 2010).

Appropriate Language

Lyons (2010) asserts that it is imperative that a counselor use professional language free of a heterosexist bias. Therapists should create a treatment atmosphere in which clients feel comfortable talking about sexual orientation issues that otherwise constitute taboos (Davison, 2001). These are stress factors that persons with same sex preference face at many social instances, in the community. It is vital for counselors to adopt the language of the client in terms of how they interact and address their partners (Conger, 1975). There are language terms, which gay men, bisexual and lesbian people use in reference to their partners or relations.In my experience of interacting with persons with same sex preference, terms such as boyfriend, girlfriend, husband, wife, or partner are common in reference to their same sex partners.

Therapists should adopt the language and manner in which gay men address themselves and their relationships. In playing to their tune, friends open up and identify themselves as partners in the long term same sex unions or relationships. They will declare their role in the relationship as to whether they are a husband, wife, boyfriend, or girlfriend. However, they can only open up when they perceive the therapist as comfortable and lacking heterosexist bias. It is, therefore, extremely essential that a counselor takes the initiative to build trust and communicate with the client on a level that ensures comfort (Hein & Matthews, 2010).

Conversion Therapy

It is vital to consider the ethical implications of the use of conversion therapy in psychological treatment of gay men (Adams, Jaques, & May, 2004). Conversion therapy is the perspective of treatment that a person who has a same sex preference can change to heterosexual preference through application of therapeutic measures (Davison, 2001). Gay men are truly free from homosexuality if they can engage comfortably in lasting heterosexual relationships. At this moment, it is vital to recall that same sex preference is not a mental disorder. The society still subscribes to the belief that becoming gay is a choice that people make. Many people find themselves in denial of their homosexual nature (Hein & Matthews, 2010). In fact, people often deny that they are gay men and try the entire lifetime to change to be heterosexual or straight, a common term in society.

People deny their nature and marry only to find that their marriage with heterosexuals cannot work. Gay men do this in a bid to satisfy the society and religion (Adams, Jaques, & May, 2004). Gay people have an inner feeling to remain what they are, but choose to go through years of emotional torture, depression, suicide attempts, a secret gay affair while in heterosexual unions imposed on them by society.In many cases, forced marriages end in divorce following revelation of secret affairs and non heterosexual behavioral expressions (Davison, 2001). It is at such points that they acknowledge their sexual nature and seek counseling. I have experience with one such case who revealed the distress that he experienced in a heterosexual marriage.

However, he felt he would continue to pretend to be heterosexual because that is what the society considers ideal regardless of the lack of happiness and comfort. Their nature cannot allow them to fantasize about women and invest in heterosexual unions emotionally (Lyons, 2010).Therapists must be aware of the extent to which gay men go just to impress the society, in showing that they are “straight”. They attend church and prayers hoping that they would change, but does not work for many of them. In the general view, conversion therapy may not be effective with statistical data suggesting an 11 to 37 % success range (Ibid). Conversion therapy involves some form of exorcism, electrical shock, desensitization, and others. In most cases, the results are depression, anxiety, sexual dysfunction, lack of self-confidence and self-efficacy, shame, self-destructive behavior, guilt, and suicide (Hein & Matthews, 2010). The results are catastrophic and require counseling.

Conclusion

Therapists face difficulty identifying gay marriages, attitudes, personal beliefs, and negative social, political climate (Adams, Jaques & May, 2004). However, these obstacles can be overcome. Therapist need to understand how to construe the problems of gay men and related dangers of stereotyping. Issues to address are social and sexual identity, family support, social invisibility, and the need for a broad perspective of community psychology. Homosexuality does not imply a mental illness. It is not ethical to portray gay men, bisexuals, and lesbians as mental cases in need of medical attention (Davison, 2001). Therapists must not condone discriminatory practices based on sexual preference. It is also a vital requirement that psychologists obtain informed consent appropriately and provide accurate information to clients regardless of sexual orientation. Counseling environment should be neutral, professional, and free of social bias.

References

Adams, J., Jaques, J., & May, K. (2004) “Counseling Gay and Lesbian Families: Theoretical Considerations” The Family Journal, 12(1): 40-42.

Conger, I. (1975) “Proceedings of the American Psychological Association, 1974” American Psychologist, 30(1): 620–651.

Davison, G. (2001) “Conceptual and ethical Issues in Psychological Therapy for bisexuals, gay men, and lesbians” Journal of Clinical Psychology, 57(5): 695-704.

Hein, L. & Matthews, A. (2010) “Reparative Therapy: The Adolescent, the Psych Nurse, and the Issues” Journal of Child & Adolescent Psychiatric Nursing, 23(1): 29-35.

Lyons, H. (2010) “Ethical Practice with Lesbian, Gay, and Bisexual Clients” Professional Psychology: Research and Practice, 41(5): 424-429.

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