Many LGBTQI  people choose to go into therapy in order to find ways to deal with personal issues and improve their relationships. Regardless of why you’re starting therapy, as a consumer, it’s important to know that in spite of ethical guidelines, many counselors do not provide affirmative therapy.

First, I’d like to define what affirmative therapy is. Don Clark sums it up the best by saying that affirmative therapists may not be LGBTQI, but they believe that that their clients’ sexual orientation should not just be accepted but appreciated. Affirmative therapists know that while there’s no need to address the question of whether or not to be LGBTQI, clients may need help from their therapists to find ways to live up to their potential.

Many therapists do not adhere to these principles. It may be from lack of education and training, or perhaps is due to a therapist’s own homophobia. The following excerpt is from my book, “Affirmative Psychotherapy and Counseling.”

“We (co-author Dr. Melissa Johnson and I) have heard therapists tell us that there is no difference between providing therapy for gay/lesbian clients and heterosexual clients. Although the message these therapists were trying to send was that they are not homophobic, these same therapists didn’t realize that they were also conveying to us that they did not understand the complexities involved in working with issues unique to lesbians and gay men.”

For therapists who experience discomfort working with lesbian and gay clients, two studies point to a need for more education. Researchers found that the rate of dissatisfaction in therapy among LGBTQI respondents was twice as high as that of a heterosexual control group. Among the LGBTQI respondents who were women or members of ethnic minority groups, dissatisfaction rates for their therapists were four times higher than for the respective control groups.

In a second study, another researcher surveyed 242 substance abuse counselors. She found that substance abuse counselors had little formal education on lesbian and gay issues, as evidenced by misunderstanding the concepts of domestic partnership and internalized homophobia. More troubling, nearly half of the counselors had negative attitudes toward lesbians and gay men.

Be Aware of the Type of Therapist you’d Like to See

There’s a chance that you could start therapy with a therapist who is not comfortable with who you are. Also, people make the assumption that because a therapist is LGBTQ or I, s/he will have a better understanding of what you’re going through and therefore can provide better therapy. However, LGB therapists can have as much homophobia as nongay therapists. For example, LGBQTI therapists who live in the closet are more likely to work out their own issues in therapy (by that, I mean, they would suggest what’s best for themselves and not you) than those therapists who are out.

That’s why it is important to do some homework to find out if a potential therapist will see your sexuality -as all sexuality- as a gift. So, what can you do to try to limit the possibility of finding a homophobic therapist?

Some Trusted Resources for Therapy Referrals

One of the most reliable sources of information about a prospective therapist is friends. Ask them which therapist they’re seeing, what they like about him or her, what they don’t like, what s/he charges, etc.

If it’s not possible to ask friends for a referral to a therapist, consider the following: Call a few therapists to request a consultation, during which time you will can ask questions before starting therapy. During the consult, ask the therapists about their credentials and if they have experience working with LGBTQI people. Get a sense of how these therapists react to your questions. If you inquire about their sexual orientation, be prepared that some therapists have a legitimate reason to not answer that question. It may relate to do his or her way of approaching therapy, so don’t assume that s/he is in the closet, straight, or closed off if s/he doesn’t answer.

Fewer therapists are likely to answer the question “Are you in a relationship?” (but some will). If a therapist doesn’t answer a question, you can follow up with why s/he doesn’t want to talk about it and you should expect an answer to that question.

In the therapist’s office suite, look around for signs of gay-friendliness. In the waiting room, are there any magazines or other signs? In the therapist’s office, are there LGBTQI books on the bookshelf?

Once You’ve Begun Therapy

When in therapy, the focus should be on you most of the time and not be on the therapist or his/her problems. If, after two or three sessions, you’re not comfortable about opening up, mention this to your therapist. If you’re still not comfortable after another session or two, consider finding another therapist. If the therapist reacts non-defensively and you feel reassured, consider that a good sign.

You will naturally have feelings for your therapist, both good and bad. If they turn sexual (which is not uncommon), and you mention this to the therapist, his or her response is important. If he or she admits an attraction to you, you should stop seeing this therapist. And of course therapy never includes sex (ever! The reason for this is because of the “power differential” in the therapy room: Your therapist knows a lot about you, but you know very little about your therapist’s life. Therefore, the therapist has more power). That’s why therapists are bound by laws and ethics to prevent them from exploiting this power.

On the other hand, if your therapist explores your attraction and inquires if it gets in the way of therapy, it’s a good first step to moving past your attraction. If you can’t get past it after several weeks, consider seeking a referral to another therapist where this isn’t a problem.

In general, is the therapist supportive of your relationship status? Is he or she nonjudgmental about any arrangements you have with your other half regarding sex or with your choice of monogamy vs. nonmonogamy? Is the therapist nonjudgmental in general about of your life decisions? If so, these are other good signs. Therapy is a process that can take several months or even years, and it is a worthwhile journey, and it’s good to know that you’re in concerned, ethical hands along the way.