2. What is it?
 Affirmative Therapy:
• Recognizes the importance of minority stress.
• Seeks to assist in the development of a positive relationship with
their sexual orientation and challenge society’s attempts to
stigmatize them.
• The idea of homosexuality is not a psychopathology/mental illness.
(Bieschke, Perez, & DeBord, 2007) (Kort, 2008)

3. Application of LGBT Affirmative
Therapy
 Application of Affirmative Therapy:
• Children and adolescents—who present a desire to change either
their sexual orientation or behavioral expression of their sexual
orientation, or whose guardian expresses a desire for the minor to
change.
• Adults—who present a desire to change their sexual orientation or
their behavioral expression of their sexual orientation, or both.
(APA, 2009)

4. Delivering Ethical Affirmative
Therapy
 Delivering Ethical Affirmative Therapy:
• Do no harm and guard against conflicts of interest that would lead
to the misuse of professional influence.
• Helps clients to achieve their goals.
• Ensures the protection and safety of clients.
• Affirm issues related to sexual orientation.
(APA, 2002) (Aducci & Baptist, 2011)

5. Guidelines For Practicing
Affirmative Therapy
 To be an LGBT affirmative therapist:
• Avoid heterosexism by minimizing heterosexists assumptions and
constructs.
 A way to do this is by the therapist examining their own attitudes
and beliefs regarding sexual orientation.
• Awareness of their own identity development.
• Examine identity development from a minority and majority
perspective.
(Bieschke, Perez, & DeBord, 2007) (Herek, 1995, p. 321)

6. Guidelines For Practicing
Affirmative Therapy
 To be an LGBT affirmative therapist:
• Awareness of the oppression, discrimination, and prejudices the LGBT
community has faced and the stigma that is placed on their sexual
orientation.
• Good, working knowledge of sexual orientation identity development.
• Identify social and family support systems.
• Recognize that clients may experience a loss of heterosexual
privilege.
 Loss of Institutional, Legal, and Societal freedoms
• Create a refuge, a safe place. (Kort, 2008)
(Bieschke, Perez, & DeBord, 2007)

7. Guidelines For Practicing
Affirmative Therapy
 To be an LGBT affirmative therapist:
• Current on past and present issues and concerns facing the LGBT
population.
• Continuing education.
• Avoid assumptions: Origins of distress and reasons for treatment
are not always linked to sexual orientation.
• Honest and Open.
• Communicate affirmation with the client.
(Bieschke, Perez, & DeBord, 2007)

8. Guidelines For Practicing
Affirmative Therapy
 To be an LGBT affirmative therapist:
• Locate and learn about the local and regional LGBT community.
 Provides an opportunity for getting to know LGBT individuals
 Helpful in developing a more positive attitude toward the
community
• Provide client with resources and information.
• Understand the coming out process for the client and what stage of
identity development they are in.
(Kort, 2008) (Herek,

9. Creating a Refuge
 A Refuge—A place of temporary respite, where some of the
rules of society are suspended to allow for a different and
supportive social experience.
• An attitude that nurtures complex ideas about gender and sexual
identity.
• Suspend the rules of culture.
• Therapy becomes a haven to challenge cultural norms and
recognize what we know about self and others.
(Stone-Fish, & Harvey, 2005)

10. Heterosexism/Homophobia
 Be aware of Heterosexist Bias.
 Heterosexism/ Homophobia:
• The ideological system that denies, denigrates, and stigmatizes
any non-heterosexual form of behavior, identity, relationship, or
community.

11. Targeting Heterosexist/Homophobic
Countertransference
 According to Kort (2008), heterosexual therapists should asks themselves
the following:
• Do I question the origins of my clients’ gayness—if not aloud, then to myself?
• Do I assume that same-sex attractions have a pathological origin? Do I infer
etiology rather than developmental identity formation?
• Do I align with my client’s reluctance to admit being gay or lesbian?
• Do I think gays and lesbians should not tell other they are gay unless they are
asked?
• How do I really feel about legal and religious marriage for gays and lesbians?
• How do I really feel about gays parenting children?
• Do I agree with complaints from gay and lesbian clients that they gay
community is immature and too focused on sex and politics?
• How comfortable am I talking to 10- to 15-year-olds about the possibility they
are gay or lesbian? Do I assume they can’t really know their sexual orientation
at that age?

12. Positive/Negative Transference From
The Client
 As a heterosexual therapist, LGBT clients may display positive and negative
transference around coming out.
 Brief guidelines:
• Watch for the desire from client that they can be cured.
• Realize that you are standing in for the good, accepting parent.
• You may become the target of heterophobia.
• Teach them to vent appropriately and respectfully as you will likely a stand-in for all
heterosexists.
(Kort, 2008)

13. References
Aducci, C. J., & Baptist, J. A. (2011). A Collaborative-Affirmative Approach to Supervisory Practice. Journal of Feminist
Family Therapy, 23(2), 88-102.
American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American
Psychologist, 57, 1060-1073.
American Psychological Association. (2009). Report of the task force on appropriate therapeutic responses to sexual
orientation. Washington, DC: American Psychological Association
Bieschke, K., Perez, R., DeBord, K. (2007) Handbook of Counseling and Psychotherapy with Lesbian, Gay, Bisexual and
Transgender Clients, 2nd Ed. Washington DC: American Psychological Association
Herek, G. M. (1994). Assessing homosexuals’ attitudes toward lesbians and gay men. In B. Greene & G. Herek (Eds.),
Psychological perspectives on lesbian issues: Vol. 1. Lesbian and gay psychology: Theory, research, and
clinical applications (pp. 206-228). Thousand Oaks, CA: Sage.
Herek, G. M. (1995). Psychological heterosexism in the United States. In A. R. D’Augelli & C. J. Patterson (Eds.),
Lesbian, gay, and bisexual identities over the lifespan: Psychological perspectives (pp 321-346). New York:
Oxford University Press.
Kort, J. (2008). Gay affirmative therapy for the straight clinician: The essential guide. New York: W.W. Norton and
Company.