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Providing Therapy for LGBTQ+

One of the essential elements to a successful therapeutic relationship is feeling comfortable and safe with your therapist and in the therapy environment. We strive to create this space at Drishti Bend for anyone who is seeking mental health counseling. Our providers all have specialties and populations that they best serve. We also spend ample time in advanced training and furthering our education to help underserved populations. Alison Pleiman is one of our counselors who works with LGBTQ+. Why is this important? Studies have reported that this population utilizes mental health services 2.5 times more than heterosexuals. There is a need, and we are here to provide for LGBTQ+ adults and youth. We sat down with Alison to learn more about how she creates a healthy therapeutic relationship.

Why did you specialize/train for therapy with the LGBTQ community?

Before moving to Oregon, I was living in Southern California, where I worked in residential treatment for substance use and co-occurring disorders for LGBTQ+ adults. This was a really eye-opening experience to be able to work in one of the very few treatment programs in the entire country that caters specifically to LGBTQ+. Working there gave me a closer look into some of the unique challenges facing this population, historically and presently; it gave me the opportunity to join people on their journey to heal from trauma and abuse, so much of which is inflicted by social discrimination in today’s society. It gave me deep appreciation for the resilience of this community and made me want to be an ally and an advocate; and it magnified how much of a need there is for specialized services for LGBTQ+.

After completing my Master of Social Work from USC, I became highly motivated to expand my training efforts so that I’d be better equipped to provide effective culturally sensitive treatment, which is also why I’ve remained committed to continuing my education postgraduate with additional courses around clinical issues and treatment strategies for LGBTQ+ youth and adults. My passion and my drive for this work have been predominantly shaped by the relationships I’ve been fortunate to build with members of this community, both personally and professionally.

What did you glean from these courses?

The information was all encompassing of the complete therapeutic experience; from terminology that is helpful or damaging to exploring the impacts of heterosexual privilege on LGBTQ+ clients. We also learned about specific topics that might be brought up in therapy: the coming out experience, transgender development, bullying, trauma, and PTSD. To be an ally and to be the best counselor for anyone, it’s imperative I am equipped to talk about these topics to support others through any journey. The LGBTQ+ community is no different.

How do you strive to make therapy comfortable for someone in this community?

As a clinician, I think it’s crucial to make no assumptions, practice with humility and curiosity, exhibit no judgment, and extend compassion and empathy with utmost sensitivity and respect. I utilize a strengths-based approach and positive psychology to help foster self-acceptance, self-love, pride, and resilience.

I also strive to create an open and safe plan to affirm someone’s narrative, whether they know exactly who they are and what they want or if they are questioning some things and unsure of what’s going on inside them. Sexual orientation and gender identity are to be treated as spectrums, more fluid than fixed, as with any personal growth or healing, so it’s important to fully embrace that mindset with clients.

Most importantly I continue to utilize clinical interventions that are both specialized for specific needs of this population and individualized to validate and honor each person’s unique experience.

How can a loved one help someone of the LGBTQ community who is struggling?

At a base level, it’s about awareness, education, and support. But I also want to emphasize the importance of compassion, respect, acceptance, and willingness to learn. There’s a lot that loved ones can do by starting with themselves. Consider one’s own biases and privilege tied to their own upbringing. Be sensitive to microaggressions, which are the everyday encounters of subtle discrimination that marginalized groups experience, and broaden their understanding of what these can be.

Most importantly, ask their loved ones about their experience. Open dialogue is crucial. This may mean summoning the courage to have important conversations that can be difficult or uncomfortable, for example asking someone if they are thinking about suicide. Also, I think a lot of times there is a tendency to put too much emphasis on the sexual piece, which can be awkward and intimidating to talk about, especially for loved ones. So rather than avoiding those opportunities to engage, I think there needs to be more focus on the identity piece. That’s to say, rather than overly fixating on the physical, it’s important to really honor the psychological, social, and even spiritual elements of the LGBTQ+ person’s experience as well.

How can therapists be more accessible for this population?

First, it’s important to clearly communicate that you are an LGBTQ+ affirming practice. It’s something that needs to be advertised explicitly to eliminate any doubt for potential clients. The rainbow flag can convey this support as well. Another step towards establishing inclusivity is displaying pronouns to reinforce that we do not make assumptions about gender identity. Taking measures to ensure intake assessments, screening measures, and other documentation used in practice is also affirming for clients of this population. And of course, normalize therapy. It’s just like going to the gym, but for your brain.


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