Virtual Field Experience Paper

To expand upon Sue and Sue’s (2003) three primary categories of awareness, knowledge, and skill that are foundational to practicing culturally competent counseling, I believe for myself I will need to further process, explore, and ultimately find peace with multicultural issues I have encountered in my life and continue to struggle with. Often times I don’t like to go there with myself in my thoughts, feelings, and words because it makes me feel weak, less than, or other. My personal negative experiences of being pigeonholed a deviant when it comes to sexual orientation and variant with gender roles by society at large is something I am constantly reminded of and experiencing. Living as I am in a heteronormative society that operates with a sexual dichotomy has an

Appleby, G A., & Anastas, J.W. (1998). Not just a passing phase: Social work with gay, lesbian and bisexual people (pp. 3–43, 44-75). New York: Columbia University Press.

Sexual and social stigmas largely affect the health of the lesbian, gay, bisexual and transgender (LGBT) population. While many reports from the Institute of Medicine, Healthy People 2020 and the Agency for Healthcare Research and Quality recognize a need to improve the quality of health care, barriers still remain. LGBT patients face legal discrimination, especially with insurance, a lack of social programs, and limited access to providers competent in LGBT health care. Although the Affordable Care Act increased access to care for LGBT patients, unless these patients feel understood by providers and develop trust in the system, they are not likely to utilize care. Healthcare providers need to recognize how these vulnerabilities, as well as persistent racism and stigma linked to sexual orientation and gender identity, make the healthcare needs of LGBT patients more challenging than the general population. Healthcare providers also need to promote cultural competence within this population and broaden their clinical lens to include health promotion, in addition to addressing concerns mentioned above within the population. Additionally, medical and nursing schools need to ensure that future providers are adequately educated by including information about this population in the curriculum.

Disclosing the details of one’s sexual orientation and activity, both in public and in a healthcare setting, is not easy. Some hide these pieces of information because they feel guilty, ashamed, or afraid of the judgement from others. There was a time when I asked a patient what the genders of his partners were. After a moment of hesitation, he eventually felt comfortable enough to tell me that he had sex with women and men. His hesitation shows the difficulty of sharing one’s sexual preferences, but by disclosing this information, he allowed me to accurately assess his risks and made sure proper tests were

The study spanned 45% of LGBT physicians in the Gay and Lesbian Medical Association and a select number of heterosexual, non-transgender physicians in the American Medical Association (AMM). Of the male physicians in the AMM, only 65% felt comfortable working with MTF patients, and 64% felt comfortable working with FTM patients (Eliason et al., 1363). The female physicians in the AMM came in with slightly elevated numbers: 66% felt comfortable working with MTF patients, and 69% felt comfortable working with FTM patients (Eliason et al., 1363). These numbers are relatively low when compared to comfortableness levels of physicians working with LGB patients. This can generally be expected, as society has had more time to grow accustomed to LGB individuals, and thus most physicians are more comfortable when practicing with LGB patients, with an average comfortableness rate of 92%, 93.5%, and 91.25%, respectively (Eliason et al., 1363). A physician’s uncomfortableness levels with MTF and FTM patients can be related to unacceptable behaviour such as denying of patient referrals and accusation of “unethical behaviour” (Eliason et al., 1365). Non-conventional gender and

In the beginning of the paper we talked about sexuality and what it means. When talking about sexuality in this reference refers to type of gender that they are sexuality attracted to. This is where a person can self-label themselves as bisexual, gay, lesbian, or straight. Dealing with a client sexuality and the gender that they self-identify with can create and help the counselor establish a rapport with the client. Being able to distinguish these two apart from each other will give the councilor the ability to have an effective goal for the client.

Mathieson, C. M., Bailey, N., & Gurevich, M. (2002). Health care services for lesbian and bisexual

No matter the individuals’ circumstances, the person in need of counseling has no particular face, body, or sexual preference. Despair has no bias. As reported by the United States Census Bureau (2015), there is over 3 million people in America, and of those people “at least eight million adults identify as gay, lesbian, or bisexual” (Advocate, 2011). These numbers represent a demand that will be in our population for counseling, and with that must emerge new and innovative ways of therapy integration. As we continue to research and discover more about lesbian, gay, bisexual, transgender (LGBT), we as counselors will be able to seek out resources, training, and experience when working across the sex and gender barriers. Although we have an estimate of the population of individuals who define themselves to be a part of the LGBT community, there are only more individuals who are feeling confused and are harboring sexual attractions and behaviors within. This knowledge is imperative to grasp in the counseling profession because many individuals may not feel open enough to talk about such new controversial issues. A clear understanding of what the Lesbian, Gay, Bisexual, and Transgender community undergoes is the first step in becoming competent enough to providing a positive moving cross-cultural experience for both client and counselor. According to AMCD Multicultural Counseling Competencies, “Culturally skilled counselors should familiarize themselves with relevant research and the latest findings regarding mental health and mental disorders that affect various ethnic and racial groups. They should actively seek out educations experiences that enrich their knowledge, understanding and cross-cultural skills for more effective counseling behavior”

The purpose of this paper is to inform the reader on how gender identity with sexuality pertains to multiculturalism in counseling. The key points in this composition will consist of what is gender identity and sexuality. How society has played its part in the introduction and awareness of gender identity with sexuality. As well as, how social media sites such as Facebook, Twitter, and etc., news feeds from local and international, and how the community has affected an uproar with gender identity with sexuality. In a counseling session how is a councilor supposed to help those with gender identity crisis, their sexuality, and those who went through the transitions of becoming a different gender. Furthermore, how can a counselor help those who

This correlates with the implications for clinical practice depicted in Derald Wing Sue and David Sue’s Counseling the Culturally Diverse book on theory and practice. Given that the scenario takes place within an LGBQT community, one must consider that mental health issues may result from stress attributable to prejudice and discrimination due to the internalized homophobia portrayed in society. Clients in this community face many struggles during their coming-out process because of the lack of support from their family, peers, or community support. This leads to experiences of sexual victimization, as may be the case represented in this scenario, which may result in substance abuse. As a counselor, one must be aware of these ethics and empathize that they may be dealing with rejection and marginalization from the LGBQT community (Sue & Sue, 2016). As a result, these allegations for clinical practice relate to the reason why our values and biases should not be imposed on the client, instead we should meet the client where they are at so that we can

“The exiting heterosexual identity process requires a realization that one’s feelings and attractions are not heterosexual as well as informing others that one is lesbian, gay or bisexual. Developing a personal LGB identity status involves determining for oneself the unique meaning being gay lesbian or bisexual will have in one’s life. Developing an LGB social identity consists of creating a support network of people who know and accept one’s sexual orientation. Becoming an LGB offspring involves disclosing one’s identity to parents and redefining one’s relationship after such disclosure. Developing an LGB intimacy status is the process of establishing an intimate relationship. When individuals enter an LGB community they make varying degrees of commitment to social and political action” (Evans et al, 2010). It’s important to note that individuals can experience any of these phases at any given time during one’s life.

Maria’s presenting problem involves coming out as a lesbian to her homophobic extended family members. This client’s inability to comfortably come out calls for an approach that is not only goal-oriented in nature, but simultaneously culturally component in its approach to minorities. Solution-focused brief therapy is a therapeutic intervention that emphasizes formulating solution strategies for an individual’s problems opposed to discussing the origin of the problems themselves (de Shazer et al., 1986). That is, focusing on how to resolve problems using solution strategies will implement an overall change of the original problem (de Shazer et al., 1986). The process of focusing on the future, and not the past, is in opposition to other therapeutic techniques that focus on problems using a retrospective procedure (Hepworth, R.H. Rooney, G.D. Rooney, & Strom-Gottfried, 2017).

The study drew its findings from 179 counsellor participants from The Northeast, mid-Atlantic, mid-south and Northwest America. Of these participants, 60.4% identified as women, 37.4% identified as men and 2.2% was missing data. The sample was predominantly heterosexual (81.9%), with 6% identifying bisexual, 9.3% gay or lesbian and 2.7% not responding. Potentially, these percentages might be said to present a gender and a sexual orientation bias within the study. However, the gender bias could be said to be to be proportionately representative of the lower ratio of male to female counsellors (Carey, 2011), but this rationale is not explored by the authors. Neither do the authors account for the percentage of heterosexual to GLB

The development of a lesbian, gay, or bisexual (LGB) sexual identity is a complex and often difficult process. . . most LGB individuals are not raised in a community of similar others from whom they learn about their identity and who reinforce

Another countertransference issue that may arise when counseling this couple is that this therapist is inexperienced treating lesbian couples. The Lesbian community is a minority population that this therapist has little knowledge on providing culturally competent services for. This therapist may over-think statements before doing them because of the fear to be culturally inappropriate. A stereotype that this therapist has about sexual minorities is that gender roles are binary, male and female, and even sexual minorities follow that gender binary. Because of that stereotype, this therapist might attempt to categorize the feminine and the masculine partner in the couple.