Infusing lesbian, gay, and bisexual issues into counselor education.

This article offers suggestions and resources for infusing information about working with gay, lesbian, and bisexual clients into a counselor education curriculum or for use in one's professional development as a counselor. Information is provided for core counseling areas and clinical instruction.

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The literature has consistently shown that graduate counseling programs are not adequately preparing students to work with gay, lesbian, and bisexual clients (e.g., Buhrke, 1989; Glenn & Russell, 1986; Graham, Rawlings, Halpern, & Hermes, 1984; Thompson & Fishburn, 1977). More recently, Phillips and Fischer (1998) found that most of the advanced-level students whom they surveyed reported that their programs had not prepared them to work with gay and lesbian clients and had prepared them even less well to work with bisexual clients.

Unfortunately, this lack of training is not benign. Glenn and Russell (1986) found that 83% of the counselor trainees whom they examined exhibited bias by responding to an ambiguous client simulation with the assumption that the client was heterosexual even though no information about sexual orientation was provided. In another analogue study, participants made a greater number of recall errors when processing information about gay or lesbian clients than when processing information about heterosexual clients (Casas, Brady, & Ponterotto, 1983). Hayes and his colleagues (Hayes & Erkis, 2000; Hayes & Gelso, 1993) found that, overall, therapists had rather low levels of homophobia; however, when homophobia was present, it predicted negative responses toward clients in analogue situations. Wisch and Mahalik (1999) found that male therapists high in gender role conflict reacted negatively to angry gay clients, whereas male therapists low in gender role conflict reacted positively to gay clients in response to randomly assigned vignettes.

In a review of programmatic research on therapeutic outcomes with lesbian, gay, and bisexual clients, Bieschke, McClanahan, Tozer, Grzegorek, and Park (2000) concluded that, although counselors tend to report lower levels of homophobia than the general public, heterosexist attitudes do interfere with their clinical behavior with this population. This may be reflective of the mixed attitudes Rudolph (1988) discussed in his earlier review. He suggested that counselors seem to be influenced both by the generally affirmative stance of the counseling profession and by the more biased attitudes of society in general. He speculated that counselors who believe they are open and affirmative, yet are still influenced by heterosexist societal norms, may lead to a potentially more dangerous situation than overt homophobia, for which clients can more easily screen when seeking counseling. In their evaluation of a seminar course on counseling gay, lesbian, and bisexual clients, Matthews and Selvidge (2002) reported significant positive changes in counseling competence with this population among students who took the course. These changes did not occur with students enrolled in a general multicultural counseling course or an advanced clinical techniques course. This suggests that conscious and deliberate training in working with this population can be beneficial. At the same time, it is not always practical for programs to offer an entire course devoted to this topic. The multicultural literature indicates that infusion of multicultural material into courses throughout a curriculum can be an effective and important way to train students in this critical area (e.g., Bowman, 1996; Ponterotto, Alexander, & Grieger, 1995). The purpose of this article is to encourage infusion of material regarding gay, lesbian, and bisexual issues into core counseling courses in a counselor education curriculum by providing information and resources for doing so. This material might also be useful for practicing counselors seeking professional development in working with this population.

CORE COUNSELING AREAS

Professional Identity

Although it is important to infuse gay, lesbian, and bisexual issues throughout the curriculum, it is especially critical to address them in the context of professional identity. The American Counseling Association (ACA, 1999), the professional association with which most counseling programs are affiliated, has a long history of fighting discrimination and promoting affirmation of gay, lesbian, and bisexual individuals. It is important for students to be aware of this history and to be aware that such an approach to sexual orientation is part of their identity as professional counselors. The brochure Discrimination Based on Sexual Orientation: History of the American Counseling Association's Position (ACA, 1999) makes a useful handout and is readily available from ACA.

Another avenue for covering this topic is through discussion of ACA's branches and divisions. The Association for Gay, Lesbian, and Bisexual Issues in Counseling (AGLBIC) has been a division of ACA since 1997. AGLBIC (n.d.-a) currently publishes an e-journal and sponsors a listserv that serves as a resource for discussion and exchange of information. AGLBIC (n.d.-b) has also developed a set of competencies for working with this population that corresponds to core counseling areas. Distributing this information early in students' programs can help them to understand that attention to this issue is integral to their development as counselors as well as provide an opportunity for assessing their own needs for growth.

There are many opportunities for discussion of gay, lesbian, and bisexual issues in the context of ethics as well, both with respect to professional orientation and throughout the curriculum. Brown (1996) wrote a useful general chapter about the ways in which the concerns of nonheterosexual clients come into play with respect to the ethical codes of the various mental health fields. She provided a historical and contemporary review of ways in which sexual minorities can be harmed by discriminatory clinical practice and policy as well as potential countertransference issues that may pertain to both heterosexual and nonheterosexual counselors. Her chapter is helpful in providing a framework for incorporating these issues into ethics discussions throughout the curriculum.

Social and Cultural Diversity

This is the area in which lesbian, gay, and bisexual issues often are covered. Certainly it is important to provide due attention to this population; however, it is equally important not to simply allocate the standard one or several class sessions (either in a multicultural class or elsewhere) to these issues and then move on. It is critical that students have opportunities to be actively involved in developing multicultural competency with this population, as with others, including the breadth and depth of attitudes, knowledge, and skills described by Sue, Arredondo, and McDavis (1992). In addition to reading about gay, lesbian, and bisexual clients, it is valuable for students to have opportunities to know them and to learn about their lives, apart from clinical concerns. This is especially significant because many students may not have the opportunity to know when they do interact with this population as a hidden minority (Fassinger, 1991).

There are numerous ways in which it is possible to build such personal exposure to gay, lesbian, and bisexual people into the curriculum. Reading fiction or watching videos and then writing a reaction paper can provide a safe introduction that can be less threatening for students for whom this is a new experience. Students can also be encouraged to go into the gay, lesbian, and bisexual community and reflect on this experience. Especially in larger communities, there are a variety of activities that students can become involved with that might interface with their own interests (e.g., outdoor activities, game nights, church services and other spiritual activities, Alcoholics Anonymous groups, social clubs). Local gay, lesbian, and bisexual switchboards or student groups can be a source for learning about such programs. Faculty may either provide such information to students or allow them to find it on their own, as gay, …