‘Training is an important step’

I don’t believe you need to be an expert to work with gender, sexual and relationship diversity (GSRD) issues, but many of my clients tell me that they have sought a counsellor with experience and knowledge in the area. I have worked with clients both where their identity is the focus of therapy and where their identity is secondary and perhaps inconsequential to what they want to talk about. Either way, a knowledgeable and affirmative approach are essential. For a counsellor who is cisgendered and/or heterosexual, the range of identities that people now identify as can feel a little daunting to keep up with. I don’t think we need to know everything, but we can prepare for this work. There are many resources that we can - and really have no excuse not to - engage with, rather than relying on clients to educate us. Textbooks, BACP resources and numerous podcasts of people talking about their lived experience can all enrich our work with LGBTQ+ clients and GSRD issues. Lived experiences are important but may be limited by bias or subjectivity. Training or engagement with reputable sources provides a more informative and objective form of learning. As a profession, incorporating these issues into training from introduction to diploma level would be an important step in supporting counsellors to feel more confident in working with these clients.

Aileen McCormack, person-centred counsellor

‘We must examine our own beliefs’

I’m not sure that clients ask for ‘expertise’ but I do hear them ask for understanding, knowledge and sensitivity. For me, this means we must first do the uncomfortable work of examining our own beliefs, assumptions, desires and fears about gender, sexuality and relationships. In my experience, that is most effectively done within knowledgeable, sensitive, culturally competent training. I think it’s easier for clients already tuned into queer/GSRD issues to find therapists than those who occupy a more heteronormative life, because they have a language, and perhaps know which directories will offer therapists who detail all their experience and knowledge in this area. GSRD clients risk a great deal by speaking about their concerns – pathologising, judgment, rejection. The least we can do is to be explicit about our knowledge and experience so the client isn’t taking all the risk, filling in the blanks and spending hours searching online. Trans and non-binary clients are fearful of encountering therapists with transphobic views or assumptions that compromise the quality of therapy. One client recently said that we should have a list of such therapists ‘so we can avoid them’. I’d love to see more therapists being explicit on a wider range of therapist directories so more people can more easily find the therapist they need.

Su Connan, person-centred counsellor

'Good intentions are not always enough’

Winnicott brought into our consciousness the idea of the good-enough parent and that aiming for perfection is not only impossible but unnecessary. The question of what makes a good-enough counsellor is key to ensuring clients are not harmed. Just as with parenting, good intentions are not always enough – skills, knowledge, examination of your own beliefs, biases and internalised prejudices and understanding of external power structures are all important. We know that gender, sexual and relationship divergent (GSRD) clients are at times harmed by therapists, from the overt, such as conversion therapy, to the covert but more common ‘conversion therapy by stealth’. It might be saying ‘Have you tried having sex with your partner?’ to the asexual person, or ‘Don’t you think you are a little old to upset your life by coming out?’ to the trans person, and ‘How do you know, if you haven’t had relationships with men and women?’ to the bi person. Expertise, which in my view is lived experience plus training, is about raising the bar of what is considered good enough. GSRD people deserve better than the profession has historically offered them.

Karen Pollack, gender, sexual and relationship diversity specialist

‘I would invite any therapist to take GSRD courses’

Being a member of the LGBTQ+ community and working with clients has taught me that not every therapist can sustain the depth of insight to meet the many unique issues that GSRD clients present and struggle with. Lived experience is an invaluable personal resource to meet certain client needs, but it can be limited. I may advertise that I have a speciality but is what I offer good enough to meet clients’ needs? Asking myself this question resulted in an honest appraisal and identified a clear step towards underpinning my ethos with further training on the social, ethical, economic and legal issues connected with the LGBTQ+ community. It can take a great deal of courage for GSRD clients to reach out for therapy. Like any client, they deserve to be welcomed without shame and to have a therapist who is clear about what can be offered and who has sufficient training and empathy to meet a client who may feel anxious and frustrated at the lack of understanding they have lived with. I believe that the first reaching out and exchange can play a part in the GSRD client feeling safe enough to unfurl long-held material, if the good-enough therapist can provide security and a safe place. I would invite any therapist to take GSRD courses to ensure that the needs of this client group are fully met. I believe we need to move with the times in views, language and competence.

Sami Almutairi, integrative counsellor

‘We should not be afraid to deepen our learning’

Specialist training always helps. I am gay but I not only immersed myself in the various proponents of LGBTQ+ affirmative counselling, I also did my placement at an LGBTQ+ charity that provided a great deal of training courses on various aspects of LGBTQ+ life. Lived experience helps, of course, but we should not be afraid to really deepen and develop our learning, even in subjects that we feel we are well-versed in. I hear fewer horror stories about therapists not being accepting of LGBTQ+ clients than when I started in the profession almost 20 years ago, but I still do hear from clients who felt their therapist maybe didn’t understand their sexuality or was insufficiently curious about it. This signalled a lack of engagement or connection that hampered the therapeutic alliance and ended up being an issue. There is also the other side of that coin, where clients are not willing to risk seeing a counsellor who may not get it, so they specifically seek out someone like me. As a profession, we could ensure that all courses have a minimum level of training on sexuality that is approved by the main membership organisations.

Ben Amponsah, psychotherapist, consultant, coach and trainer