LGB-Affirmative Therapists' Use of Developmental Models of LGB- Identity in Therapy

Western Michigan University ScholarWorks at WMU Dissertations Graduate College 8-2010 LGB-Affirmative Therapists' Use of Developmental Models of LGB- Identity in Therapy. A Phenomenological Investigation Victoria E. Cane Western Michigan University Follow this and additional works at: https://scholarworks.wmich.edu/dissertations Part of the Counseling Commons, Gender and Sexuality Commons, and the Mental and Social Health Commons Recommended Citation Cane, Victoria E., "LGB-Affirmative Therapists' Use of Developmental Models of LGB-Identity in Therapy. A Phenomenological Investigation" (2010). Dissertations. 548. https://scholarworks.wmich.edu/dissertations/548 This Dissertation-Open Access is brought to you for free and open access by the Graduate College at ScholarWorks at WMU. It has been accepted for inclusion in Dissertations by an authorized administrator of ScholarWorks at WMU. For more information, please contact [email protected]. LGB-AFFIRMATIVE THERAPISTS' USE OF DEVELOPMENTAL MODELS OF LGB-IDENTITY IN THERAPY. A PHENOMENOLOGICAL INVESTIGATION by Victoria E. Cane A Dissertation Submitted to the Faculty of The Graduate College in partial fufillment of the requirements for the Degree of Doctor of Philosophy Department of Counselor Education and Counseling Psychology Advisor: James Croteau, Ph.D. Western Michigan University Kalamazoo, Michigan August 2010 LGB-AFFIRMATIVE THERAPISTS' USE OF DEVELOPMENTAL MODELS OF LGB-IDENTITY IN THERAPY: A PHENOMENOLOGICAL INVESTIGATION Victoria E. Cane, Ph.D. Western Michigan University, 2010 Socially sanctioned hostility toward sexual minority persons continues to be a reality in the United States and worldwide. Therapists working with sexual minorities have responsibility to provide non-pathologizing, affirmative therapy to these clients. A central aspect of affirmative therapy is therapists' recognition and understanding of sexual orientation (SO) identity and developmental models of sexual minority identity have a played a vital role in promoting this understanding. Although such models have been central to the practice and training of affirmative therapy, therapists' applied use of the models has not been empirically investigated. For this phenomenological study, nine affirmative therapists were interviewed to explore their use of developmental models of LGB identity in therapy and other ways they might address SO identity more generally. Three themes emerged from this study that directly spoke to the explored phenomena: Main Therapeutic Functions of Developmental Models of LGB Identity: Instilling Hope and Conceptualization, Therapists' Recognition/identification of Models' Limitations, and Specific Strategies Used When Addressing Sexual Orientation Identity in Therapy. Therapists identified that a core aspect of addressing SO identity was allowing clients to take the lead in the process and brought to light the complex interplay between general affirmative practice and specific attention to SO identity development. The results of this study culminated in the creation of an overarching essence unifying the nine therapists' perspectives. This study is one of the first to empirically examine therapists' applied use of developmental models of LGB identity and produced numerous implications for affirmative practice, training, and research. One primary implication for practice and training highlights the potential for developmental models of LGB identity to provide sexual minority clients with a sense of hope, an aspect of the models' therapeutic utility not previously explored. Suggestions for future research include study of a wider population of affirmative therapists using other qualitative methods such as consensual qualitative research. UMI Number: 3424510 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. UMT Dissertation Publishing UMI 3424510 Copyright 2010 by ProQuest LLC. All rights reserved. This edition of the work is protected against unauthorized copying under Title 17, United States Code. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 Copyright by Victoria E. Cane 2010 ACKNOWLEDGMENTS The completion of this near-Herculean effort would not have been possible without some amazing people in my life. I owe an indescribable amount of appreciation to my partner in all things, Tim Cane. He has patiently supported me throughout seven years of doctoral study and three hard years of focus on this dissertation. He walks the walk of equal partnership in parenting and in life. I would also like to thank those in our life who represent family in the truest sense: Stephan Minovich, Chris and Mary Cane, The Olmsteads, and Mark and Martha Johnson. This dissertation was written while finishing doctoral coursework, working on other research, working as a therapist, birthing and caring for two children, and completing a pre-doctoral internship. I did this by writing consistently for a period of about two hours every day; so I would like to thank my two beautiful boys for being great nappers. Jasper and Finlay, may you live to see a world where mass discrimination and oppression are spoken about as history. My disseration at times served as my anchor, my hope, and my sanity. There were only brief moments towards the pushing stage in this labor where I cursed its name, but as we DBT therapists are known for saying, "it is (was) as it should be". Another significant factor that fostered my connection to this study was the mentorship of my chair, Jim Croteau, who modelled persistance, 11 Acknowledgments-Continued excellence, and keen curiosity. My identity as an ally and an affirmative counseling psychologist has been greatly enriched by my relationship with Jim. I look forward to reading his research and hopefully collaborating with him again in the coming years. I am also deeply grateful to my committee members, Mary Anderson and Ann Miles. Mary provided a sharp eye and a warm soul in perfect balance. Ann was a true sport as she agreed to swim in unfamiliar water. She did so while bringing a welcome new perspective and without disturbing the ocean. I'd also like to thank my participants whose words never felt old to me even after reading them more times than I could count. Along this journey I realized I have some really great friends in my life. They lent me a shoulder to cry on, brought food when babies came or illness fell, said, "you can do it" when I got tired, watched my kids, or just generally made our lives better. Thank you Warren, Katie, Johanna, Matt, Kirsten, Gwen, and Jody. Lastly, I'd like to give a "shout out" to the five other beautiful and strong women in my cohort: Jody, Liz, Kenlana, Michelle, and Kara. Mothers, sisters, daughters, fighters, lovers, partners, dancers, nurturers, comedians, and now psychologists. Victoria E. Cane in TABLE OF CONTENTS ACKNOWLEDGMENTS ii LIST OF TABLES x CHAPTER I. INTRODUCTION 1 Overview of the Literature 6 Developmental models of minority sexual identity 7 LGB-affirmative therapy 12 Practical applications of LGB identity models in psychotherapy 14 Method 17 Participants 18 Procedure 20 Results 27 Arrival at identity as an affirmative therapist 28 Specific strategies used in the practice of affirmative therapy 30 Specific strategies used when addressing sexual orientation identity in therapy 33 Main therapeutic functions of developmental models of LGB identity: Providing hope and conceptualization 38 IV Table of Contents-Continued CHAPTER Therapists' recognition/identification of models' limitations 39 Positive aspects of research participation 42 Affirmative therapists' collective experience addressing sexual orientation identity with clients and using developmental models of LGB identity in therapy 43 Discussion 46 Synopsis of results in relation to research questions and the literature 46 Implications for practice and training 48 Limitations and future directions 55 Conclusion and Reflections 60 II. LITERATURE REVIEW 65 Models of LGB Identity Development 66 Cass 70 Coleman 76 Troiden 79 Weinberg, Williams, and Pryor 82 McCarn and Fassinger 85 Fassinger and Arseneau 89 Critiques of the models 93 v Table of Contents-Continued CHAPTER LGB-affirmative Therapy 98 Critique of the affirmative-therapy literature 104 Practical Applications of LGB Identity Models in Psychotherapy 105 Ritter and Terndrup's phase-specific interventions 107 Critique of the literature on practical applications of LGB identity models in psychotherapy 111 III. METHODOLOGY 113 Qualitative Research and Rationale for a Phenomenological Approach 114 Steps in Phenomenological Research 118 Step 1: The literature review 120 Step 2: Researcher self-exploration 121 Step 3: Identification of the phenomenon and construction of research questions 131 Step 4: Identification and recruitment of appropriate participants 132 Step 5: Collection of data 143 Step 6: Analysis of data 147 Step 7: Data verification (member checking) 151 Step 8: Additional analysis 153 vi Table of Contents-Continued CHAPTER Review of the Study's Rigor 153 IV. RESULTS 157 Context and Background Regarding the Results 157 Results Presented in Table Format 161 Main Themes Identified in this Study 163 Arrival at identity as an affirmative therapist 163 Specific strategies used in the practice

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