Gay affirmative psychotherapy is a form of psychotherapy for non-heterosexuals, specifically gay and lesbian clients, which focuses on client comfort in working towards authenticity and self-acceptance regarding sexual orientation, and does not attempt to "change" them to heterosexual, or to "eliminate or diminish" same-sex "desires and behaviors". The American Psychological Association offers guidelines and materials for gay affirmative psychotherapy. Affirmative psychotherapy states that homosexuality or bisexuality is not a mental illness, in accordance with global scientific consensus. In fact, embracing and affirming gay identity can be a key component to recovery from other mental illnesses or substance abuse. Clients whose religious beliefs are interpreted as teaching against homosexual behavior may require some other method of integration of their possibly conflicting religious and sexual selves.
Guidelines
For many years, psychiatry viewed homosexuality as a mental illness. Current guidelines instead encourage psychotherapists to assist patients in overcoming the stigma of homosexuality rather than try to change their sexual orientation. Because some mental health professionals are unfamiliar with the social difficulties of the coming out process, particular to other factors such as age, race, ethnicity, or religious affiliation, they are encouraged by the APA to learn more about how gay, lesbian, and bisexual clients face discrimination in its various forms. Many gays and lesbians are rejected from their own families and form their own familial relationships and support systems that may also be unfamiliar to mental health professionals, who are encouraged to take into account the diversity of extended relationships in lieu of family. For some clients, acting on same-sex attraction may not be a fulfilling solution as it may conflict with their religious beliefs; licensed mental health providers may approach such a situation by neither rejecting nor promoting celibacy.
Research
One of the emerging areas of research regarding gay affirmative psychotherapy is related to the process of assisting LGBTQ individuals from religious backgrounds feel comfortable with their sexual and gender orientation. Narrative analyses of clinicians' reports regarding gay affirmative psychotherapy suggest that the majority of conflicts discussed within the therapeutic context by gay men and their relatives from religious backgrounds are related to the interaction between family, self, and religion. Clinicians report that gay men and their families struggle more frequently with the institution, community, and practices of religion rather than directly with God. Chana Etengoff and Colette Daiute report in the Journal of Homosexuality that clinicians most frequently address these tensions by emphasizing the mediational strategies of increasing self-awareness, seeking secular support, and increasing positive communication between family members.
In March 2008, the German federal government summarized the professional consensus as indicating that homosexuality is not an illness, and that conversion therapy is dangerous and doesn't help homosexual people. Voluntary changes to sexual orientation are not an option, according to the administration's answer to parliamentary questioning, as these attempts may cause personal harm. The German government also made the point that Gay Affirmative Psychotherapy can help clients.
Literature
Adelman, M.. Stigma, gay lifestyles, and adjustment to aging: A study of later-life gay men and lesbians. Journal of Homosexuality, 20, 7-32.
Allen, M., & Burrell, N.. Comparing the impact of homosexual and heterosexual parents on children: Meta-analysis of existing research. Journal of Homosexuality, 32, 19-35.
Allison, K., Crawford, I., Echemendia, R., Robinson, L., Knepp, D.. Human diversity and professional competence: Training in clinical and counseling psychology revisited. American Psychologist, 49, 792-796.
American Psychological Association.. Appropriate therapeutic responses to sexual orientation in the proceedings of the American Psychological Association, Incorporated, for the legislative year 1997. American Psychologist, 53, 882-939.
Browning, C.. Therapeutic issues and intervention strategies with young adult lesbian clients: A developmental approach. Journal of Homosexuality, 14, 45-52.
Buhrke, R.. Female student perspectives on training in lesbian and gay issues. Counseling Psychologist, 17, 629-636.
Cabaj, R., & Klinger, R.. Psychotherapeutic interventions with lesbian and gay couples. In R. Cabaj & T. Stein, Textbook of homosexuality and mental health. Washington, DC: American Psychiatric Press.
Pachankis, J. E., & Goldfried, M. R.. Clinical issues in working with lesbian, gay, and bisexual clients. Psychotherapy: Theory, Research, Practice, and Training, 41, 227-246.
Udo Rauchfleisch, . Gleich und doch anders: Psychotherapie und Beratung von Lesben, Schwulen, Bisexuellen und ihren Angehörigen. Stuttgart: Klett-Cotta.
Kathleen Ritter and Anthony Terndrup,. Handbook of Affirmative Psychotherapy with Lesbians and Gay Men. New York: Guilford.
