The myth of the safe space: Sexual orientation disparities in therapist effectiveness.

Psychotherapy has been shown to be effective on a broad level (e.g., Wampold & Imel, 2015); however, a growing body of literature has revealed that some therapists have outcome inequities within their caseloads. These inequities have been observed on the basis of social identities including race (see Imel et al., 2011, for example) and gender measured on the binary (Owen et al., 2009). However, despite the great need for further research on sexual minority populations in psychotherapy, this phenomenon has yet to be explored on the basis of sexual orientation (i.e., if a disparity exists within-therapist caseloads between queer-identified and heterosexual clients). The present study was comprised of a sample of 1,725 clients treated by 50 therapists at a university counseling center (17.7% of the sample endorsed a sexual minority status). Multilevel modeling was used to analyze data from the Behavioral Health Measure-20 (BHM-20; Kopta & Lowry, 2002). The results indicated that clients' sexual orientation status was not significantly associated with any of the BHM-20 subscales or with the Global Mental Health Scale (GMH). Of interest was that therapists varied in the extent to which their clients' symptoms and GMH improved and how that improvement varied by client sexual orientation status. Thus, attention must be paid not only to which therapists are more and less effective overall, but also to the specifics of which clients (and the social identities those clients hold) are improving while under their care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Internalized Binegativity, LGBQ+ Community Involvement, and Definitions of Bisexuality.

Bisexual people can internalize stigma from both heterosexual and gay/lesbian communities, which often occurs in the form of monosexism, the belief that people should only be attracted to one gender. Although community involvement is protective for lesbian, gay, bisexual, and queer+ (LGBQ+) people, bisexual people may benefit more from bisexual-specific communities than LGBQ+ communities because of monosexism. Further, how bisexual people define their identity may be related to internalized binegativity, especially given the historical invisibility of bisexuality in mainstream media and recent debates about the definition of bisexuality within LGBQ+ communities. We examined LGBQ+ and bisexual-specific community involvement, definitions of bisexuality, and internalized binegativity among an online sample of 816 bisexual adults. Multivariate regression analyses showed that those with spectrum definitions, which acknowledged the nuanced understanding of sex, gender, and sexuality, reported lower internalized binegativity than those with binary definitions, which described sexuality as consistent with mainstream norms. Involvement in LGBQ+ communities, but not bisexual communities, was associated with lower internalized binegativity. There was no interaction between the type of definition and type of community involvement. Our results suggest that broad community involvement may be protective for internalized binegativity, but findings should be considered in light of a lack of well-funded, local bisexual communities. The current study adds to a growing literature on sexual minority stressors among bisexual people, a population that continues to be understudied.

HIV Prevention in Gay Family and House Networks: Fostering Self-Determination and Sexual Safety.

Many gay, bisexual, and transgender (GBT) people of color (POC) join house and/or constructed family communities, which serve as support networks composed mostly of other non-biologically related GBT/POC. These networks can decrease or increase the risk of exposure to HIV via multiple mechanisms (e.g., providing informal sexual safety education versus stigmatizing family members with HIV, encouraging sexual safety practices versus unsafe escorting, teaching self-care versus substance use) but act to support family members in the face of social and economic hardship. Researchers interviewed ten members of these social networks in the Boston metro area of the US and produced a saturated grounded theory analysis to explore the role of gay family/house networks in HIV risk management. While network members utilized HIV prevention resources, interviewees described how their efficacy was related to the intentions of leadership and strength of kinship boundaries within their community, economic opportunities, and communication skills. Clinical and research implications are discussed.