Referring Clients Based Solely on Sexual Orientation: An Exploration of the Role of Homophobia and Clinical Competence

Abstract

The purpose cf this study was to explore how homophobia and clinical competence influence experienced clinicians' beliefs and practices regarding referring a LGB client based solely on the sexual orientation of the client. The data for this study came from a larger study with a sample of 741 experienced clinicians who were all members of the American Association of Marriage and Family Therapy (AAMFT). Participants were contacted through email and if they chose to participate they completed the survey on-line. There were two measures used for this study, 1) the combined Modem Homophobia Scale (MHS); (Raja & Stokes, 1998) and 2) the combined knowledge/skill subscale from the Revised-Sexual Orientation Counselor Competency Scale (R-SOCCS); (Bidell, 2005; Carlson, McGeorge, & Toomey, in press) as well as two yes/no questions about referring LGB clients. The results of this study indicated that therapists who have referred a LGB client based solely on the client's sexual orientation had higher levels of homophobia than those who had never referred a LGB client based solely on the client's sexual orientation. Clinicians' level of clinical competence to work with LGB clients did not appear to influence their beliefs about the ethical nature or practices of referring a LGB client based solely on the client's sexual orientation. Furthermore, many therapists in this study believe it should be ethical to refer a client based solely on the sexual orientation of the client, though most of them had not actually made such a referral. The AAMFT Code of Ethics is discussed throughout this thesis in order to explore the ethical issues related to referring a client based solely on the client's sexual orientation. This study provides important implications for therapists, couple and family therapy training programs, as well as the AAMFT regarding the ethical nature of the practice of referring a LGB client based solely on the client's sexual orientation.