Trainees' Use of Supervision for Clinical Work with Lesbian, Gay, and Bisexual Clients: A Qualitative Study

Abstract

Most studies considering lesbian, gay, and bisexual (LGB) clients and their therapists have primarily focused on the clients' experience in therapy (Israel, Walther, Gorcheva, & Sulzner, 2007; Liddle, 1996) or on the therapist's experience of the client (Bieschke & Matthews, 1996; Garnets, Hancock, Cochran, Goodchilds, & Peplau, 1991). However, the role that clinical supervision plays in therapists' development in working with LGB clients is rarely studied. Not enough is known about how supervision is perceived from the perspective of the supervisee who is developing skills in working with LGB clients. The current study examined 12 interviews with randomly selected predoctoral interns at APA-accredited counseling centers around the country, to explore how they made use of the clinical supervision they received for their work with LGB clients. The single previous qualitative investigation of this topic (Burkard, Knox, Hess, & Shultz, 2009) examined interviews with LGB advanced doctoral students. The current study extends the investigation of this topic by interviewing six heterosexual-identified trainees in addition to six trainees who identified as LGB or queer (Q), and by investigating a more geographically heterogeneous sample. The interviews explored various aspects of the supervision experience, including trainees' expectations of their supervisor for supervision of their work with their LGB client, the contributions of trainees and their supervisors to the supervision process, and the impact of supervision on work with the LGB client and other clients. The data were analyzed using Consensual Qualitative Research (CQR; Hill, Knox, Thompson, Williams, Hess, & Ladany, 2005; Hill, Thompson, & Williams, 1997). All participants valued their supervision relationship, and found their supervisors helpful in assisting them in their therapeutic work with their LGB client. Trainees typically experienced their supervisors as multiculturally sensitive, and some felt that their supervisors helped them with LGB-specific interventions and case conceptualizations. Some differences between how heterosexual and LGB-identified trainees used supervision for their work with their LGB clients. All participants reported gains from their supervision experience with their LGB client that positively affected their work with other clients, regardless of these clients' sexual orientation.