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Dissertation

Psychotherapy with HIV+, lesbian, gay, bisexual, and transgender individuals: A survey examining the therapeutic alliance and therapist characteristics

21 July 2006

Abstract

An exploratory study was conducted in order to examine some of the complex factors that influence HIV+/AIDS and lesbianlgaylbisexualltransgender (LGBT) individuals' ability to succeed in and benefit from psychotherapy. The intent of this study was to address ways in which therapists can better serve these ,Populations by pinpointing therapist variables, as well as aspects of the therapeutic alliance, which HIV+ and LGBT individuals perceive as playing key factors in the successful-outcome of a course of psychotherapy. Another focus was to investigate whether LGBT individuals' developmental stages of sexual identity formation are associated with preference for therapist characteristics, such as gender and sexual orientation. Results indicated that the therapist characteristic of "acceptance ofHIV+ individuals, as well as LGBT as reasonable, viable lifestyles worthy of respect, care and support" was perceived by LGBT research participants as having a high correlation to their ability to experience progress in therapy. Findings revealed that "honesty, integrity, trustworthiness" was rated as one of the top three therapist characteristics in importance by LGBT and HIV+ subjects, followed by fifteen (35.7%) participants having rated "skill as a therapist" and ten (23.8%) subjects having rated both "sensitivity/empathy" and "acceptance of HIV+ individuals as well as LGBT as reasonable, viable lifestyles worthy of respect, care and support." Analyses evidenced that male subjects perceived the characteristic of therapists that are HIV+ themselves or have some personal experience with this illness as contributing to therapeutic outcome. HIV infected subjects' responses evidenced a perception that HIV +/LGBT -related therapist characteristics influence their ability to benefit from psychotherapy. Findings suggested that both specific aspects of the therapeutic alliance "I like the therapist as a person" and "I trust the therapist's judgment" were rated highest by research participants. Results from this study indicated that both HN+ and LGBT subjects rated statements corresponding to the task subscale of the WAI-SF slightly higher than the other subscales. Critical issues confronting members of these populations are also highlighted throughout this study, and it provides a brief overview of clinical and counseling issues that clinicians who work with these populations should be aware of.


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