Family Therapy Related to a Child’s Homosexuality

Introduction

When working with clients, counselors should be guided by theoretical knowledge and practical skills of proper assessment, relevant treatment choice, and the establishment of a safe therapy environment. Counseling work requires the integration of the particularities of a given situation with which the clients struggle. To provide proper therapeutic care, a social worker is expected to validate ethical, legal, and recovery-based interventions based on relevant evidence-based theories. This case study focuses on a 16-year-old African American male who disclosed his homosexuality to his parents, who are religious people and do not accept their son’s sexuality. Moreover, the parents claim that the devil has influenced their son, and it is necessary to cure him of his gay identity. The case study is designed to integrate relationship-focused interventions psychoeducational and coping skills development practices for all the family members to help parents accept their gay son and their functional supporting relationships in the future.

Initial Meetings with Family Members and Client Identification

Given the outlined situation, the initial meeting should be conducted with the parents of the gay person. Evident discontent validates such a decision, and the lack of acceptance on the part of the parents who are challenged with a crisis of dealing with their religious beliefs being disrupted by their son’s ‘coming-out.’ Studies demonstrate that the decision to declare as a gay or lesbian person is a healthy behavior motivated by the wish to be transparent in identity disclosure (Diamond, Boruchovitz-Zamir, Gat, & Nir-Gottlieb, 2019; Ghosh, 2020). Thus, according to the structural family theory, the parents require initial consultation to establish their needs and expectations (Diamond et al., 2019). However, the social worker’s clients will be all three family members since their collective inclusion and the work on the relationship-building should be prioritized. This decision is validated by family-based therapy principles aligned with the structural family theory and relationship-focused therapy that prioritize the inclusion of all family members in the solving process and recovery (Gehart, 2017). Thus, the choice of initial meetings and clients is validated by relevant theoretical knowledge.

Safety Issues Assessment

Safety is among the essential elements of qualitative social work. The social worker will clarify whether the teenager experiences any threats to his well-being to ensure safety in the therapeutic environment when meeting with the clients. In particular, the following questions might be asked:

• Do you feel safe at home with your parents?
• Do you experience any threats to your health and wellbeing?

Moreover, it is important to establish safety for the social worker, which might be illustrated by asking the following question:

• Are you aware that this setting is designed for your benefit and the rules of respectful behavior should be followed at all times?

Family’s Strengths and Resources

When planning the treatment process and assessing the family for its needs and capabilities in care, the social worker should clarify its strengths and resources. Within the framework of structural family theory and relationship-focused therapy, in particular, it is relevant to apply the method of mapping. According to Colapinto (2019), mapping identifies the patterns in relationships, family dynamics, and the possible difficulties underpinning the crisis. This method might be used to collect information on the family’s strengths and resources. In particular, the following questions might be asked:

• How much time do you spend together?
• Do you support each other in difficult times?
• Do you feel empathy toward each other?
• How close are you to your father/mother/son?
• Do you communicate openly about problematic issues?

These questions will allow for identifying the family dynamics identify such strengths as affection, support, and sincerity of communication (Colapinto, 2019). The resources implied in the skills and relationship-building capacity will demonstrate what areas of relationships should be used as the basis for further development. Moreover, the identified weaknesses should be used as the areas for improvement during the intervention.

Analysis of Cultural, Ethnic, and Religious Beliefs

The analysis of the family’s cultural, ethnic, and religious beliefs is essential for the context of therapy and the choice of culturally sensitive interventions and communication strategies. In particular, to identify these beliefs, the social worker might ask the following questions:

• What is your ethnic identity?
• What are the roles of men and women in your community/culture?
• What values do you prioritize in relationships?
• What are your religious beliefs? How do they influence your attitude to gender roles?

Social Work Ethical Standards

When identifying ethical standards for social work with the family, the counselor should ask themselves the following three questions:

• Are the selected interventions legal?
• Is the treatment or communication harmful?
• How will it benefit the client?

According to Gehart (2017), any conduct of a counselor with clients in the context of family therapy interventions should be validated by ethical and legal standards. In particular, the principle of non-maleficence should be followed to eliminate the risk of causing any harm to the served population. In addition, the ethical principle of beneficence should be preserved to guarantee that the counselor will contribute to the psychological wellbeing of the clients within the framework of his or her professionalism and competencies. Moreover, the principle of autonomy should be guaranteed to ensure that each client within the served family is given independence and determination. Overall, the adherence to these principles will ensure that the counselor conducts evidence-based, quality-directed, safe, and recovering therapy sessions that prioritize ethical and legal procedures.

Theory of Intervention Applicable to the Family’s Case

The theoretical framework selected for treating the case family is the structural family theory with the implementation of relationship-focused therapy. In particular, the goal of relationship-focused therapy for sexual and gender minorities is to help these individuals and their parents “re-establish or develop loving, supportive, mutually respectful, meaningful relationships” (Diamond et al., 2019, p. 432). According to the structural family theory, the family is viewed as a structural unit where each member’s contribution and relationship with others is at the center of therapy. In this regard, the parents’ and child’s individual needs and the family’s collective needs are identified and addressed through the combinations of individual and conjoint sessions. As a result, the relationships “in which the adult child can authentically and openly express all aspects of their identity without fear of rejection or of being negatively judged” are developed and encouraged (Diamond et al., 2019, p. 432). This theoretical approach will inform the treatment and evaluation plans, as well as the psychoeducational interventions for the case family.

Psychoeducational Intervention

It is essential to implement a psychoeducational intervention to expand parents’ knowledge and awareness about homosexuality. Overall, it is supported by research findings that the role of parents in their child’s ‘coming-out’ is particularly important, where children seek support and protection. In contrast, parents often exhibit criticism and disconnect. Indeed, as an outcome, “ongoing parental criticism, invalidation, and rejection of one’s sexual orientation or gender identity can take a psychological toll” (Diamond et al., 2019, p. 431). In the present family case, parents are strictly opposing their son’s gay identity validating their position by religious beliefs about homosexuality due to the devil’s work of evil. Therefore, the primary purpose of the proposed psychoeducational intervention is to broaden the parents’ views on homosexuality by introducing them to research.

Evidence retrieved from relevant research demonstrates that even opposing families with strong religious beliefs are likely to change their perspectives under the influence of education. Indeed, according to Ghosh (2020), “coming out as a family, parents often become advocates of lesbian and gay people within their extended families and churches, especially when they encounter religious conservatism in their churches” (p. 25). Moreover, another element in the proposed psychoeducational intervention is eliminating the sense of isolation that the parents experience in such a situation. In this regard, it is pivotal to ensure that they interact with other parents experiencing the same crisis to demonstrate that they are not alone. Thus, the proposed intervention is a series of group sessions for parents of lesbian and gay people. During these sessions, the parents of the 16-year-old African American male will exchange coping experiences and acceptance journeys with other parents. The social worker will guide the sessions to ensure deliberate lectures and discussions aimed at educating and inducing experience exchange between participants.

Proposed Treatment Plan

The proposed treatment plan is an integrated system of multifaceted practices implemented during a sequence of conjoint and individual sessions with family members according to structural family theory and relationship-focused therapy principles. According to Varghese, Kirpekar, and Loganathan (2020), “working with families involves education, counseling, and coping skills” (p. 192). Thus, these essential components will be prioritized during the session. The questions that might help the counselor determine the treatment plan are as follows:

• What are the current family dynamics?
• What are the needs of each family member?
• What are the treatment goals of each family member?

The following is the outlined plan of interventions aimed at working on the relationship and coping-skills improvement of the family members. The five tasks that are treated as separate stages of the treatment plan are adopted from the relationship-focused therapy for sexual and gender minorities (Diamond et al., 2019).

1. Mapping. At this stage, the information about family dynamics is collected to inform the needs, challenges, and expected outcomes (Colapinto, 2019).
2. Task I Completion. At this stage, a conjoint session with both the adult child and the parents is conducted to establish relationship-building and identify the goals of treatment (Diamond et al., 2019).
3. Task II Completion. The social worker will initiate a series of individual sessions with the teenager in the family. The sessions will be aimed at clarifying the needs of unmet attachment and adaptive mechanisms. Moreover, the capability to share these “feelings and needs with parents in subsequent conjoint attachment/identity episodes, and prepare the adult child for such episodes” will be addressed during the sessions (Diamond et al., 2019, p. 435).
4. Task III Completion. During this stage, individual sessions with parents will be conducted to educate and counsel them on the relationship with their child and their grief over their son’s heterosexuality. In particular, it will be achieved through “creating a therapeutic bond with parents; exploring and working through their fear, shame, grief, and anger associated with having a sexual/gender minority offspring” (Diamond et al., 2019, p. 435).
5. Task IV Completion. Conjoint sessions with parents and their son will be conducted to regulate emotions in their communication. The sessions will be focused on “facilitating in-session corrective emotional experiences by helping the adult child share their emotions and unmet attachment and identity needs and helping parents respond in an empathic, accepting manner” (Diamond et al., 2019, p. 435).
6. Task V Completion. This stage follows after tensions are addressed, and acceptance is exhibited. This task “involves helping family members collaboratively solve current problems, as well as anticipate and plan for future challenges” (Diamond et al., 2019, p. 435).

Evaluation of the Intervention

To evaluate the outcomes of the proposed treatment plan, a two-fold measurement approach will be implemented. Firstly, the social worker will keep a reflective journal to detect and record qualitative changes in family dynamics to identify improvements and possible drawbacks throughout the course. Secondly, the family members will conduct a self-reporting measurement before and after the treatment to compare the initial state and the outcomes.

Conclusion

In summation, the outlined treatment plan, theoretical basis, and the evaluation of the intervention outcomes demonstrate the multifaceted and complete approach to family therapy with the clients. The validation of the selected structural family theory focuses on relationships, coping skills, and education is based on the specific characteristics of the family case. In particular, since all three family members are involved in the crisis where the collision of sexual identity and religious beliefs is evident, the combination of educational and coping strategies is pivotal. Moreover, the provided treatment plan incorporates the interests and issues of both the opposing and non-accepting parents and the son who has come out. The five-task framework at the center of the proposed intervention allows for clear step-by-step implementation and its consequent evaluation. Overall, the credibility and reliability of the theoretical basis, measurability, and clarity of the proposed therapeutic process and outcome evaluation allow for expecting positive recovery outcomes for all three family members.

References

Colapinto, J. (2019). Mapping in structural family therapy. In J. L. Lebow et al. (Eds.), Encyclopedia of Couple and Family Therapy (pp. 1766-1767), Switzerland, AG: Springer Nature. Web.

Diamond, G. M., Boruchovitz-Zamir, R., Gat, I., & Nir-Gottlieb, O. (2019). Relationship-focused therapy for sexual and gender minority individuals and their parents. In J. E. Pachankis & S. A. Safren (Eds.), Handbook of evidence-based mental health practice with sexual and gender minorities (pp. 430–456). Oxford University Press, New York, NY: Web.

Gehart, D. R. (2017). Mastering competencies in family therapy: A practical approach to theory and clinical case documentation. Andover, UK: Cengage Learning.

Ghosh, A. (2020). After coming out: Parental acceptance of young lesbian and gay people. Sociology Compass, 14(1), 1-20.

Varghese, M., Kirpekar, V., & Loganathan, S. (2020). Family interventions: Basic principles and techniques. Indian Journal of Psychiatry, 62(2), 192-200.