Spengler Elliot S, Miller Deborah J, Spengler Paul M
Department of Psychology, University of Tennessee.
Department of Psychology, Indiana University East.
Psychotherapy (Chic). 2016 Sep;53(3):360-366. doi: 10.1037/pst0000073.
Sexual minority (SM) individuals live in a heterosexist society that denigrates their sexual orientation identity. The stigma and prejudice they regularly encounter is hypothesized to lead to their significantly increased risk for developing mental health disorders. Because of these factors, therapists should be diligent to create an affirming and supportive therapeutic environment but this is often not the case. SM clients frequently report experiencing sexual orientation microaggressions in therapy, such as heteronormative statements, a disregard for their sexual orientation identity, and an assumption that their presenting issues are rooted in their sexual orientation identity. These microaggressions should be viewed as bias manifested as clinical errors because of how they weaken therapeutic alliance, decrease the effectiveness of treatment, decrease utilization intent, and cultivate feelings of shame, anger, and misunderstanding. This article provides empirically supported findings regarding common SM clinical errors and microaggressions, a clinical example of such biases with corrective examples along with the author's personal reactions, and more general strategies for avoiding microaggressive errors with SM clients. Implications for practice, training, and research are discussed. (PsycINFO Database Record
性少数群体（SM）个体生活在一个诋毁他们性取向身份的异性恋至上社会中。据推测，他们经常遇到的污名和偏见会导致他们患心理健康障碍的风险显著增加。由于这些因素，治疗师应努力营造一个肯定和支持性的治疗环境，但实际情况往往并非如此。SM客户经常报告在治疗中经历性取向微侵犯，例如异性恋规范陈述、对他们性取向身份的漠视，以及认为他们提出的问题源于其性取向身份的假设。这些微侵犯应被视为因削弱治疗联盟、降低治疗效果、降低治疗意愿以及引发羞耻、愤怒和误解感而表现为临床错误的偏见。本文提供了关于常见的SM临床错误和微侵犯的实证研究结果、此类偏见的临床实例及纠正示例以及作者的个人反应，还有避免对SM客户出现微侵犯性错误的更通用策略。文中还讨论了对实践、培训和研究的启示。（PsycINFO数据库记录）
