An exploration of the therapeutic process in suicide intervention therapy with lesbian gay and bisexual clients

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Flannery, Paul
Issue Date
MA in Psychotherapy
Dublin Business School
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The purpose of this research was to explore the experiences of therapists working with lesbian gay and bisexual (LGB) individuals presenting at a suicide crisis intervention centre. The policy of the centre is to offer clients brief solution-focused therapy with exploration of underlying issues excluded. The focus of the centre’s approach is to lift suicidal ideation or self-harming behaviour and replace the reasons for dying or harming with reasons for living with dignity. Due to the high levels of suicidality among LGB people relative to their heterosexual peers which is more than 2 times higher on average and up to 7 times higher between the ages of 12-17, an explorative research into the therapeutic process was selected. The methodology chosen was qualitative research and five semi-structure interviews were carried out with Integrative and Humanistic therapists employed in the suicide intervention centre. The data was analysed using thematic analysis and the findings comprised of three themes. Theme 1. Minimisation and rejection of the notion that different therapeutic approaches are offered to LGB and non-LGB clients. Yet on exploring this further, it was clear that subtle differences in approach emerged. Theme 2. Getting-It; the enhanced ability of some therapist was noted, to communicate to the clients an experience of ‘being got’ through empathically addressing the underlying issues concerning their suicidal ideation and self-harm. Theme 3. The consequential tension that was evident between the adherence to policy and the desire of the therapist to work with some of the underlying issues relating to the client’s SI or DSH. Conclusions: the participant therapists responded to this conflict or tension in different ways (i) there was evidence of deeper levels of empathy and some therapist endeavoured to impart to the client a deep felt sense of understanding the client’s early non-identification with his or her environment and the people in it, in a manner that may be sufficient to encourage the client to explore this further after their suicidality is no longer the priority. (ii) Other therapists expressed a defensive stance by continuing to reject the notion of a differential response and defended the need for time limits and content boundaries in order to address only the surface issues of suicidality. It is believed that further research into the ability of some therapists to empathically connect at a deeper level with the early self-esteem injury and suicidality will add further light on the above findings. Author keywords: LGB, lesbian, gay, bisexual, suicide, self harm, brief-solution-focused-therapy