“Blurred facilitation stand” – the hidden factor when working with LGBTQ: Diagnosis and addressing an unspoken effect of internalized homophobia

ABSTRACT While there is always a ‘dance’ of hierarchy and leadership between therapist and client, this article posits that treating LGBTQ clients contains a unique factor that shapes the relationship. Singular challenges may surface as a result of internalized homophobia; it can undermine a client’s stance, in a vague and latent way, to take part meaningfully and effectively in a therapeutic alliance. Moreover, a client may project dimensions rooted in homophobia onto the therapist. As such, it could stymie or undermine the therapeutic alliance. We’ve coined this phenomenon in a therapeutic relationship the ‘blurred facilitation stand”©. This term seeks to underscore a unique effect that can surface in an encounter between a heterosexual or non-heterosexual therapist and a non-heterosexual client. It bears mention this effect may undermine the potency of a therapeutic alliance, which theoreticians and researchers affirm has unique dimensions in working with LBGTQ clients. The ‘blurred facilitation stand’ may damage the hope potential that is essential for the placebo effect in a client’s mind and experience in the long-awaited therapeutic process. We discuss factors that lead to the ‘blurred facilitation stand’ and propose steps in the therapeutic process to reduce its effect.