Queer-Identified Clients’ Preferences in Counseling Practice

This dissertation includes two manuscripts: a content analysis that sought to understand the state of the counseling literature related to counseling queer-identified clients and a Q Methodology study that identified preferences of queer-identified in counseling. In the first manuscript, all articles published from 2014 - 2020 in American Counseling Association journals and affiliates were examined. Articles were included in the final sample (N = 64) if they contained implications for working with LGBTQ+ clients in community settings. Using content analysis overlaid with Consensual Qualitative Research - Modified, the first manuscript provides a foundation for the second by exploring the current literature and distilling it into domains that describe counseling practices including, conceptual frameworks, counseling interventions, and person as counselor. These domains are the groundwork for the Q Sort in the second study. The second manuscript builds on the first by expanding the identified domains through a community survey and examination of current competencies for working with queer-identified clients. These three sources were used to create a concourse and Q Sort that participants sorted, identifying their counseling preferences. Participants (N = 50) in this study were queer-identified individuals who have attended counseling for at least seven sessions with the same Licensed Professional Counselor (LPC) within the last two years. From the Q Sort, three sets of preferences emerged: building relationship, enacting LGBTQ+ specific knowledge, and development through the lens of queer identity. Factor one centered on building trust, creating and maintaining safety, and doing no harm. Factor two centered on counselor knowledge, affirming queer identity, and broaching skills. Factor three was characterized by a more complex and complete understanding of queerness and the ability to enact higher-order interventions and skills. These sets of preferences are explored in the context of counseling practice, counselor education, and research.