Clinicians\u27 Perceptions of the Mental Health of Gay Clients and the Effects of Diversity Competency and Modern Homophobia

Attitudes within the psychological community regarding sexual minorities have evolved over time with a significant history of assigning pathology to lesbian, gay, and bisexual (LGB) clients. Though attitudes have shifted, prejudice has not disappeared. Modern forms of homophobia are less overt and subtler expressions of contempt, disapproval, or discrimination and are rooted in internal conflict. In mental health training programs, LGB clients have historically received little attention, failing to prepare professionals to competently work with this population; encouragingly, this trend is changing. The present study investigated how mental health clinicians assess the level of mental health of gay male clients considering modern homophobia and LGB competency. Specifically, it was hypothesized that less mental health would be assigned to gay clients when compared with heterosexual clients, higher levels of modern homophobia would lead to lower levels of assessed mental health, and LGB competency would moderate both of these associations. Eighty-six mental health trainees and clinicians were randomly assigned a case vignette with either a gay client or a heterosexual client. The vignettes maintained the same symptoms and presenting concerns, yet implied different sexual orientations. Participants completed instruments measuring the mental health of the client, modern homophobia, and diversity competency. Results revealed that the sexual orientation of the client significantly predicted the level of mental health functioning assigned with more health being ascribed to the heterosexual client; however, LGB competency did not moderate this relationship. Modern homophobia did not significantly predict the extent of mental health assigned nor was it moderated by LGB competency. Post-hoc analyses suggested that there might be a difference in the assessment of mental health versus assessment of pathology, with the latter being significantly related to modern homophobia. Implications of the study for practice and training are discussed