Case vignette

Supporting a client sharing their sexual orientation.

Inclusive Language Illustration

Supporting a client sharing their sexual orientation.

Here's the dialogue between the therapist and Shaina, the client.


Shaina

There’s something that I didn’t bring up in our initial session that I’ve been wanting to share, but I’m not sure how to talk about it.

Therapist

Thank you for bringing this up. Is this something that you’d like to talk about now?

Shaina

I think so… but I’m not sure how, and I’m also not sure how you’ll react. This is the first time I’ve spoken to anyone about this.

Therapist

Sharing something about ourselves for the first time can be scary, even in therapy, but so can holding in something important because we’re afraid of how others will react. I want you to know this is a place for you to bring anything you’d like to share. There’s enough room here for every part of your life, and every part of you. What do you think of that?

Shaina

That makes sense. Thank you. Okay… so I’ve never told anyone this before, but I’m starting to realize that I’m attracted to women…*pause*

Therapist

Thank you so much for sharing that. I know how much it took to do so. Let’s sit with that a bit. How does it feel to share?

Shaina

A big relief to be honest. And you didn’t have any bad reaction either.

Therapist

No, I did not and I won’t. Our time together is for you to be able to express yourself and be who you are. I want to acknowledge how big it was for you to share that with me.

Shaina

It was big. I have so much to talk about...

Therapist

Shaina

Therapist

Shaina

Therapist

Things to consider.

01

Creating a supportive space, as well as fostering an ongoing therapeutic relationship can help patients get comfortable with sharing new things about themselves, including their sexualities.

02

Navigating the coming out process in personal, family, work and other settings can look very different. The decision to come out, in any context, is a very personal one. Supporting patients in their decision can help them navigate the feelings that arise.

Question to think about:

How would you support a patient who was coming out for the first time, in the therapy room?

Ask for pronouns
Ask how the patient is doing
Ask for consent before touching
All of the above