Designing a comprehensive care program for high-cost clients in a managed care environment.
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Biomedical subjects
Publications and source records attributed to D P McWhirter.
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Although a body of scientific data about working with parents and families of gays and lesbians has not yet developed, there is a growing body of literature of an anecdotal and personal nature that has been cited. These works provide therapists with background information and clients needing assistance with guided reading. Therapists working with families and friends of gay men can find the experience rewarding and the therapeutic interventions effective. Much of the work is common sense, listening with the "third" ear for those underlying issues separate from the son's gayness that may affect the person's attitudes, feelings, and responses. Maintaining a professional demeanor while conveying a sense of caring and concern for the individuals is a key issue. As gay people become more visible in society and as the number of individuals coming out increases, there will be a need for more therapists who can assist families with their own coming out process. This article provides some basic guidelines and, as individual therapists gain more experience in this area, it will be important that others report those experiences, sharing them with the rest of the therapist community.
Any characteristic in the developmental stages of relationships has the potential for being at the core of a stage discrepancy problem. A few of the more frequently seen stage discrepancies are (a) reappearance of the individual in Stage Three in conflict with the merging of Stage One, (b) reappearance of the individual in Stage Three threatening the dependability of the partner in Stage Four, and (c) the high limerence of Stage One in sharp contrast with the loss of limerence in Stage Two. As a side issue, and as has been stated elsewhere, one of the most common causes for terminating male relationships toward the end of the first year is the loss of limerence. Examples of characteristics in conflict are as numerous as the characteristics in male couples. In some instances, characteristics of later stages appear earlier as symptoms of insecurity, dependency, or difficulty in managing the aging process. Stage discrepancies often appear as behavioral manifestations, or as symptoms of the difficulties that the couple or individual is having in resolving the stage discrepancy problem. However, the conflicts are often presented to the psychotherapy as problems of: (a) developing or maintaining intimacy; (b) power, competition, or control issues; (c) jealousy; or (d) differences in dealing with expressions of anger or tenderness. Utilizing the framework of stages of relationships and the possibility of discrepancy in the developmental characteristics can give the psychotherapist added understanding of the presenting complaints of male couples, which in turn can lead to a better assessment of the couples' difficulties and the development of new strategies of treatment intervention.
This paper reports a 2-year experience in treating sexual dysfunction in 22 gay male couples. The full range of arousal, orgasmic and desire phase disorders as well as case examples and variations in treatment techniques are discussed. To date, this comparative neglected area of research and treatment has yielded encouraging results.
Although there is no specific therapy for gay male couples, this paper outlines the more critical issues therapists must understand to provide optimal treatment for gay male dyads. Additionally, the authors present new assumptions arising from their five year research study of 156 gay male couples living together from one to over 37 years. The most therapeutically useful finding is that stages of these relationships parallel stages of clinical development. Each stage has its own unique characteristics, stresses and benefits. Stages are affected by many influences, and individuals can be at different stages simultaneously.