Diverse Paths Psychotherapy
Clinical Consultation for Therapists
Many of us clinicians are LGBTQIA -friendly, or tolerant of folx who engage in kink, BDSM, or alternative relationship styles like polyamory, but friendliness and tolerance are not competence. If you've found yourself serving a client who identifies with any, or all, of these populations, and you are often confused or feel uninformed, I'm here to help! Competence training in the form of clinical consultation can be an effective way to both learn broadly about a population to expand your cultural competence as well get help with a specific case.
I've heard all too often from new clients that they have left their previous therapist due only to the fact that they were ignorant in some way about their lifestyle or cultural identity. Don't let this be you!
What is kink-competent therapy?
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Kink-competent therapy is a therapeutic approach that acknowledges and respects diverse expressions of human sexuality, particularly those related to kink, BDSM (bondage, discipline, dominance, submission, sadism, masochism), fetishism, and other alternative sexual practices. It is a type of therapy that honors client’s kinks and seeks to explore them without judgment. This work often involves helping clients dissolve their shame and guilt around certain kinks or fetishes. Kink-competent therapists understand that these desires are valid and can play an integral role in an individual's identity and well-being. Kink can even play a vital role in trauma-recovery. Work is done collaboratively with clients to address any issues or concerns they may have related to their kink interests while promoting self-acceptance, communication, and consent.
If you have kinky clients and need support in becoming more competent with their sexuality, I am here to help!
What is non-monogamy-competent therapy?
Non-monogamy-competent psychotherapy is informed by, and affirming of, consensual non-monogamy (CNM) in its various forms (such as polyamory, open relationships, and relationship anarchy), rather than being implicitly organized around monogamous norms. The clinician approaches CNM as one valid form of relationship structure among many and does not treat it as synonymous with infidelity or as evidence of psychopathology.
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For clinicians, this begins with a substantive knowledge base. Non-monogamy-competent therapists have a working understanding of common CNM configurations, language, and practices, as well as typical stressors that clients may face. These stressors often include stigma and minority stress, risks related to disclosure or being outed, legal and parenting concerns, and the impact of community and subcultural norms. Competent clinicians are familiar with the emerging research literature on CNM and can differentiate between problems that arise from the relationship structure itself and problems that arise from external pressures and discrimination.
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A central component is an affirming, non-pathologizing stance. The therapist treats CNM as a legitimate relational choice rather than automatically linking it to trauma histories, fear of commitment, or personality pathology. This includes active examination and management of one’s own biases, as well as an awareness of the broader cultural narratives that position non-monogamy as inherently unstable or harmful. A minority stress framework is useful here, helping the clinician to recognize how social stigma and structural factors contribute to distress, rather than attributing difficulties solely to the presence of multiple partners.
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Clinically, competence involves the ability to work effectively with issues that are common or uniquely complex in CNM contexts. This may include navigating attachment patterns across multiple significant relationships, addressing jealousy and insecurity without moralizing, supporting nuanced boundary-setting and renegotiation, and facilitating communication and conflict resolution in multi-partner systems. The therapist must be able to conceptualize cases in ways that do not default to a single primary dyad, and to think flexibly about loyalty, commitment, and alliance when more than two people are involved. Attention to power dynamics, privilege, and potential triangulation within multi-partner constellations is also essential.
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Non-monogamy-competent psychotherapy is grounded in client-defined relationship goals. Rather than assuming that “healthy” relationships are monogamous or that therapy should move clients toward monogamy (or toward any particular CNM configuration), the clinician collaborates with clients to articulate what health, commitment, and success mean for them within their chosen structures. The therapist respects the level at which clients wish to work—whether individually, as a dyad, or as a larger partner group—while maintaining clear agreements about roles, confidentiality, and boundaries with each participant.
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Finally, a key aspect of competence is transparency about the limits of one’s expertise. Non-monogamy-competent clinicians are honest with clients about their experience with CNM populations and do not rely on clients to provide basic education about non-monogamy. They seek consultation, supervision, and continuing professional development specific to CNM when appropriate, and they refer to more specialized providers if the client’s needs fall outside their current scope of competence.
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That's where I come in! Please book a professional consultation with me today so that I might help you with your blind-spots and provide you with valuable resources.
What is LGBTQIA+ -competent therapy?
LGBTQIA-competent therapy is grounded in an accurate, current understanding of sexual orientation, gender identity and expression, and variations in sex characteristics, and that is explicitly affirming of lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other sexually and gender-diverse people. We work to de-center cisgender, heterosexual identities as the prescribed norm.
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For clinicians, LGBTQIA competence begins with a solid knowledge base. This includes an understanding of basic and more nuanced terminology (e.g., distinctions between sexual orientation, gender identity, gender expression, and sex assigned at birth; the diversity within trans, non-binary, intersex, and asexual communities; and cultural differences in identity labels). It also involves familiarity with the empirical literature on LGBTQIA mental health, including elevated rates of anxiety, depression, suicidality, and substance use, and the fact that these disparities are better explained by minority stress, victimization, and structural exclusion than by LGBTQIA identities themselves.
Clinicians need to be aware of relevant developmental issues (such as coming out, identity integration, and family responses), as well as the impact of religious, cultural, racial, and socioeconomic contexts.
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An affirming, non-pathologizing stance is central. LGBTQIA-competent therapists do not conceptualize sexual or gender diversity as inherently disordered, nor do they frame LGBTQIA identities as symptoms to be treated or as problems to be “fixed.” They explicitly reject and avoid any form of conversion or “reparative” efforts. Instead, they adopt a minority stress framework, recognizing how stigma, discrimination, internalized oppression, and the anticipation of rejection contribute to psychological distress. This allows the clinician to distinguish between distress arising from the client’s internal world and distress that is a rational response to unsafe or invalidating environments, and to target interventions accordingly.
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Clinically, competence entails skill in addressing concerns that commonly arise in LGBTQIA populations and in recognizing when seemingly “generic” issues are shaped by sexual and gender minority status. The therapist is able to work effectively with identity development, coming out and disclosure decisions, family rejection or ambivalence, relationship structures and norms within queer communities, and the psychological impact of harassment, violence, and institutional discrimination. For transgender and non-binary clients, this includes understanding gender dysphoria and gender euphoria, the range of social and medical affirmation pathways, and the mental health sequelae of gatekeeping, misgendering, and lack of access to gender-affirming care. For intersex clients, this includes awareness of medical trauma, non-consensual interventions, and secrecy in families and medical systems. The clinician can assess risk and resilience in ways that account for these realities and can integrate trauma-informed approaches when appropriate.
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LGBTQIA-competent therapy is also culturally responsive and intersectional. Competent clinicians recognize that LGBTQIA clients are not a monolith and that sexual and gender diversity intersect with race, ethnicity, disability, immigration status, religion, and class in ways that shape both stress and resilience. They explore how these intersecting identities influence the client’s experience of safety, community, and discrimination, and they avoid imposing White, Western, or middle-class queer norms as the benchmark for healthy identity expression. They attend to power dynamics in the therapeutic relationship, including how their own identities and social locations (e.g., as cis or trans, straight or queer) may affect the client’s perceptions of safety and trust.
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In practice, LGBTQIA competence is reflected in the structure and environment of care as well as in the therapist’s attitudes. This includes using correct names and pronouns, asking about and respecting partners and family configurations without heteronormative or cisnormative assumptions, and ensuring that intake forms, documentation, and office materials are inclusive. It also involves thoughtful handling of confidentiality and safety concerns—for example, around outing in unsupportive families, workplaces, or cultural communities—and careful navigation of legal and institutional constraints that may impact gender-affirming care or relationship recognition.
Finally, LGBTQIA-competent clinicians are transparent about their scope of competence and remain engaged in ongoing learning. They do not expect clients to serve as their primary educators about basic LGBTQIA issues. Instead, they seek supervision, consultation, and continuing education specific to LGBTQIA mental health, stay current with evolving language and standards of care, and refer to more specialized providers when a client’s needs exceed their expertise (for example, around complex medical transition decisions or intersex-specific advocacy).
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In sum, LGBTQIA-competent therapy is not merely “being welcoming to everyone”; it is the integration of affirming attitudes, substantive knowledge, and specific clinical skills that enable clinicians to work ethically, effectively, and collaboratively with LGBTQIA clients, with a clear appreciation of how systemic oppression and minority stress shape their lives and mental health.
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Please reach out if clinical consultation would benefit your practice and your clients!