Managed care is the bane of most therapists’ lives. Our paperwork load has increased beyond belief. Our incomes have been cut in half or worse. And we are expected to do something most of us were never trained to do: talk about what we do in the therapy room in some measurable way.

Many therapists have dealt with the plummeting income problem by leaving the field. Those of us who are left have learned to broaden our practice areas. But we still struggle to describe our therapy in a way that satisfies managed care’s insatiable appetite for behavioral therapeutic goals.

Hallelujah! J. M. Evosevich and Michael Avriette have given therapists who work with gay men and lesbians an answer to the problem: a treatment planner. Like the first book in the series, The Complete Adult Psychotherapy Treatment Planner, this second treatment planner is impressively comprehensive: twenty-seven different problems lesbian and gay clients are likely to bring to therapy.

The presenting problem list falls into three basic categories. The first group consists of those problems, like anxiety and depression, common to both gays and heterosexuals. The second group consists of problems specific to the gay and lesbian population, such as, coming out and internalized homophobia. The third group consists of problems common to gays and heterosexuals but requiring considerably different emphasis when presented by gays and lesbians. These problems include adoption and religious conflicts.

No matter which problem area they are addressing, the authors’ position is that being gay or lesbian is not the problem. Their implied assumption is that family of origin, organized religion and dominant culture frequently have a problem with people who are gay or lesbian. These larger groups then create problems for gays and lesbians and those problems impact mental health.

What can you expect to find in this book? The Treatment Planner provides an overall description of the problem as well as short-term and long-term therapeutic goals. Then we are given a selection of interventions, all described in behavioral terms. Most importantly, we are also given clear instructions on how to formulate a treatment plan: step one…step two…step three… Evosevich and Avriette walk us through the process of creating a treatment plan that is clear, behavioral and likely to please the most finicky managed care company.

Of course, gay and lesbian clients sometimes present with issues in which sexual orientation is irrelevant to the problem. For those times this book is of limited value and the therapist will have to use other resources.

Bottom line: is this book worth buying? If you are a therapist working with gay men and lesbians, The Gay and Lesbian Psychotherapy Treatment Planner may be one of the most useful and most used books you buy this year.

Gail Ann Rekers, Ph.D. is psychologist in private practice in Dallas, TX. She has over 15 years experience doing psychotherapy with a highly diverse population. She also consults with attorneys and their clients as a jury and litigation consultant. In addition, Dr. Rekers teaches as an adjunct at the University of Texas at Dallas.

Categories: Psychotherapy