A Comparison of How Social Workers' Positive Practice and Determinants of Practice Vary Towards Lesbian and Gay, Bisexual, and Gender Minority Clients

Background and Purpose: Sexual and gender minority (SGM) clients use behavioral health treatment at greater rates than the general population, likely due to disproportionate rates of depression and anxiety, panic disorders, phobias, and substance use disorders.  Incidence and prevalence rates indicate that behavioral health problems vary among SGM sub-communities, including lesbians, gay men, bisexuals, and gender minority individuals.

In spite of these differences, research on positive social work practices with SGM clients focuses on lesbians and gay men, the results of which are then extrapolated to social work practice with bisexual and GM clients.  There is minimal research on positive social work practice and practice determinants with bisexual and GM clients and no research comparing these by client type.

This study assesses how social workers’ positive practice and determinants of practice vary among SGM sub-communities (lesbians and gay male clients, bisexual clients, and GM clients).  Specific determinants include social workers’ knowledge, skills, attitudes, affirmative counseling self-efficacy, and beliefs about positive practice.  This study also examines the interaction between these practice determinants and client type in predicting social workers’ positive practice behavior.

Methods: This study uses primary data collected via a cross-sectional survey.  Study participants (n=357) are a convenience sample of social workers serving as field instructors at a large, Mid-Atlantic University.  Participants received one of three versions of an online survey: 25% were asked about practice with lesbian and gay male clients, 25% were asked about practice with bisexual clients, and 50% were asked about practice with GM clients. The majority of the sample identified as white (79.3%), female (85.0%), and heterosexual (88.4%), and the most common age range was 30-39 (30.1%).

Factorial MANOVA with 1,000 bootstrap samples was used to compare social workers’ beliefs, knowledge, attitudes, skills, self-efficacy, and SGMT behaviors between lesbian and gay clients, bisexual clients, and GM clients.  To address unequal group sizes and the heterogeneity of variance, post-hoc comparisons between groups were calculated using Dunnett’s T3 Test.  Regression was used to test whether the interaction between each practice determinant and client type predicted social worker behavior.

Results: Results show that determinants of practice vary by client type.  Social workers had more positive attitudes about lesbian and gay male clients than GM clients.  Social workers reported more practice skills for lesbian and gay male clients than either bisexual or GM clients.  In spite of these differences in determinants of practice, engagement in positive practice behaviors did not vary between client type, and there was no interaction between practice determinants and client type in predicting social worker practice.

Conclusions and Implications: This research emphasizes the importance of considering SGM sub-groups separately from one another, especially in developing interventions designed to improve social workers’ skills and attitudes about SGM clients.  This research further suggests the need to explore whether other research findings on lesbian and gay clients are generalizable to bisexual and GM clients.