Monday, April 4, 2011

Coming Out, Coming Home: Interview with Michael C. LaSala, Ph.D.

Today's Social Work Podcast is about helping families adjust to a gay or lesbian child. According to the website, comingoutcominghome.com, "The discovery that a child is gay or lesbian can send shockwaves throughout a family. A mother will question how she's raised her son; a father will worry that his daughter will experience discrimination. From the child's perspective, gay and lesbian youth fear their families will reject them, and that they will lose financial and emotional support. All in all, learning a child is gay challenges long held views about sexuality and relationships, and the resulting uncertainty can produce, for all parties, anger, resentment, and concern for safety and acceptance." So, how can social workers help families adjust to a gay or lesbian child?

To get some answers, I spoke with Dr. Michael LaSala author of the 2010 book, Coming Out, Coming Home: Helping Families Adjust to a Gay or Lesbian Child, published by Columbia University Press. Dr. LaSala is director of the MSW program and associate professor at the School of Social Work at Rutgers University. He has been in practice for more than twenty-five years and he currently treats LGBT individuals and families at the Institute for Personal Growth in Highland Park, NJ. (http://www.ipgcounseling.com/). Dr. LaSala recently completed a Fulbright Fellowship in Estonia where he investigated the impacts of stigma on Estonian lesbians and gay men. In addition to his book and numerous scholarly publications, you can read his blog on Gay and Lesbian Well-Being on PsychologyToday.com

I had the pleasure of meeting Dr. LaSala when he came to Temple University to give the 2011 Social Work Research Lecture, sponsored by Temple’s School of Social Work and Center for Intervention and Practice Research. He gave a very engaging and informative talk to students and faculty about his federally funded, qualitative study of 65 families of gay and lesbian youth.  One of the surprising findings in his study was that some of the young people he interviewed “wanted to disclose their sexual orientation to their mothers and fathers because they believed that their parents could provide the support they needed to cope with the challenges of being gay” (LaSala, 2010, p. 55). Ok, so what’s surprising about kids wanting their parents support? Well, until recently, it was just kind of assumed that straight parents wouldn’t be supportive if and when they found out their child was gay or lesbian. Gay and lesbian children often found themselves disowned, kicked out of the house, cut-off financially, and even abused. As a result individual therapists and programs for LGBT youth focused on finding support networks - peers, friends, gay and lesbian adults, straight supporters, people who became the youth’s “chosen family” - who could provide emotional, financial and emergency support when biological families turned their backs on their LGBT kids.  For decades it was standard operating procedure for professionals to support youth to stay “in the closet” until college or into adulthood when they could be financially and emotionally independent of their parents.

So, ignoring the family seemed to make sense in 1980. But, according to researchers like Michael LaSala, Cindy Conley – whose work on concerns of parents of lesbians and gays was featured in Episode 62 of the Social Work Podcast, Caitlin Ryan – who talks about her groundbreaking work on the effects of families on the health and well-being of gay and lesbian in Episode 33 of Living Proof, the podcast series of the School of Social Work at the University at Buffalo – and others, ignoring the family doesn't work so well for gay and lesbian youth in in 2011. And clearly, it didn’t work for the kids in Dr. LaSala’s study.

There are a couple of very practical reasons for this recent focus on the family of gay and lesbian youth: For one, youth are coming out much younger than in the past. According to a 2006 study by Caitlin Ryan and her colleagues, kids in the USA are, on average, 13 when they come out. For professionals this means that you’re not dealing with kids about to graduate from high school, or in the middle of college. You’re dealing with 8th graders. And there’s a big difference between supporting a graduating senior to stay in the closet for three months so that her parents won’t refuse to pay for college, and supporting an 8th grader to stay in the closet for five to six years.


We’ve also learned that that parental support matters to adolescents. Even though peer influence increases during adolescence, it turns out that parents and families play a huge role in whether kids do well or do poorly. Pop quiz - what’s more important in keeping high school students from trying to kill themselves – parental support or peer support? Ok. I know that was a bad pop quiz because I set you up for the answer. But, just to be clear, it is parental support (Kidd et al., 2006).


The importance of families in the health and well-being of LGBT youth was highlighted by the Institute of Medicine's first-ever report on LGBT health, published in April 2011. In that report, families were identified as "an important social structure." Now the kids in Dr. LaSala's study didn't need to read an IOM report to know that. They knew that their families were an important source of support. They also knew that coming out wouldn't be easy, and that's why they wanted to come out to their parents - so their parents could provide that support. The IOM report also said that families were "a promising venue for interventions." Dr. LaSala's study, Coming Out, Coming Home, provides valuable insight into the types of interventions that might be useful with families of gay and lesbian youth.

In today's interview, Michael and I talked about the five stages that families in his study described going through before, during, and after finding out their child was gay or lesbian. We talked about some of the challenges that social workers face when a child hasn't come out to his or her parents. Michael gave some examples of practical and useful indirect questions that therapists can use with young clients whom they suspect are questioning their sexual orientation, but are ambivalent about discussing it. We talked about how managing stigma was a family affair. We ended our conversation with a discussion about empirical support for family-based work with gay and lesbian youth, as well as resources for social workers interested in learning more.

And now, on to Episode 66 of the Social Work Podcast: Coming Out, Coming Home: Interview with Michael C. LaSala, Ph.D.

Download MP3 [21:42]


Michael C. LaSala, Ph.D., LCSW
Director of MSW Program/Associate Professor
School of Social Work
Rutgers, The State University of New Jersey
536 George Street
New Brunswick, New Jersey 08901
http://www.michaellasala.com/
http://www.comingoutcominghome.com/

Transcript


Jonathan Singer: Michael, thanks so much for being here and talking with us today about families of gay and lesbian youth. And my first question for you is what are the stages that families go through?

Michael LaSala: Okay. Of course, that’s an excellent question and that’s central to the premise in my book. I became interested in looking at family stages because the traditional stories we hear about kids coming out to their parents is something – it goes something like this: Kid feels lonely and scared, comes out to his parents, parents are all upset, maybe they reject the child, maybe they don’t. They feel guilty. They feel anxious. They feel worried. They get education. They feel better. They embrace their child and then off they go into the sunset.

I strongly suspected that the process was much more complicated. Through my research, my interviews of 65 gay and lesbian youth and their parents, I realized that it wasn’t an individual process that parents were going through but instead it was a family coming out process and a family adjustment process.

And so, I came up with these five stages based on my research interviews: 1) family sensitization, which is the period of time before the child comes out but when the child is starting to come to terms with his or her own sexual orientation. 2) pre-coming out, which is that brief period of time - could be anywhere from one to three months - where tension is rising in the family and particularly among the kid and he feels like or she feels like gee, I really got to do something. I’m, you know, busting out of my skin here. 3) family discovery, which is when the parents find out about the child’s sexual orientation either because the child comes out or because the parent confronts the child and sort of pushes the child to come out. 4) family recovery, which is when the family starts to recover from the child coming out, starts to go through recovery process, begin that recovery process and then stage 5) family renewal. Family renewal is a stage where parents and the family gets to a point where it's closer and stronger than ever before than certainly before the coming out experience and so not all families get to the family renewal stage but some of them do.

Jonathan Singer: In your book, you talk about this pre-coming out phase, right.

Michael LaSala: Yes.

Jonathan Singer: The second one. It really seemed like it was one of the most challenging phases for the kids, the parents and also clinicians.

Michael LaSala: Well, it's very challenging because in the families that I interviewed and also in some of the families that I have done therapy with the parents know something is happening but they're not really sure what. The child is distancing or seems distressed or seems upset about something but nobody is really talking about it.

And so it's as if a balloon is being, is expanding and more and more air is going into it and it's like it's about to explode and so it's a very tricky time I think for families and also clinicians who may see families who are saying listen, there's something wrong. There's something wrong with our child but we don’t know exactly what it is and so that’s what makes it so challenging.

Jonathan Singer: Okay. So, the child does what it is. It's just that the parents don’t.

Michael LaSala: The parents don’t. The child is usually experiencing some kind stress related to his or her sexual orientation. Either the child is being bullied in school and is coming to a boiling point, a romance in school has broken up either a authentic romantic sexual relationship or a platonic relationship about which the child had some hopes and wishes for and that can set the child into a crisis and not knowing what to do, not knowing where to turn and the child becomes upset and so – then the parents know something is wrong and they don’t know what it is.

Jonathan Singer: I remember you talked about, with the folks that you interviewed, they said “my daughter was really sweet and pleasant and then something happened. I don’t know why she got really angry, she got really upset.” And it sounds like it was at that phase that some of them, some of the parents took their kids for services–

Michael LaSala: Yes.

Jonathan Singer: – and some didn’t.

Michael LaSala: Yes. I think parents had a very hard time. You could see from the interviews that they really struggled with did my child change because my child is now an adolescent or did my child start to become changed and become more irritable and moody because there was something else going on. And so parents needed to sort of do a differential diagnosis if you will. There's something – how much of this normal and how much isn’t.

Some parents were really clear that what was happening wasn’t normal because of the drama of some of the behaviors and then some were not sure. And so, that’s what made it kind of tricky for them. Going back to the pre-coming out phase, why it's also challenging for clinicians is that the clinician may also know something is wrong but the child isn't ready to say what it is.

And so, I had stories in the book if you recall of kids who had been sent to see a therapist or school social worker and knew that their problem was related to oh my God, I think I’m gay and I don’t know how to handle it but really didn’t feel comfortable enough to tell their social worker or their therapist. And to me, this is rather tragic because here was help right there for them and they didn’t feel like they could avail themselves of it.

And what these kids told me was that even if the social worker specifically asked about this which the social workers generally do not, they would not have told them because then they thought the social worker will then go tell their parents and then their secret will be out and they're not ready for the secret to be out. So, that’s another big challenge of this pre-coming out phase.

Jonathan Singer: You also talked about the challenge of the therapist who think that they should–

Michael LaSala: Oh yes.

Jonathan Singer: – talk about this, can you talk about that?

Michael LaSala: Okay. Well, I do think a social worker or a therapist who works really hard to present themselves as somebody who is really accepting and tolerant and open to a person’s sexual orientation and wants the child to disclose if that’s what the issue is, I think those – I think their heart is definitely in the right place. But this is not something that you can push onto a child or make them disclose.

I compared it in the book to, you know, a child coming to terms with their sexual orientation takes a while and it's almost like if you confront them too soon it's like taking a cake out of the oven before it's fully baked. They're just not ready. Maybe a better metaphor is almost like ripping a Band Aid off too soon off of a wound. It's just too soon. And most kids I know just will stonewall you anyway.

So, I think that this is not something you can confront a child on. I do list some questions in the book and I borrowed them from some esteemed colleagues who’ve written a book on, another book on family therapy with these families, some indirect questions that therapists can ask if they suspect the child is gay or lesbian, that kind of let the kid know that if this is something you're struggling with I can handle it.

More like projective type of questions like what do you think of a boy who falls in love with another boy? What do think his friends would think? What should a girl do if she has a crush on her best friend? Those kinds of things, I would recommend going at those very gently and gingerly. In the meantime, you know, social workers are very concerned about environment and the environments in, you know, in which we work with our clients, so if you're seeing clients in an office and you want to project that you have a positive attitude about LGBT people then perhaps there should be magazines, LGBT magazines, rainbow flag somewhere in the office that communicates to a kid who may be struggling who is not quite ready yet to say anything but communicates to that kid, okay, this is somebody I could probably go to and tell if I need to and I think that’s, that’s what I would recommend.

Jonathan Singer: And it sounds like having those environmental cues addresses this issue that you bring up over and over in your book which is stigma–

Michael LaSala: Right.

Jonathan Singer: – which is this idea that there's, there's stigma and - what did you call the evil handmaiden - “shame?”

Michael LaSala: Shame, exactly.

Jonathan Singer: Which I thought was a beautiful phrase.

Michael LaSala: Thank you. Yes. But I think that’s true I mean it's beautiful but, of course, tragic in a way that people who are – that shame is, of course, the by-product of being stigmatized and so if you make your office a place where this kid is not going to experience that kind of stigma then, of course, I think it makes them more open and more willing or more likely to talk about other, talk about their issues of sexual orientation, their confusion around that, etc.

Jonathan Singer: And one of the things that you wrote in your book was that managing stigma is a family affair and I think this gets back to your idea that working with kids or gay and lesbian isn't just about working with kids or gay and lesbians, working with their families.

Michael LaSala: Right.

Jonathan Singer: Could you talk about what you meant by that?

Michael LaSala: Right. What I think – what I thought was so interesting is that even in the best adjusted families, they still had to deal with the ongoing issue of stigma, that once a child comes out it's as if they’ve taken the stigma ball and handed it to the parents and now the parents have to deal with – parents were talking to me a lot in this research about now when I go to work and somebody says an anti-gay joke, I don’t know what to do.

Should I speak up? Should I not? Should I tell my co-worker that my kid is gay or not? On the one hand, it’s really just about what my kid does in bed. But on the other hand, you know, it's also about my kid’s social life and co-workers are saying that their children are getting married and they're asking me do you have kids, are they married, do they have a boyfriend or girlfriend. So, to watch – it was very interesting to watch these parents struggle with issues that those of us who are gay or lesbian have had to struggle with all along.

So, what I recommend in the book in working with these families is that when families are struggling with who do I tell? What happens if somebody says a gay joke? Do I tell people at work, etc. that they lean on their kids a bit because their children in many ways may be experts in this area and may be able to shepherd them through some of these things.

Jonathan Singer: Right because the kids have had to go through this. I mean, they–

Michael LaSala: Exactly. And usually have had a history of dealing with this way before they tell their parents and so that history can be used to inform parents about okay, how, how does this get handled?

Jonathan Singer: There's a lot of pressure to use empirically supported treatments, evidenced-based practices–

Michael LaSala: Mm-hmm.

Jonathan Singer: – and I’m wondering what your recommendation is. You mentioned a lot in this book about, that this is research but you, you inform it with your clinical practice and so if we have families or clinicians out there that are listening to this and they're thinking yes, I do work with these families, am I doing evidence-based practice if I do what Dr. LaSala says?

Michael LaSala: Well, I can't say that that’s true. As a matter of fact, I think there's a real shortage and I’m not sure if I can think offhand of any evidence-based practices for this population per se. Certainly, the interventions that I recommend here are research-informed interventions and the way I see it is that the research form the bricks and clinical wisdom is the mortar in terms of building, you know, clinical practice with, with these kinds of families and maybe with any, in any kind of clinical practice that would reflect my opinions about that that you need really a combination.

But nevertheless I think that a worthy study could be to take some of the interventions I have come up with and for somebody to submit them to some empirical testing that that would be quite interesting.

Jonathan Singer: That would be a nice way of furthering the research.

Michael LaSala: It certainly would. I'll be glad to help anybody or work with anybody who’d be willing to do something like that.

Jonathan Singer: All right. So, if you're into this and you're in a doctoral program and you're listening to this, you know, you can go to the website and get Dr. LaSala contact information.

Michael LaSala: Right.

Jonathan Singer: So, other than your book–

Michael LaSala: Mm-hmm.

Jonathan Singer: – what resources are there that you could recommend for folks who are interested in knowing how to be better providers, better service providers for families with gay and lesbian youth?

Michael LaSala: There’s a lot of books in the bibliography of my book. I highly recommend though that people consult whether they're clinicians or parents or kids that they consult an organization called PFLAG and PFLAG is an acronym for Parents, Families and Friends of Lesbians and Gays. PFLAG is an organization, a national organization with chapters, local chapters everywhere and the purpose of this organization is to provide support for parents and family members of lesbians and gays and also to do some political advocacy.

And so I would recommend – you can go to their website and there's lots of good resources there, http://www.pflag.org/. There are a lot of authors that have written useful books that will help clinicians. There's somebody named Lopata L-O-P-A-T-A who’s written a very interesting book on how Catholic families struggle with this issue from a religious perspective. The work of Ritch Savin-Williams who’s a very esteemed colleague of mine.

I have not met him yet but I have a lot of admiration for his work. The work of Gilbert Herdt, Tony D’Augelli who’s written predominantly articles about suicidal – the protective factors of the family in mental health and also the work of Caitlin Ryan out in San Francisco, I would recommend as well.

Jonathan Singer: Well, that’s great. Well, Michael, thank you so much for taking the time to talk with us today about your research and the work that you’ve done with these families of gay and lesbian youth.

Michael LaSala: Thank you for having me. It's my pleasure.

--END--

References and Resources


APA (6th ed) citation for this podcast:

Singer, J. B. (Producer). (2011, April 4). Coming Out, Coming Home: An Interview with Michael C. LaSala, Ph.D. [Episode 66]. Social Work Podcast [Audio podcast]. Retrieved from http://socialworkpodcast.com/2011/04/coming-out-coming-home-interview-with.html

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