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Research Articles

Mental health provider bias and clinical competence in addressing asexuality, consensual non-monogamy, and BDSM: a narrative review

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Pages 131-154 | Received 20 Mar 2021, Accepted 02 Aug 2021, Published online: 01 Sep 2021

References

  • Aicken, C. R. H., Mercer, C. H., & Cassell, J. A. (2013). Who reports absence of sexual attraction in Britain? Evidence from national probability surveys. Psychology and Sexuality, 4(2), 121–135. https://doi.org/10.1080/19419899.2013.774161
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
  • American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57(12), 1060–1073. https://doi.org/10.1037/0003-066X.57.12.1060
  • American Psychological Association. (2012). Guidelines for psychological practice with lesbian, gay, and bisexual clients. American Psychologist, 67(1), 10–42. https://doi.org/10.1037/a0024659
  • American Psychological Association. (2015). Guidelines for psychological practice with transgender and gender nonconforming people. American Psychologist, 70(9), 832–864. https://doi.org/10.1037/a0039906
  • American Psychological Association. (2021). Guidelines for psychological practice with sexual minority persons. https://www.apa.org/about/policy/psychological-sexual-minority-persons.pdf
  • Barker, M., & Langdridge, D. (2010). Whatever happened to non-monogamies? Critical reflections on recent research and theory. Sexualities, 13(6), 748–772. https://doi.org/10.1177/1363460710384645
  • Berry, M. D., & Lezos, A. N. (2017). Inclusive sex therapy practices: A qualitative study of the techniques sex therapists use when working with diverse sexual populations. Sexual and Relationship Therapy, 32(1), 2–21. https://doi.org/10.1080/14681994.2016.1193133
  • Bogaert, A. F. (2004). Asexuality: Prevalence and associated factors in a national probability sample. Journal of Sex Research, 41(3), 279–287. https://doi.org/10.1080/00224490409552235
  • Bogaert, A. F. (2015). Asexuality: What it is and why it matters. Journal of Sex Research, 52(4), 362–379. https://doi.org/10.1080/00224499.2015.1015713
  • Brotto, L. A., Knudson, G., Inskip, J., Rhodes, K., & Erskine, Y. (2010). Asexuality: A mixed-methods approach. Archives of Sexual Behavior, 39(3), 599–618. https://doi.org/10.1007/s10508-008-9434-x
  • Brotto, L. A., & Yule, M. A. (2011). Physiological and subjective sexual arousal in self-identified asexual women. Archives of Sexual Behavior, 40(4), 699–712. https://doi.org/10.1007/s10508-010-9671-7
  • Burnes, T. R., Singh, A. A., & Witherspoon, R. G. (2017). Graduate counseling psychology training in sex and sexuality: An exploratory analysis. The Counseling Psychologist, 45(4), 504–527. https://doi.org/10.1177/0011000017714765
  • Carrigan, M. (2011). There’s more to life than sex? Difference and commonality within the asexual community. Sexualities, 14(4), 462–478. https://doi.org/10.1177/1363460711406462
  • Cassidy, T., & Wong, G. (2018). Consensually nonmonogamous clients and the impact of mononormativity in therapy. Canadian Journal of Counselling and Psychotherapy, 52(2), 119–139. https://cjc-rcc.ucalgary.ca/article/view/61124
  • Conley, T. D., Matsick, J. L., Moors, A. C., & Ziegler, A. (2017). Investigation of consensually nonmonogamous relationships: Theories, methods, and new directions. Perspectives on Psychological Science, 12(2), 205–232. https://doi.org/10.1177/1745691616667925
  • Dunkley, C. R., & Brotto, L. A. (2018). Clinical considerations in treating BDSM practitioners: A review. Journal of Sex & Marital Therapy, 44(7), 701–712. https://doi.org/10.1080/0092623X.2018.1451792
  • Flanagan, S. K., & Peters, H. J. (2020). Asexual-identified adults: Interactions with health-care practitioners. Archives of Sexual Behavior, 49(5), 1631–1643. https://doi.org/10.1007/s10508-020-01670-6
  • Ferrari, R. (2015). Writing narrative style literature reviews. Medical Writing, 24(4), 230–235. https://doi.org/10.1179/2047480615Z.000000000329
  • Finn, M. D., Tunariu, A. D., & Lee, K. C. (2012). A critical analysis of affirmative therapeutic engagements with consensual non-monogamy. Sexual and Relationship Therapy, 27(3), 205–216. https://doi.org/10.1080/14681994.2012.702893
  • Ford, M. P., & Hendrick, S. S. (2003). Therapists’ sexual values for self and clients: Implications for practice and training. Professional Psychology: Research and Practice, 34(1), 80–87. https://doi.org/10.1037/0735-7028.34.1.80
  • Foster, A. B., & Scherrer, K. S. (2014). Asexual-identified clients in clinical settings: Implications for culturally competent practice. Psychology of Sexual Orientation and Gender Diversity, 1(4), 422–430. https://doi.org/10.1037/sgd0000058
  • Ginicola, M. M., & Ruggiero, A. (2017). Counseling asexual clients. In M. M. Ginicola, C. Smith, & J. M. Filmore (Eds.), Affirmative counseling with LGBTQI + people (pp. 251–258). American Counseling Association.
  • Girard, A., & Brownlee, A. (2015). Assessment guidelines and clinical implications for therapists working with couples in sexually open marriages. Sexual and Relationship Therapy, 30(4), 462–474. https://doi.org/10.1080/14681994.2015.1028352
  • Graham, N. (2014). Polyamory: A call for increased mental health professional awareness. Archives of Sexual Behavior, 43(6), 1031–1034. https://doi.org/10.1007/s10508-014-0321-3
  • Greaves, L. M., Barlow, F. K., Huang, Y., Stronge, S., Fraser, G., & Sibley, C. G. (2017). Asexual identity in a New Zealand national sample: Demographics, well-being, and health. Archives of Sexual Behavior, 46(8), 2417–2427. https://doi.org/10.1007/s10508-017-0977-6
  • Grunt-Mejer, K., & Campbell, C. (2016). Around consensual nonmonogamies: Assessing attitudes toward nonexclusive relationships. Journal of Sex Research, 53(1), 45–53. https://doi.org/10.1080/00224499.2015.1010193
  • Grunt-Mejer, K., & Łyś, A. (2019). They must be sick: Consensual nonmonogamy through the eyes of psychotherapists. Sexual and Relationship Therapy, Advanced online publication. https://doi.org/10.1080/14681994.2019.1670787
  • Gupta, K. (2017). What does asexuality teach us about sexual disinterest? Recommendations for health professionals based on a qualitative study with asexually identified people. Journal of Sex & Marital Therapy, 43(1), 1–14. https://doi.org/10.1080/0092623X.2015.1113593
  • Haupert, M. L., Gesselman, A. N., Moors, A. C., Fisher, H. E., & Garcia, J. R. (2017). Prevalence of experiences with consensual nonmonogamous relationships: Findings from two national samples of single Americans. Journal of Sex & Marital Therapy, 43(5), 424–440. https://doi.org/10.1080/0092623X.2016.1178675
  • Henrich, R., & Trawinski, C. (2016). Social and therapeutic challenges facing polyamorous clients. Sexual and Relationship Therapy, 31(3), 1–390. https://doi.org/10.1080/14681994.2016.1174331
  • Hillier, K. (2018). Counselling diverse groups: Addressing counsellor bias toward the BDSM and D/S subculture. Canadian Journal of Counselling and Psychotherapy, 52(1), 65–77. https://cjc-rcc.ucalgary.ca/article/view/61095
  • Hoff, G., & Sprott, R. A. (2009). Therapy experiences of clients with BDSM sexualities: Listening to a stigmatized sexuality. Electronic Journal of Human Sexuality, 12. http://mail.ejhs.org/Volume12/bdsm.htm
  • Hutzler, K. T., Giuliano, T. A., Herselman, J. R., & Johnson, S. M. (2016). Three’s a crowd: Public awareness and (mis)perceptions of polyamory. Psychology & Sexuality, 7(2), 69–87. https://doi.org/10.1080/19419899.2015.1004102
  • Jordan, L. S. (2018). “My mind kept creeping back …this relationship can’t last”: Developing self-awareness of monogamous bias. Journal of Feminist Family Therapy, 30(2), 109–127. https://doi.org/10.1080/08952833.2018.1430459
  • Katz, M. I. L., & Graham, J. R. (2020). Building competence in practice with the polyamorous community: A scoping review. Social Work, 65(2), 188–196. https://doi.org/10.1093/sw/swaa011
  • Kelsey, K., Stiles, B. L., Spiller, L., & Diekhoff, G. M. (2013). Assessment of therapists’ attitudes towards BDSM. Psychology and Sexuality, 4(3), 255–267. https://doi.org/10.1080/19419899.2012.655255
  • Kink Clinical Practice Guidelines Project. (2019). Clinical practice guidelines for working with people with kink interests. https://www.kinkguidelines.com/the-guidelines
  • Kolmes, K., Stock, W., & Moser, C. (2006). Investigating bias in psychotherapy with BDSM clients. Journal of Homosexuality, 50(2-3), 301–324. https://doi.org/10.1300/J082v50n02_15
  • Kolmes, K., & Witherspoon, R. G. (2017). Therapy with a consensually nonmonogamous couple. Journal of Clinical Psychology, 73(8), 954–964. https://doi.org/10.1002/jclp.22509
  • Lawrence, A. A., & Love-Crowell, J. (2008). Psychotherapists’ experience with clients who engage in consensual sadomasochism: A qualitative study. Journal of Sex & Marital Therapy, 34(1), 67–85. https://doi.org/10.1080/00926230701620936
  • Lick, D. J., Durso, L. E., & Johnson, K. L. (2013). Minority stress and physical health among sexual minorities. Perspectives on Psychological Science, 8(5), 521–548. https://doi.org/10.1177/1745691613497965
  • Lin, K. (2017). The medicalization and demedicalization of kink: Shifting contexts of sexual politics. Sexualities, 20(3), 302–323. https://doi.org/10.1177/1363460716651420
  • MacInnis, C. C., & Hodson, G. (2012). Intergroup bias toward “Group X”: Evidence of prejudice, dehumanization, avoidance, and discrimination against asexuals. Group Processes & Intergroup Relations, 15(6), 725–743. https://doi.org/10.1177/1368430212442419
  • Matsick, J. L., Conley, T. D., Ziegler, A., Moors, A. C., & Rubin, J. D. (2014). Love and sex: Polyamorous relationships are perceived more favourably than swinging and open relationships. Psychology & Sexuality, 5(4), 339–348. https://doi.org/10.1080/19419899.2013.832934
  • McCoy, M. A., Stinson, M. A., Ross, D. B., & Hjelmstad, L. R. (2015). Who’s in our clients’ bed? A case illustration of sex therapy with a polyamorous couple. Journal of Sex & Marital Therapy, 41(2), 134–144. https://doi.org/10.1080/0092623X.2013.864366
  • Meixel, A., Yanchar, E., & Fugh-Berman, A. (2015). Hypoactive sexual desire disorder: Inventing a disease to sell low libido. Journal of Medical Ethics, 41(10), 859–862. https://doi.org/10.1136/medethics-2014-102596
  • Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674
  • Miller, S. A., & Byers, E. S. (2010). Psychologists’ sexual education and training in graduate school. Canadian Journal of Behavioural Science/Revue Canadienne des Sciences du Comportement, 42(2), 93–100. https://doi.org/10.1037/a0018571
  • Nichols, M. (2006). Psychotherapeutic issues with “kinky” clients: Clinical problems, yours and theirs. Journal of Homosexuality, 50(2-3), 281–348. https://doi.org/10.1300/J082v50n02_14
  • Pillai-Friedman, S., Pollitt, J. L., & Castaldo, A. (2015). Becoming kink-aware – A necessity for sexuality professionals. Sexual and Relationship Therapy, 30(2), 196–210. https://doi.org/10.1080/14681994.2014.975681
  • Pinto, S. A. (2014). ASEXUally: On being an ally to the asexual community. Journal of LGBT Issues in Counseling, 8(4), 331–343. https://doi.org/10.1080/15538605.2014.960130
  • Richters, J., De Visser, R. O., Rissel, C. E., Grulich, A. E., & Smith, A. M. A. (2008). Demographic and psychosocial features of participants in Bondage and Discipline, “Sadomasochism” or Dominance and Submission (BDSM): Data from a national survey. The Journal of Sexual Medicine, 5(7), 1660–1668. https://doi.org/10.1111/j.1743-6109.2008.00795.x
  • Rothblum, E. D., Krueger, E. A., Kittle, K. R., & Meyer, I. H. (2020). Asexual and non-asexual respondents from a U.S. population-based study of sexual minorities. Archives of Sexual Behavior, 49(2), 757–767. https://doi.org/10.1007/s10508-019-01485-0
  • Sabin, J. A., Riskind, R. G., & Nosek, B. A. (2015). Health care providers’ implicit and explicit attitudes toward lesbian women and gay men. American Journal of Public Health, 105(9), 1831–1841. https://doi.org/10.2105/AJPH.2015.302631
  • Schechinger, H. A., Sakaluk, J. K., & Moors, A. C. (2018). Harmful and helpful therapy practices with consensually non-monogamous clients: Toward an inclusive framework. Journal of Consulting and Clinical Psychology, 86(11), 879–891. https://doi.org/10.1037/ccp0000349
  • Shahbaz, C., & Chirinos, P. (2017). Becoming a kink aware therapist. Routledge/Taylor & Francis Group.
  • Sheff, E., & Hammers, C. (2011). The privilege of perversities: Race, class and education among polyamorists and kinksters. Psychology and Sexuality, 2(3), 198–223. https://doi.org/10.1080/19419899.2010.537674
  • Sizemore, K. M., & Olmstead, S. B. (2017). A systematic review of research on attitudes towards and willingness to engage in consensual non-monogamy among emerging adults: Methodological issues considered. Psychology & Sexuality, 8(1-2), 4–23. https://doi.org/10.1080/19419899.2017.1319407
  • Snowden, L. R. (2003). Bias in mental health assessment and intervention: Theory and evidence. American Journal of Public Health, 93(2), 239–243. https://doi.org/10.2105/ajph.93.2.239
  • Sprott, R., & Randall, A. (2017). Health disparities among kinky sex practitioners. Current Sexual Health Reports, 9(3), 104–108. https://doi.org/10.1007/s11930-017-0113-6
  • Sprott, R. A., & Schechinger, H. (2019, April). Consensual non-monogamy: A brief summary of key findings and recent advancements. The Family Psychologist. http://www.apadivisions.org/division-43/publications/newsletters/2019/04/non-monogamy
  • Stayton, W. R. (1998). A curriculum for training professionals in human sexuality using the Sexual Attitude Restructuring (SAR) model. Journal of Sex Education and Therapy, 23(1), 26–32. https://doi.org/10.1080/01614576.1998.11074203
  • Steelman, S. M., & Hertlein, K. M. (2016). Underexplored identities: Attending to asexuality in therapeutic contexts. Journal of Family Psychotherapy, 27(2), 85–98. https://doi.org/10.1080/08975353.2016.1169014
  • Stockwell, F. M. J., Hopkins, L. S., & Walker, D. J. (2017). Implicit and explicit attitudes toward mainstream and BDSM sexual practices and their relation to interviewer behavior: An analogue study. The Psychological Record, 67(4), 435–446. https://doi.org/10.1007/s40732-017-0225-4
  • Weitzman, G. (2006). Therapy with clients who are bisexual and polyamorous. Journal of Bisexuality, 6(1-2), 137–164. https://doi.org/10.1300/J159v06n01_08
  • Weitzman, G. D. (2017). Counseling clients in polyamorous relationships. In J. Fitzgerald (Ed.), Foundations for couples’ therapy: Research for the real world (pp. 310–319). Routledge/Taylor & Francis Group.
  • White Hughto, J. M., Reisner, S. L., & Pachankis, J. E. (2015). Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions. Social Science & Medicine, 147(Supplement C), 222–231. https://doi.org/10.1016/j.socscimed.2015.11.010
  • Wright, S. (2006). Discrimination of SM-identified individuals. Journal of Homosexuality, 50(2-3), 217–231. https://doi.org/10.1300/J082v50n02_10
  • Wright, S. (2014). Kinky parents and child custody: The effect of the DSM-5 differentiation between the paraphilias and paraphilic disorders. Archives of Sexual Behavior, 43(7), 1257–1258. https://doi.org/10.1007/s10508-013-0250-6
  • Zimmerman, K. J. (2012). Clients in sexually open relationships: Considerations for therapists. Journal of Feminist Family Therapy, 24(3), 272–289. https://doi.org/10.1080/08952833.2012.648143

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