The Impact of Identity-Based Matching on the Psychotherapy Experiences of Lesbian, Gay, Bisexual, Transgender, and Queer People of Color

Abstract

LGBTQ people of color (POC) have an increased need for mental health care but experience various barriers to continued participation in psychotherapy. Identity-based matching has demonstrated some positive impacts on marginalized clients' experiences in psychotherapy, yet few studies examine how matching influences the therapeutic relationship and the therapy process. Extant research also conceptualizes identity as distinct categories, implying that identities influence the therapy process rather than implicating the power structures that act upon those identities. This intersectional, qualitative study explores the impact of identity-based matching on the psychotherapy process for LGBTQ POC. Twenty-five LGBTQ POC participated in in-depth, semi-structured interviews about why they sought matched therapy, what they expected thereof, and how their experiences compared to their expectations. Data were analyzed using inductive thematic analysis to yield three overarching themes: 1) Clients sought matched therapy hoping their identities would be safely integrated into the therapy process. Shared identities served as a proxy for shared lived experiences, identity-related competence, and oppression-related competence. 2) Matching operated through the therapeutic relationship by facilitating clients' feelings of trust and safety. 3) Matching reduced the need for clients to educate matched therapists, facilitating efficient and deep engagement in therapy. Clinicians from multiply marginalized backgrounds should be trained and supported to integrate the expertise gained from their lived experiences into their clinical practice. Future research should examine what client factors increase their likelihood to benefit from identity-based matched psychotherapy.