The American Journal of Family Therapy, 36:196–210, 2008

Copyright © Taylor & Francis Group, LLC

ISSN: 0192-6187 print / 1521-0383 online
DOI: 10.1080/01926180701236498

Narrative Sexual Identity Therapy

MARK A. YARHOUSE
Regent University, Virginia Beach, Virginia, USA

Sexual identity therapy is an alternative to the two polarized posi-

tions of sexual reorientation therapy and gay-integrative therapy
for clients who present with sexual identity concerns. This alter-
native model focuses on sexual identity—the private and public
acts of identifying and communicating one’s sexual preferences—
and how the decision to do so is informed by dominant stories
about what sexual attractions mean to a client. As one expres-
sion of sexual identity therapy, this paper presents narrative sexual
identity therapy, an approach that utilizes a narrative therapeutic
approach and techniques to facilitate exploration of dominant nar-
ratives and counter-narratives that speak to sexual identity with the
goal of achieving a synthesis that reflects felt congruence of clients’
beliefs/values and behavior/identity.

INTRODUCTION

One of the most controversial topics in clinical psychology has to do with sex-
ual orientation and whether it can be changed through professional interven-
tion. This has been the topic of a number of scholarly articles (e.g., Haldeman,
1994; Yarhouse, 1998), professional symposia (e.g., Throckmorton, 2000),
and textbooks on controversial topics in psychology (e.g., Halgin, 2004).
The debates include discussions of empirical evidence for and against claims
of change of orientation, but they also delve into ethical and professional
practice issues such as respect for autonomy and self-determination, as well
as political concerns and ideological assumptions behind the question of
change even being asked in the 21st century.
Of particular interest in these discussions is the topic of religious/spiritual
beliefs of clients who are sorting out how to live in light of their same-sex
feelings. Indeed, the potential conflict between religion and sexual identity

Address correspondence to Mark A. Yarhouse, Regent University, CRB 161, 1000 Regent
University Drive, Virginia Beach, VA 23464. E-mail: markyar@regent.edu

196
 Narrative Sexual Identity Therapy 197

has also generated a lot of discussion about how to navigate sexual identity
confusion (e.g., Yarhouse & Tan, 2005) in a way that is respectful of both
gay, lesbian, and bisexual (GLB) community interests as well as traditional
religious community interests.
In a previous discussion of professional services being offered, Yarhouse
and Burkett (2002) presented a continuum of services related to sexual iden-
tity that included gay-integrative therapy, chastity-based therapy, sexual iden-
tity management, and reorientation therapy. Gay affirmative or gay integra-
tive therapy is described an approach that affirms the inherent goodness of
identifying as GLB and seeks to assist clients as they integrate their expe-
riences of same-sex attraction into a GLB identity. On the other end of the
continuum is reorientation therapy—the controversial practice of helping a
client change sexual orientation from same-sex to opposite-sex in terms of
sexual preference. The third approach discussed is chastity-based therapy, an
approach that helps clients live celibate lives in keeping with their personal
beliefs and values. The final approach discussed by the authors is sexual
identity management or sexual identity therapy, and this approach focuses
on how people identify themselves and their sexual preferences privately
(to themselves) and publicly (to others). It has also been described as an
approach that focuses on helping clients seek congruence between their be-
liefs and their behavior, so that how clients live is consistent with what they
value (see Throckmorton & Yarhouse, 2006; Yarhouse, 2001, for a theoretical
framework). There may be other emerging approaches to therapy, but these
are four that have been presented in the literature.
The purpose of this paper is to take one of these approaches to
therapy—sexual identity therapy—and to explore one form of it that is be-
ing referred to as narrative sexual identity therapy. Presumably, a variety of
theoretical frameworks could be utilized to facilitate therapy focused on sex-
ual identity and how it develops and synthesizes over time (e.g., cognitive-
behavioral sexual identity therapy, client-centered sexual identity therapy,
psychodynamic sexual identity therapy, and so on). As its name suggests,
narrative sexual identity therapy utilizes clinical tools and assumptions in
narrative therapy and brings them to bear on the clinical practice of assisting
clients with their sexual identity concerns.

NARRATIVE THERAPY
Overview of Narrative Therapy
Narrative therapy considers how clients have come to see themselves, assert-
ing that people are constituted in language. Clients live the stories they are
told or come to tell about themselves. If they go unchallenged, the stories
tend to be written through the dominant norms in a society or subculture
(White & Epston, 1990).
198 M. A. Yarhouse

From a clinical standpoint, the assumption is that if clients can learn

how they construct themselves, they will be in a better position to make
changes. What becomes critical is recognizing and giving voice to the client
reality as it is locally defined (White & Epston, 1990). By locally defined,
narrative therapists are thinking here of the subjective view of the clients
themselves as contrasted with how others view, label, and relate to them (for
further discussion, see White & Epston, 1990). In the final analysis, narrative
therapists highlight the stories people live by and ways in which people think
about, tell, and live their stories.
Michael White is the founder of the narrative therapy movement. He
was influenced by the writings of French philosopher Michel Foucault and
by the clinical work of Gregory Bateson (Nichols & Schwartz, 2006). He
came to reject the systems approach to family therapy; instead, White came
to appreciate the importance of how people construe the world around
them. David Epston is another influential theorist who specifically helped
with the development of the narrative metaphor (Nichols & Schwartz, 2006;
Piercy, Sprenkle, Wetchler et al., 1996). Epston is also known for develop-
ing community resources and support networks for people struggling with
the similar concerns, so that they can share and become mutual supports
and resources.

Philosophical Assumptions of Narrative Therapy

The philosophical assumptions underlying narrative therapy can be traced to
the emergence of postmodernism in the early 20th century. Postmodernism
grew out of a critique of modernist assumptions, particularly those that were
related to rationalism, foundationalism, and a confidence in the pursuit of
objective knowledge through science (Grenz, 1996).
Related to these postmodern critiques of modernist assumptions, nar-
rative family therapy is indebted to existentialism, literary criticism (e.g.,
Derrida), and French philosophy (e.g., Foucault). Existentialists came to value
individual experience and decisions as the essential source of knowledge and
morality. Jacques Derrida argued against “onto-theology” or the “ontological
descriptions of reality” and the “metaphysics of presence” or “the idea that
something transcendent is present in reality” (Grenz, 1996, p. 6). Michel Fou-
cault critiqued social institutions and underscored the relationship between
power and knowledge, holding that “every interpretation of reality is an as-
sertion of power” (p. 6).
These postmodern assumptions stand in contrast to a modernist confi-
dence in objective knowledge and absolute truth (Becvar & Becvar, 2006).
What is claimed to be real or true is merely a subjective construction based
upon one’s perspective, and that experience is discussed with reference to
one’s community, such that “postmodern truth is relative to the community
in which a person participates” (Grenz, 1996, p. 14).
 Narrative Sexual Identity Therapy 199

It was mentioned above that a narrative approach has philosophical un-

derpinnings that can be traced to the writings of Foucault, who emphasized
power-laden relationships and categories. From a narrative therapy perspec-
tive, this can happen when people are labeled with a diagnosis, and the
individual or family can construe themselves in keeping with that diagnosis:
“Instead of ‘making the problem the problem,’ persons experiencing prob-
lems are problematized. Once in this position, a sense of helplessness and
loss of personal agency can arise, making self-initiated change quite difficult”
(Barry, 1997, p. 33).
Constructivism is the understanding that through the act of perceiving
and describing our personal experience we construct our own understanding
of that experience as well as the reality about that experience itself (Becvar
& Becvar, 2006). In terms of epistemology—or how we know things—our
perception of the way things are is a function of our beliefs.
From a social constructionist perspective, these acts of construction de-
scribed above are then communicated to individuals and groups. For the
purposes of the present discussion, it can be helpful to identify these acts of
construction, the language used to communicate assumptions about persons
and groups, as well as how therapy might be a resource for exploring these
constructions.
So what are the implications of the view that knowing or knowledge is
actually socially constructed through language and communication and are
therefore situationally or context dependent? One implication is that what
clients take to be “real” in terms of how they are functioning, what their
strengths and weaknesses are, and so on, can be related to dominant beliefs
within the family and within the society (Piercy et al., 1996).

For the social constructionist, language is not a reporting device for our
experiences. . . Rather, it is a defining framework. Thus, a change in lan-
guage equals a change in the experience; for reality can only be experi-
enced, and the ‘reality’ experienced is inseparable from the prepackaged
thoughts of the society. . . . (Becvar & Becvar, 2006, pp. 91–92)

A second implication is that clients cannot be approached as though they

were isolated from their context. Indeed, “a social constructivist would say
that we cannot accurately observe a [client] because what we see is colored
by our previous beliefs and interactions with [them]” (Piercy et al., 1996,
p. 130).

Each of us is born into and assimilates preexisting forms of language in

a culturally created linguistic system. In the process of socialization, we
learn to speak in accepted ways and simultaneously to adopt the shared
values and ideology of our language system. Thus, our words express the
conventions, the symbols, the metaphors of our particular group. And we
200 M. A. Yarhouse

cannot speak in a language separate from that of our community. (Becvar

& Becvar, 2006, p. 93)

A third implication of the view that knowing is context dependent is the

impact on models of healthy functioning. Narrative therapy has historically
resisted the urge to develop a model of healthy functioning, at least not a
model that is comprised of universally accepted principles that can be ap-
plied to all persons across time. Narrative therapists avoid making judgments
about what is normal and abnormal functioning. Not surprisingly, as a move-
ment narrative approaches tend to be skeptical about diagnostic labels and
universal notions of pathology (Barry, 1997; Nichols & Schwartz, 2006).
Several of the assumptions that underlie narrative therapy may assist
clinicians who are looking for alternatives to therapies that begin at the
outset by establishing a preferred outcome, be it reorientation therapy or
gay-integrative therapy. Narrative sexual identity therapy creates space for
dominant stories to be identified and for taken-for-granted realities to be
explored.

NARRATIVE SEXUAL IDENTITY THERAPY

As has been suggested, a narrative approach to sexual identity therapy does

not make assumptions about the nature of the clinical problem. It acknowl-
edges, of course, that dominant sociocultural discourses have privileged het-
erosexuality and heterosexuality has been the normative and prescribed—by
religious and broader cultural authority—sexual behavior with limited excep-
tions associated with culture-specific roles and rituals (see Herdt, 1996). What
narrative sexual identity therapists are concerned with is how clients are in-
fluenced by the primary story of their sexual attractions, how the story came
to make sense to them over time. This is what might be referred to as looking
for “sense-making stories” (Barry, 1997, p. 32), and they are told over and
over again and become part of the individual’s identity as a whole.
Clients seek help with their sexual identity for any number of reasons,
but those reasons are often assumed to be tied to individual identity or
personally relevant questions as understood by “sense-making stories” and
dominant narratives. “Dominant story” is a phrase from White and Epston
(1990) that describes an individual’s principal view of himself or herself and
the world. A dominant story can be helpful or unhelpful, and this distinction
is essentially based on whether the client is able to resolve the concerns that
bring him or her in for therapy.
An assumption in narrative sexual identity therapy is that
interpretation—in this case of what same-sex attractions signal about
a person—has a powerful influence on one’s life, and the problems clients
have are viewed as resulting from internalizing dominant discourses from
either the broader culture or a dominant subculture. Dominant discourses
 Narrative Sexual Identity Therapy 201

can make some behavior or activities more likely and limit others. These be-
haviors and activities may facilitate an identity and eventually consolidate it:

Cultural stories determine the dimensions that organize people’s expe-

rience. These narratives about what is canonical provide a backdrop
against which experiences are interpreted. Cultural stories are not neu-
tral. . . . They lead to constructions of a normative view, generally re-
flecting the dominant culture’s specifications, from which people know
themselves and against which people compare themselves. (Zimmerman
& Dickerson, 1994, p. 235)

Hermeneutics in a narrative therapy approach refers to the activity of

understanding achieved through the interpretation of stories (Nichols &
Schwartz, 2006). Indeed, in her ethnographic study of Christians who ei-
ther identified as gay or dis-identified with the gay community, Wolkomir
(2006) discusses how group members in both communities utilized “innova-
tive interpretive” strategies and “ideological maneuvering” to create “within
their religious beliefs a new interpretive space that they could later use to
construct an alternative and affirming theology/ideology” (p. 95). The gay
Christians came to value inclusivity and tolerance, while the ex-gay Chris-
tians came to value righteousness, but both groups “maneuvered” in such
a way that they could make meaning out of their experiences of attraction
while achieving congruence in terms of their beliefs and behaviors, their
values and identity.

THE PRACTICE OF NARRATIVE SEXUAL IDENTITY THERAPY

In general, by bringing forth multiple points of view, as opposed to a

normative or expert view, clients can decide how and where they would
like to situate their lives, based on their preferred values and intentions.
(Zimmerman & Dickerson, 1994, pp. 235–236)

Assisting clients in determining how they would prefer to live and iden-
tify themselves involves facilitating a transformational sexual identity narra-
tive. The place to begin is to create interpretive space by identifying the prob-
lem story and to eventually explore ways to assist the client in developing
or recognizing a potential or emerging counter-narrative. This general pro-
cess of “transformational narrative” has been described elsewhere (Coulehan
et al., 1998) and is being adapted for this discussion centering on sexual
identity.
Conceptually, the therapist is essentially facilitating a congruence-
focused transformational sexual identity narrative. It is congruence-focused
in that therapists assist clients in living their lives in a manner that is consistent
with their beliefs and values. Again, out of respect for client autonomy and
202 M. A. Yarhouse

self-determination, it is up to the client to identify how they wish to “situate

their lives” based upon their “preferred values and intentions” (Zimmerman
& Dickerson, 1994, p. 236). Narrative sexual identity therapy can be utilized
to facilitate a gay identification or the dis-identification with the gay com-
munity and the persons and organizations that support that identity. It is a
transformational sexual identity narrative because the therapist is helping
the client identify the conflict they have with the dominant narrative about
their sexual identity, examine the taken-for-granted realities, and explore al-
ternatives that require a transformation of some kind, so that their beliefs and
values are congruent with their behaviors and identity.

Case Illustrations
Here are two contrasting problem-saturated stories. The first (Jordan) rep-
resents a more traditional narrative therapy understanding as it applies to
sexual identity concerns. The second (Jess) provides an example of the flex-
ibility of narrative sexual identity therapy in addressing a range of possible
identity conflicts. Both cases are adapted from the author’s files.
In the initial session Jordan shares that he experiences same-sex attrac-
tion. He states that because of his family and religious upbringing as
Mormon, he is reluctant to identify himself as gay or participate in same-
sex relationships. As he closes the initial session, he expresses initial en-
thusiasm and a renewed effort to maintain chaste relationships with both
the same and opposite-sex. Over the course of therapy, however, Jordan
admits to increased struggles with his initial commitment to chastity. He
has begun to initiate same-sex relationships, and several of these have
increased his interest in finding someone with whom he can have a long-
term relationship. Jordan reports having tried to be celibate, but he ad-
mits that he really feels at peace when he is in a same-sex relationship. In
subsequent sessions Jordan identifies the dominant story that has become
distressing to him. That story was that same-sex behavior is immoral and
that it would be wrong to identify as gay—a story that implicated his
family upbringing and traditional religious faith community. Over time,
Jordan begins to discuss and experience a counternarrative to that domi-
nant narrative. The counternarrative is based on the belief that same-sex
attractions signal who he is as a person, and that the expression of his sex-
ual desires in sexual behavior is an extension or expression of his identity
and desires. Indeed, Jordan begins to talk about discovering who he is
as a gay person and utilizes the relevant self-defining attribution, “I am
gay.”

To the extent that Jordan further explores this counter-narrative, his work
in therapy represents what might be thought of as a more traditional narra-
tive therapy understanding because the taken-for-granted realities are tied to
traditional, religious understandings accepted and communicated through a
 Narrative Sexual Identity Therapy 203

community of faith. As painful and difficult as it may be, Jordan may even-
tually choose to leave his traditional faith community for a community of
like-minded believers who hold similar beliefs and values, and he may face
additional struggles related to how he maintains relationships with friends
and family members who reflect the beliefs and values of that community.
The following case (Jess) shifts the focus of the taken-for-granted reali-
ties to assumptions made by the gay community and communicated to Jess
through entertainment, the media, and her peer group:

Jess comes from a conservative Christian family. She identifies herself as

a Christian, and she shares that she is distressed by experiences of same-
sex attraction and a recent relationship that she has had difficulty ending.
Her therapist works with her to identify her dominant narrative, that is,
the assumption that her experiences of same-sex attraction signal who
she “really is” as a person, and that she should identify as GLB and find a
way for her religious beliefs and values to accommodate her identity as a
lesbian. She reports identifying as lesbian at about 15 and being identified
by others as such, and feeling somewhat “locked” into an identity that
was then recognized by the use of the label itself. Over the course of
therapy, Jess comes to deconstruct messages she received from the gay
community, as well as the broader culture (e.g., her peer group and
friends, popular movies and television shows and characters, portrayals
of GLB individuals), and she begins to identify a counter-narrative that
places her identity as a Christian as primary, with her experiences of same-
sex attraction as secondary and part of an emerging counter-narrative in
which she chooses to discontinue same-sex intimate relationships in favor
of chastity in all of her relationships and an exploration of other aspects
of her identity. She recognizes that while she finds herself experiencing
attraction to the same sex, she has choices to make about whether to
integrate her attractions into a lesbian identity. In the course of therapy
she is able to identify a supportive faith community that reaches out to
her and supports her as she navigates these concerns.

In both cases the client is assisted in examining taken-for-granted beliefs

and values. These beliefs and values for Jordan came from the broader culture
and conservative religious community, while the beliefs and values for Jess
came from the GLB community and segments of the broader culture that
reinforced those messages.

Presenting Concern of Sexual Identity Conflict

As we have seen with the two case examples, narrative sexual identity therapy
begins with the presenting concern of sexual identity conflict (see Figure 1).
That conflict may revolve around upbringing in a religious community that
views same-sex behavior as immoral, or it may revolve around unwanted
204 M. A. Yarhouse

FIGURE 1 Congruence-Focused Transformational Sexual Identity Narrative.

same-sex attractions. In our previous case example, Jordan struggles initially

with a gay identity, but eventually he feels more at peace in same-sex re-
lationships and is unwilling to dis-identify with this part of himself. Over
time, he is drawn to the notion that he has discovered his true self—but his
conflict is with the implications of that decision in light of his religious up-
bringing. A starting point in narrative sexual identity therapy is to recognize
the role of socially constructed “scripts” from which clients read. The rea-
son that Jordan’s story is more in keeping with “traditional” narrative therapy
approaches is that many of the dominant structures in society that are chal-
lenged are White, male, and heterosexual, so the taken-for-granted realities
are often informed by organizations and institutions that have supported and
communicated norms for people from their explanatory frameworks.
In contrast, Jess reported a conflict regarding the attractions themselves.
More specifically, her conflict is that she has personal beliefs and values that
are informed by her religious faith, and she views same-sex behavior as
a moral concern. A GLB story can be inevitable in the societal context in
which it evolves (and the story makes sense to the person). A characteris-
tic observed in those who integrate their experiences of same-sex attraction
into a GLB identity is a tendency to define the self as tied in fundamental
ways to experiences of same-sex attractions (Yarhouse & Tan, 2004), bring-
ing in expectations that they relate to others out of that labeled identity. If
 Narrative Sexual Identity Therapy 205

the client brings and voices doubts and concerns about that labeled identity,
then the therapist joining them in their questions and concerns can begin
to open up space for an alternative discourse or counter-narrative. Put dif-
ferently, when messages from the GLB community conflict with the client’s
beliefs and values, then these messages too can be deconstructed insofar as
a client examines previously taken-for-granted assumptions (see Wolkomir,
2001; Wolkomir, 2006; Yarhouse & Tan, 2004).
Some clients will also ask about the role of biology in their identity,
asking whether a gay identity is predetermined genetically. But, of course,
this conflates orientation and identity, and there is no consensus as to
the etiology of sexual orientation—whether biology, environment, or a
combination of both (Jones & Kwee, 2005). And insofar as same-sex
attraction, orientation, and sexual identity are treated as synonymous, this
can be deconstructed as well.

Mapping the Dominant Narrative

Once the dominant narrative has been identified, it can be helpful to ex-
plore ways in which the dominant narrative came to be communicated to
the client. If the conflict is with traditional religious community, for example,
it may be helpful to explore messages communicated to the client about ho-
mosexuality, same-sex attractions, same-sex behavior, and so on. For Jordan,
for example, it may be helpful to ask, What were some of the messages you
received growing up about identifying as gay?
If the conflict is with the GLB community, then it may be equally
helpful to explore messages communicated to the client about what same-
sex attractions signal about them as a person—perhaps exploring the ten-
dency to treat same-sex attractions as synonymous with a gay identity
(Yarhouse, 2005). For Jess, a relevant question might be, How was the mes-
sage communicated to you that feelings toward the same-sex meant you
were gay?
As clients explore these messages they can share with the narrative
sexual identity therapist how they made meaning out of their experiences of
same-sex attraction. This might entail coming to a clearer understanding of
what their sexual attractions have signaled about them in the past, as well
as what they mean to them now. Jordan, for example, might share how he
thought his same-sex attractions signaled that he was “sick” or “sinful.” Jess,
in contrast, might discuss ways in which the same-sex feelings were initially
thought to signal her “true self”, while today they might be viewed as part
her experience that she can recognize and appreciate while choosing not to
form an identity around them.
A next step in narrative sexual identity therapy is to map how the client
has responded to the dominant narrative. Some of the responses will es-
sentially be coping activities, such identifying sources of social support,
206 M. A. Yarhouse

developing healthy self-care behaviors, and so on, and it can be helpful

to gauge these responses and how adaptive they have been for the client.

Recognize Preferred Metaphor

There are at least two broad metaphors clients may draw upon in under-
standing their sexual identity. The first is the metaphor of discovery. This is
the dominant metaphor in the GLB community. People who are sorting out
sexual identity concerns are thought to be gay or not—but the presumption
is that if they are gay, then they will simply come to point at which they
discover this pre-existing fact about themselves. The image conveyed in this
metaphor implies an uncovering of what already exists and needs only be
recognized and affirmed as a positive GLB identity. They accept themselves
as a gay person, which is their true identity.
An alternative metaphor is that of integration. When thinking about sex-
ual identity concerns with reference to this metaphor, the client is essentially
talking about integrating sexual attractions into a gay identity or choosing
not to do so. What is volitional with the integration metaphor is not whether
a person experiences same-sex attraction, but what a person does with their
identity vis a vis their attractions. There is evidence that some people dis-
identify with a gay identity and the persons and institutions that would sup-
port that identity (see Yarhouse & Tan, 2005). This suggests to some that
these individuals are not relying upon a discovery metaphor; rather, some
are drawing upon an integration metaphor and making choices not to inte-
grate their experiences of sexual attraction into a gay identity.
It may be helpful in identifying the dominant narrative to reflect upon
at least these two metaphors. There may be additional metaphors, too, that
capture a specific client’s experiences.

Recognize Exceptions to Dominant Narrative (Counter-Narrative)

It can be helpful to recognize exceptions to the dominant narrative by ex-
ploring experiences that clients have had that challenge ways in which they
have previously made meaning out of their experiences. If they have been
identifying experiences and attributions that support the dominant narrative,
can they begin to explore experiences and attributions that are contrary to or
in some way call into question the dominant narrative? A question to assist in
this process might be, In what ways are you understanding your sexual iden-
tity differently than when you first thought of yourself? (Buchanan, Dzelme,
Harris, & Hecker, 2001).
This practice of recognizing exceptions to the dominant narrative pro-
vides interpretive space for a counter-narrative to emerge. We might refer to
this as an “edited script,” insofar as it is a departure from the script handed
 Narrative Sexual Identity Therapy 207

to them as the dominant narrative that had been so problematic and led to
the initiation of therapy.
Exploration of the dominant narrative might also entail situating a gay
identity or gay self within the sociocultural and political context. Doing so
might be a relief to Jordan, who over time might speak of liberation and
authenticity in his newly discovered gay identity (see Wolkomir, 2006). Jess, in
contrast, may experience a gay identity or the “gay self” as rhetoric of sexual
self-actualization, one which she chooses to reject in favor of an emerging
counter-narrative.

Highlight Sexual Identity-Congruent Attributions and Activities

Beyond creating space for a counter-narrative to emerge, it can be help-
ful to highlight attributions and meaning-making regarding same-sex attrac-
tion that support the counter-narrative. Put differently, clinicians can con-
sider ways to make meaning out of experiences of same-sex attraction that
signal something in keeping with the emerging, preferred story. A help-
ful question might be, In what ways would you like to challenge some
of the messages you’ve received about your sexual identity? Someone like
Jordan challenges negative messages about a gay identity by exploring self-
defining attributions, such as “I am gay,” to make sense of his experiences
of same-sex attraction and to help consolidate his identity and transfor-
mational narrative. In contrast, Jess might say of herself: “I am a woman
and a Christian, and I also experience same-sex attraction,” making a con-
scious choice to dis-identify with a gay identity and associated self-defining
attributions.
As the counter-narrative emerges, clinicians can identify coping re-
sponses that are congruent with clients’ preferred story. This might involve
identifying personal strengths that support the counter-narrative. The clini-
cian might begin by identifying ways in which the client already demonstrates
resilience by recognizing strengths, such as resourcefulness, a passion for jus-
tice, a sense of humor, or a commitment to personal integrity. The clinician
can also identify community resources that are identity-congruent and in
keeping with preferred narrative. Jordan or Jess might talk about the value
in identifying literature that support their emerging counter-narrative, joining
support groups for persons who are walking a similar path, or participat-
ing in faith communities that are supportive environments for persons like
themselves.

Resolution/Congruence
Narrative sexual identity therapy is essentially concerned with a person’s
“preferred way of being” (Buchanan et al., 2001, p. 444). The outcome of
narrative sexual identity therapy is that clients come to a preferred way of
208 M. A. Yarhouse

being with respect to both their sexual identity and their religious or spiritual
identity—what we might think of as a place of resolution because they live in
a way that is congruent; they live in a way that is consistent with their beliefs
and values. From a sexual identity standpoint, successful outcome is helping
clients line up their beliefs and values with their behavior and identity.
Consistent with the narrative metaphor, clients live in ways that are in
keeping with their preferred story. The clinician can facilitate this by asking
questions that extend the preferred narrative into the future (adapted from
Buchanan et al., 2001, pp. 444–445). Questions such as In the course of the
next few months or so, what do you see as the relationship between your
sexual identity and your religious or spiritual identity? or Can you share a
little of the way you would like to describe your sexual identity in the year to
come?
These questions and many others like them not only cast a vision for
the preferred narrative and how it might evolve in the future, but they help
consolidate the gains made thus far in therapy. An additional way to assist in
consolidating the gains made in narrative sexual identity therapy is to provide
therapeutic audiencing. What this means is that the clinician supports the
work being done by participating as an audience member viewing their work
on “stage.” One such technique developed by David Epston is letter writing,
and therapists can write letters to their clients that support the preferred
story—either in the direction of what is experienced as an emerging gay
identity or in the act of dis-identification with a gay identity.
In closing, although space does not permit a detailed discussion of
the ethical and professional issues associated with providing therapy to ad-
dress sexual identity concerns, it can be noted and communicated to clients
that there are no well-designed outcome studies that address sexual iden-
tity concerns—whether reorientation, gay-affirmative/integrative, or sexual
identity approaches. Initial frameworks for providing such services have
been developed (see Throckmorton & Yarhouse, 2006) and can also be
reviewed.

CONCLUSION

The purpose of this paper was to offer an alternative to the two polarized po-
sitions of sexual reorientation therapy and gay-integrative therapy for clients
who present with sexual identity concerns. This alternative model focuses
on sexual identity, how it develops and synthesizes over time, and the felt
congruence of clients’ beliefs/values and behavior/identity. Narrative sexual
identity therapy is an approach that utilizes a narrative therapeutic under-
standing and techniques to facilitate exploration of dominant narratives and
counter-narratives that speak to sexual identity and a client’s “preferred way
of being” (Buchanan et al., 2001, p. 444).
 Narrative Sexual Identity Therapy 209

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