Lesbian, Gay, and Bisexual Affirmative Counseling Self-Efficacy Inventory

Abstract

The Lesbian, Gay, and Bisexual Affirmative Counseling Self-Efficacy Inventory (LGB-CSI) is a 32-item psychometric instrument designed to measure a mental health professional’s perceived self-efficacy in performing counseling behaviors that affirm lesbian, gay, and bisexual (LGB) clients. Developed and validated across five comprehensive studies, the scale is grounded in Social Cognitive Theory, positing that high levels of efficacy beliefs are crucial for implementing effective LGB-affirmative practices and achieving positive therapeutic outcomes. The inventory yields a total score and five distinct subscale scores, with higher scores indicating greater confidence in counseling LGB individuals.

The LGB-CSI is intended for use with various mental health professionals, including psychologists, social workers, and counselors, regardless of their professional background or level of experience. Its development involved extensive literature review to define five core competencies necessary for LGB-affirmative psychotherapy, ensuring strong content validity through expert review.

Keywords

LGB-CSI, self-efficacy, affirmative counseling, lesbian, gay, bisexual, social cognitive theory, counseling psychology, psychometric scale

Authors

FRANK R. DILLON, ROGER L. WORTHINGTON

Purpose

The primary purpose of the Lesbian, Gay, and Bisexual Affirmative Counseling Self-Efficacy Inventory (LGB-CSI) is to quantitatively assess participants’ perceived confidence, or self-efficacy, in performing essential LGB-affirmative counseling behaviors. This measurement tool is critical for evaluating the effectiveness of training programs aimed at fostering competence among psychotherapists and trainees working with LGB clients.

The theoretical foundation draws heavily from Social Cognitive Theory (Bandura, 1986), which suggests that exposure to four sources of self-efficacy (performance accomplishments, vicarious learning, verbal reinforcement, and physiological states/reactions) promotes increased affirmative counselor self-efficacy. By measuring this construct, the LGB-CSI serves as a mechanism for predicting the implementation of positive therapeutic behaviors and promoting psychotherapists’ interest in providing LGB-affirmative psychotherapy.

Construct

The LGB-CSI measures the psychological construct of **LGB-Affirmative Counseling Self-Efficacy**. This construct is defined as a counselor’s belief in their ability to successfully execute the specific counseling behaviors required to effectively and affirmatively work with lesbian, gay, and bisexual clients. This self-efficacy is conceptualized across five core domains, or factors, of affirmative practice:

• Application of Knowledge: The ability to counsel LGB clients through unique issues using specialized knowledge of LGB issues in psychology, including sexual identity theory, internalized homophobia, and the impacts of various cultural variables.
• Advocacy Skills: Competence in identifying and utilizing community resources, social networks, and legal supports that are affirming and supportive of LGB clients’ concerns.
• Awareness: Maintaining awareness of one’s own attitudes, biases (such as heterosexism), and sexual identity development process, and understanding how these factors may influence the client relationship.
• Assessment: The skill set necessary for assessing relevant issues and problems specific to LGB clients, including clinical data integration, domestic violence in same-sex relationships, and post-traumatic stress related to hate crimes.
• Relationship: The ability to build a strong, affirming working alliance and atmosphere of mutual trust with LGB clients, including normalizing feelings during the coming out process.

Validity

The validity of the LGB-CSI was established through a multi-study development process (Dillon & Worthington, 2003). **Content validity** was rigorously determined during Study 1 via an expert panel review. Experts assessed the initial pool of 101 items for content appropriateness and clarity against established LGB-affirmative counseling competencies gleaned from a thorough literature review.

Construct validity received extensive support. Initial support was provided through exploratory factor analyses (EFA), followed by confirmation via confirmatory factor analyses (CFA). These analyses affirmed the hypothesized five-factor structure of the scale. Furthermore, construct validity was supported by findings in Study 5, which indicated that measured levels of self-efficacy varied commensurate with the professional status and experience level of the participants.

Convergent validity was established through correlations between the LGB-CSI total scale and subscales and established measures of general counseling self-efficacy and attitudes toward LGB individuals. **Discriminant validity** was evidenced by the lack of significant correlation between the LGB-CSI scores and measures designed to detect response bias, specifically social desirability, self-deceptive positivity, and impression management.

Reliability

The reliability of the LGB-CSI was primarily assessed in Studies 3 and 4, focusing on internal consistency and test-retest stability. The inventory demonstrated high **internal consistency** for both the total scale and all five subscales across multiple studies (Dillon & Worthington, 2003; Dillon et al., 2008). Specifically, Cronbach’s alpha coefficients consistently exceeded the acceptable threshold of .70, indicating that the items within the scale measure the same underlying construct reliably.

However, estimates of **test-retest reliability**, assessed over a 2-week interval, suggested that LGB-CSI total and subscale scores were relatively unstable. This finding implies that the perceived confidence or self-efficacy of counselors in this domain may be susceptible to fluctuation over short time periods, possibly due to training interventions, clinical experiences, or reflection.

Factor Analysis

The development of the final 32-item LGB-CSI involved rigorous factor analytical procedures across two initial studies. Study 1 utilized a principal axis factor extraction analysis (EFA) on the refined item pool. The goal was to determine the underlying structure of the affirmative counseling competencies. A five-factor solution, employing a promax rotation, was determined to yield the most conceptually interpretable and psychometrically sound structure.

The five factors identified through the EFA corresponded precisely to the five theoretically hypothesized domains of LGB-affirmative counseling competencies: Application of Knowledge, Advocacy Skills, Awareness, Assessment, and Relationship. In Study 2, the stability and structure of this initial EFA solution were cross-validated using **confirmatory factor analyses (CFA)**, which confirmed the robustness of the five-factor model for measuring LGB-affirmative counseling self-efficacy.

Instrument

Test Type: Self-Report Inventory (Psychological Scale)

Format: 32 items responded to using a 6-point Likert-type scale.

Language Available: English (Original development)

Population Group: Mental Health Professionals and Trainees

Age Group: Adult (Professionals and graduate students)

Population Details: Psychologists, counselors, social workers, and other mental health providers, ranging in professional background and level of experience.

Test Methodology: Participants indicate their level of confidence in their current ability to perform each specific LGB-affirmative counseling activity. The response scale ranges from 1 (Not at all Confident) to 6 (Extremely Confident). Completion typically requires 15 minutes.

Keywords

counseling self-efficacy, affirmative practice, mental health training, assessment tools, professional development, social work, psychology, therapist competence

Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: Not provided in source content.

Correspondence Address: Not provided in source content.

Permissions & Fee and Test Year

The original development and validation of the LGB-CSI were published in 2003 (Dillon & Worthington, 2003). Information regarding current permissions and associated fees must be obtained directly from the authors, Frank R. Dillon (Florida International University) and Roger L. Worthington (University of Missouri).

Reference’s

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.

Bieschke, K. J., Eberz, A. B., Bard, C. C., & Croteau, J. M. (1998). Using social cognitive career theory to create affirmative lesbian, gay, and bisexual research training environments. The Counseling Psychologist, 26, 735–753.

Bieschke, K. J., McClanahan, M., Tozer, E., Grzegorek, J. L., & Park, J. (2000). Programmatic research on the treatment of lesbian, gay, and bisexual clients: The past, the present, and the course for the future. In R. M. Perez, K. A. DeBord, & K. J. Bieschke (Eds.), Handbook of counseling and psychotherapy with lesbian, gay, and bisexual clients (pp. 309–336). Washington, DC: American Psychological Association.

Dillon, F. R., & Worthington, R. L. (2003). The Lesbian, Gay, and Bisexual Affirmative Counseling Self-Efficacy Inventory (LGB-CSI): Development, validation, and training implications. Journal of Counseling Psychology, 50, 235–251.

Dillon, F. R., Worthington, R. L., Soth-McNett, A. M., & Schwartz, S. J. (2008). Gender and sexual identity based predictors of lesbian, gay, and bisexual affirmative counseling self-efficacy. Professional Psychology: Research and Practice, 39, 353–360.

Items of the Lesbian, Gay, and Bisexual Affirmative Counseling Self-Efficacy Inventory

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

Instructions: Below is a list of activities regarding counseling/psychotherapy. Indicate your confidence in your current ability to perform each activity by marking the appropriate answer below each question ranging from Not at all Confident to Extremely Confident. Please answer each item based on how you feel now, not on your anticipated (or previous) ability. I am interested in your actual judgments, so please be honest in your responses.

How confident am I in my ability to . . .?

1. Directly apply sexual orientation/identity development theory in my clinical interventions with lesbian, gay, and bisexual (LGB) clients.
2. Directly apply my knowledge of the coming out process with LGB clients.
3. Identify specific mental health issues associated with the coming out process.
4. Understand the socially constructed nature of categories and identities such as lesbian, bisexual, gay, and heterosexual.
5. Explain the impact of gender role socialization on a client’s sexual orientation/identity development.
6. Apply existing American Psychological Association guidelines regarding LGB-affirmative counseling practices.
7. Use current research findings about LGB clients’ critical issues in the counseling process.
8. Assist LGB clients to develop effective strategies to deal with heterosexism and homophobia.
9. Evaluate counseling theories for appropriateness in working with an LGB client’s presenting concerns.
10. Help a client identify sources of internalized homophobia and/or biphobia.
11. Select affirmative counseling techniques and interventions when working with LGB clients.
12. Assist in the development of coping strategies to help same-sex couples who experience different stages in their individual coming out processes.
13. Facilitate an LGB-affirmative counseling/support group.
14. Recognize when my own potential heterosexist biases may suggest the need to refer an LGB client to an LGB-affirmative counselor.
15. Examine my own sexual orientation/identity development process.
16. Identify the specific areas in which I may need continuing education and supervision regarding LGB issues.
17. Identify my own feelings about my own sexual orientation and how it may influence a client.
18. Recognize my real feelings versus idealized feelings in an effort to be more genuine and empathic with LGB clients.
19. Provide a list of LGB-affirmative community resources, support groups, and social networks to a client.
20. Refer an LGB client to affirmative social services in cases of estrangement from their families of origin.
21. Refer LGB clients to LGB-affirmative legal and social supports.
22. Provide a client with city, state, federal, and institutional ordinances and laws concerning civil rights of LGB individuals.
23. Help a same-sex couple access local LGB-affirmative resources and support.
24. Refer an LGB elderly client to LGB-affirmative living accommodations and other social services.
25. Refer an LGB client with religious concerns to an LGB-affirmative clergy member.
26. Integrate clinical data (e.g., mental status exam, intake assessments, presenting concern) of an LGB client.
27. Complete an assessment for a potentially abusive same-sex relationship in an LGB-affirmative manner.
28. Assess for post-traumatic stress felt by LGB victims of hate crimes based on their sexual orientations/identities.
29. Assess the role of alcohol and drugs on LGB clients’ social, interpersonal, and intrapersonal functioning.
30. Establish an atmosphere of mutual trust and affirmation when working with LGB clients.
31. Normalize an LGB client’s feelings during different points of the coming out process.
32. Establish a safe space for LGB couples to explore parenting.