“It Was Traumatizing for me”: the Relationships between LGBTQ Individuals with Mental Illness and Social Workers in Rehabilitative Housing Within the Mental Health System

Abstract This study examines how LGBTQ clients experience and interpret therapeutic relationships with social workers in supported housing services within Israel’s mental health system. This qualitative study included 29 interviews with LGBTQ individuals diagnosed with psychiatric disorders who use supported housing services provided through Israel’s psychiatric rehabilitation basket of services. Thematic analysis of the interviews revealed two central themes: (1) the reproduction of trauma within therapeutic relationships; and (2) lack of professional knowledge and cultural competence as sources of harm in therapeutic spaces. The study amplifies the voices of individuals facing the intersection of complex identities from their subjective standpoint. Moreover, the findings highlight how therapeutic and rehabilitative relationships, which are intended to be safe and inclusive, often reproduce patterns and experiences of exclusion and rejection that participants had previously encountered within their families. Consequently, many participants reported adopting both conscious and unconscious defense mechanisms of concealment as a strategy for coping with therapeutic environments perceived as threatening. The study underscores the need for clinical training on LGBTQ issues for social workers in mental health services.