Description
Counseling Older LGBTQ+ Adults of Color:
Relational?Cultural Theory in Practice
Christian D. Chan, Camille D. Frank, Melisa DeMeyer,
Aishwarya Joshi, Edson Andrade Vargas, Nicole Silverio
The Professional Counselor?
Volume 11, Issue 3, Pages 370?382
http://tpcjournal.nbcc.org
? 2021 NBCC, Inc. and Affiliates
doi: 10.15241/cdc.11.3.370
Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities have faced a history of discriminatory
incidents with deleterious effects on mental health and wellness. Compounded with other historically
marginalized identities, LGBTQ+ people of color continue to experience disenfranchisement, inequities,
and invisibility, leading to complex experiences of oppression and resilience. Moving into later stages of
life span development, older adults of color in LGBTQ+ communities navigate unique nuances within their
transitions. The article addresses the following goals to connect relational?cultural theory (RCT) as a relevant
theoretical framework for counseling with older LGBTQ+ adults of color: (a) explication of conceptual and
empirical research related to older LGBTQ+ adults of color; (b) outline of key principles involved in the RCT
approach; and (c) RCT applications in practice and research for older LGBTQ+ adults of color.
Keywords: relational?cultural theory, theoretical framework, older adults, LGBTQ+, people of color
Multiple forms of oppression have been historically documented across conceptual and empirical
literature for the broad spectrum of lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities
across the life span (Chan, 2018; Chan & Erby, 2018; Meyer, 2014, 2016; Singh, 2013). Further, Black,
indigenous, and people of color (BIPOC) have experienced multiplicative deleterious effects combined
with psychosocial factors that culminate in racial discrimination and marginalization (David et al., 2019;
Sue et al., 2019). Oppression for BIPOC communities and LGBTQ+ communities often cascades across
the life span and culminates in a number of health disparities (Choi & Meyer, 2016; Fredriksen-Goldsen
et al., 2015, 2017). Given these complex dimensions with social identities, researchers have expanded
their focus to examine social conditions, such as education and health care, to accentuate the needs of
older LGBTQ+ adults of color (Howard et al., 2019; Kim et al., 2017). Although researchers have given
more attention to LGBTQ+ BIPOC (e.g., Jackson et al., 2020; Velez et al., 2019), older adults within these
communities are typically omitted in practice, advocacy, and policy (Kimmel, 2014; Porter et al., 2016;
Seelman et al., 2017; South, 2017). Combined with this pattern of exclusion, older LGBTQ+ adults of color
are forced to navigate a dearth of resources and complicated climates that fail to properly recognize
multiple overlapping forms of racism, heterosexism, genderism, and ageism (Kim et al., 2017; Woody,
2014). Within the counseling profession, gaps in culturally responsive services and advocacy combine
with alarming rates of barriers, health disparities, and underutilization of mental health services (Chan &
Silverio, in press; Kim et al., 2017; Lecompte et al., 2021).
Relational?cultural theory (RCT) operates as a cohesive and modern theoretical approach founded on
values of feminism, equity, empowerment, and social justice (see Comstock et al., 2008; Duffey & Trepal,
2016; Hammer et al., 2016; Kress et al., 2018). Instances of disconnection can be prominent at older adult
stages of life (Seelman et al., 2017), and RCT offers a purposeful framework for increasing relational
Christian D. Chan, PhD, NCC, is an assistant professor at the University of North Carolina at Greensboro. Camille D. Frank, PhD, NCC, LPC, is
a lecturer at Eastern Washington University. Melisa DeMeyer, PhD, NCC, LPC, is an assistant professor and program coordinator at Oregon
State University-Cascades. Aishwarya Joshi, MA, NCC, LPC, is a doctoral candidate at Idaho State University. Edson Andrade Vargas, PhD,
is a visiting assistant professor at Palo Alto University. Nicole Silverio, MA, NCC, LMHC, LMFT, is a doctoral student at the University of
North Carolina at Greensboro. Correspondence may be addressed to Christian D. Chan, 228 Curry Building, Department of Counseling and
Educational Development, The University of North Carolina at Greensboro, P.O. Box 26170, Greensboro, NC 27402, [email protected].
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awareness (Hammer et al., 2016), relational growth (Kress et al., 2018), and investment in professional
counseling relationships (Fullen et al., 2020). Given developmental concerns and life span transitions,
older LGBTQ+ adults of color can remain disconnected from family, society, institutional resources,
and professional counselors (Jones et al., 2018; Mereish & Poteat, 2015; Seelman et al., 2017). Using an
RCT approach accounts for these factors and increases the awareness of disconnections between people
and others in their environment (Hammer et al., 2016; Singh & Moss, 2016). Because of its emphasis
on relationships, RCT?s focus on mutually fostering growth and dismantling oppression provides a
platform for professional counselors to integrate the themes of equity, social justice, and feminism into
counseling practice with older LGBTQ+ adults of color (Rausch & Wikoff, 2017; Singh et al., 2020). RCT
demonstrates that intersections of social identities mirror several overlapping forms of oppression and
hierarchies of power (Addison & Coolhart, 2015; Chan & Erby, 2018; Hammer et al., 2016).
Within this conceptual framework, we intentionally use LGBTQ+ communities to inclusively highlight
communities featured across the spectrum of sexuality, affectional identity, and gender identity (Griffith
et al., 2017). As counselors address the intersections among social identities, applying philosophical
underpinnings of RCT equips them to tackle cultural, social, and contextual barriers that disconnect
older LGBTQ+ people of color from society, resources, and health care access. Consequently, this article
entails a three-pronged approach: (a) an overview of extant conceptual and empirical research relevant
for older LGBTQ+ adults of color; (b) in-depth illustration of key principles within the RCT approach;
and (c) RCT applications for counseling practice and research to support older LGBTQ+ adults of color.
Intersections of Older Adults, LGBTQ+ Communities, and Communities of Color
Scholars across disciplines (e.g., psychology, social work, counseling, sociology, education) continue
to explore intersections of racial and ethnic identities in confluence with sexuality, affection, and
gender identity (Chan & Erby, 2018; Jackson et al., 2020; Van Sluytman & Torres, 2014). Researchers
can ostensibly benefit from a gerontological focus to critically examine social conditions and structures
sustained by ageism (Chaney & Whitman, 2020; Kim et al., 2017). The lack of attention to gerontology,
ageism, or older adults within LGBTQ+, racial, and ethnic identity research has further underscored
the impact of health disparities and social determinants of health (e.g., education, economic resources,
career, income) that precipitate an underutilization of mental health services and health care,
specifically among LGBTQ+ people of color (Choi & Meyer, 2016; Du & Xu, 2016; Fredriksen-Goldsen,
2014; Rowan & Giunta, 2016; Seelman et al., 2017). Kim and colleagues (2017) specifically observed
that race and ethnicity have been historically excluded as variables and outcomes in LGBTQ+ older
adult research. Building further on this gap, Woody?s (2014) study of African American LGBT elders
exemplified the need to address these intersections of identities. In the study, Woody noted that African
American LGBT elders consistently faced conflicts in negotiating ethnic and spiritual values together
with sexual and gender identities. Outside of oppressive circumstances, older adults already face
realities associated with the aging process, health concerns, maintaining an economic standard of living,
retirement, and housing barriers related to developmental life tasks and the stages of older adulthood
(Brennan-Ing et al., 2014; Choi & Meyer, 2016; Porter et al., 2016). Several of these concerns coincide
with a consistent gap in culturally responsive counseling practices focused on older adults (Chan &
Silverio, in press; Fullen, 2018) and the call to action by Fullen and colleagues (2019) to broaden research
evidence in gerontological counseling.
Health Disparities
As gerontological and health researchers attempt to shed light on the experiences of older LGBTQ+
adults of color, overall trends continue to reveal cultural, social, psychological, and physical implications
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of intersecting forms of oppression. In fact, a study by Kim et al. (2017) documented that African
American LGBT elders faced higher rates of lifetime discrimination, which adversely affected their
physical and mental health. Similarly, incidents that contribute to the lack of identity affirmation,
community networks, and social support exacerbate a number of health disparities and adverse
outcomes of mental health (Fredriksen-Goldsen et al., 2013; Seelman et al., 2017; Woody, 2014, 2015).
Consistent with patterns in health disparities research, oppression tends to serve as a catalyst for higher
prevalence of suicidality among older LGBTQ+ adults of color (Choi & Meyer, 2016; Meyer, 2014,
2016). In fact, Fullen and colleagues (2018) noted that internalized ageism can predispose older adults
to a myriad of mental health issues, symptoms, and increased rates of suicidal ideation. According
to Seelman (2019), the combination of responding to discrimination along with barriers to access can
significantly increase the mortality rate for older LGBTQ+ adults of color. Conversely, the preservation
of cultural identity (Fullen, 2016) and identity affirmation (Fredriksen-Goldsen et al., 2017; Howard et al.,
2019; Kim et al., 2017) buffers the effects of oppression and encourages older LGBTQ+ adults of color to
seek help and health care.
Older LGBTQ+ adults of color also face disproportionate access to resources, especially adequate
and LGBTQ-affirming health care services (Hinrichs & Donaldson, 2017; Kimmel, 2014). Among the
variety of health conditions tied to the aging process, the risk of HIV increases for older LGBTQ+
adults of color as a result of psychosocial factors, such as poverty, stigma, marginalization, and lack
of education (Bower et al., 2021; Jones et al., 2018; Karpiak & Brennan-Ing, 2016; Yarns et al., 2016).
Many of these barriers can be traced to the marginalization attached to ageism, classism, racism,
genderism, and heterosexism (Brennan-Ing et al., 2014; Robinson-Wood & Weber, 2016). During
this stage, older LGBTQ+ adults of color face drastic changes to mental health based on cumulative
interactions with societal stigma and internalized heterosexism and genderism (Correro & Nielson,
2020; Yarns et al., 2016). Consistently responding to discrimination can eventually culminate in a
variety of mental health symptoms (e.g., anxiety, depression) or mental exhaustion (FredriksenGoldsen, 2014; Fredriksen-Goldsen et al., 2013).
Social Isolation, Grief, and Loss
Compounded with multiple overlapping forms of oppression, older LGBTQ+ adults of color can
have a multifaceted experience of social isolation and loss as they transition into the stages of older
adulthood (Dzierzewski, 2014). Although older adults generally experience grief and loss as part of
the transition in aging (Chaney & Whitman, 2020; Kampfe, 2015), these experiences are heightened
for older LGBTQ+ adults of color as an outcome of navigating racism, heterosexism, and genderism
(Bockting et al., 2016; Woody, 2014, 2015). The loss of family, friends, social networks, and intimate
partners for older LGBTQ+ adults of color can converge with an overall lack of affirmation and
heighten experiences of racial, sexual, and gender discrimination (Seelman et al., 2017). Instances of
isolation and loss are pervasive because of the confluence of racism and heterosexism converging in
this stage of the life span (Woody, 2015). Woody?s (2015) study noted that older African American
lesbian women cited the proliferation of racism as a more prominent issue than their experiences with
other forms of oppression (e.g., heterosexism). Compounding these losses, barriers to housing and
the likelihood of eviction for older LGBTQ+ adults of color can amplify feelings of displacement from
communities and society (Brennan-Ing et al., 2014; Robinson-Wood & Weber, 2016).
Additionally, older LGBTQ+ adults of color consistently contend with coming out across the life
span (Hinrichs & Donaldson, 2017; Mabey, 2011). Experiences of coming out and self-disclosure of these
social identities can be complex because of the loss of connections, fear of rejection, and incivility from
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trusted communities of support (Dzierzewski, 2014; Woody, 2014; Yarns et al., 2016). Complicating the
range of concerns within the older adult stages, the chronic effects of marginalization can increase risk
factors for substance use and addictions as coping mechanisms for older LGBTQ+ adults of color (Bryan
et al., 2017; Veldhuis et al., 2017). Substance use and addictions have become a more visible crisis facing
these communities, and they can combine with the risks of displacement from social supports and vital
community resources (Brennan-Ing et al., 2014; Cloyes, 2016; Rowan & Giunta, 2016).
The Model of Relational?Cultural Theory (RCT)
RCT can be used by counselors to reflect experiences with societal forces of oppression (Singh &
Moss, 2016) and social determinants tied to health, connection, and wellness (Hammer et al., 2016).
RCT has surfaced as an applicable theoretical approach for older LGBTQ+ adults of color with the most
recent uptick of research and scholarship (Mereish & Poteat, 2015; Singh et al., 2020). Given the core
values of RCT generated with social context, authenticity, connection, and social justice, the approach
addresses needs, social conditions, barriers, and marginalization experiences for older LGBTQ+ adults
of color (Chan & Erby, 2018; Rausch & Wikoff, 2017; Singh & Moss, 2016). The history of RCT provides
context for current practice and underscores the foundation of a relationally centered paradigm.
The concepts of relational images, growth-fostering relationships, and the central relational paradox
inform counseling with clients experiencing such positions of resilience and oppression (Duffey &
Trepal, 2016). The relevance of an RCT approach to a number of client concerns has gained traction as
counseling professionals are charged with implementing more culturally responsive approaches (Flores
& Sheely-Moore, 2020; Haskins & Appling, 2017; Singh et al., 2020). To support RCT?s utility, a recent
review from Lenz (2016) concluded that empirical research has consistently supported RCT constructs
and its use as a framework for understanding client experiences.
Key Principles
Originally positioned within Miller?s (1976) Five Good Things, the principles of RCT in counseling
practice have imminently evolved into a robust theoretical framework centered in (a) clarity of self
and others, (b) creativity, (c) zest, (d) empowerment, and (e) connection. As Jordan (2000) provided in an
influential comprehensive overview of RCT, the main themes for the framework can be summarized
in four distinct areas. The first principle posits that people are generally oriented toward growing
individually and collectively within their relationships across the life span (Jordan, 2010, 2017), which
results in growth-fostering relationships (Miller, 1976; Miller & Stiver, 1997). Secondly, growth-fostering
relationships require mutuality, which is defined as mutual empathy and mutual empowerment (Jordan,
2010; Kress et al., 2018). Because of mutuality in growth-fostering relationships, assessing growth of
individuals and relationships is contingent on authenticity, or individual genuineness, as the third
component (Duffey & Trepal, 2016; Jordan, 2000, 2017). Individuals? abilities to represent themselves
authentically in their relationships can be a function of this growth (Duffey & Somody, 2011; Hammer
et al., 2016). Because authenticity underpins mutuality and growth-fostering relationships, the fourth
area of RCT involves the central relational paradox. The central relational paradox illustrates how the
fear of vulnerability reduces authentic expression and maintains disconnections, despite a proclivity
for connection with others (Miller & Stiver, 1997). When mutuality and authenticity are prioritized,
professional counselors using RCT assume that conflict can be a normal dynamic in the relationship,
in which high-level growth in the relationship involves the ability to actively address this relational
difference (Comstock et al., 2008; Duffey, 2007; Jordan & Carlson, 2013). The primary function of RCT in
counseling then focuses on building relational competence (Kress et al., 2018; Singh & Moss, 2016).
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To build further on these constructs, several researchers have provided a foundation for using RCT
with older LGBTQ+ adults of color (Flores & Sheely-Moore, 2020; Mereish & Poteat, 2015; Singh & Moss,
2016). There are cultural, social, and political implications underlying the connection between RCT and
older LGBTQ+ adults of color. For example, older LGBTQ+ adults of color are forced to contend with
multiple points of disconnection from society through histories of racism, genderism, heterosexism, and
ageism. Although multiple forms of oppression can disconnect historically marginalized communities,
ageism is distinct because it focuses on marginalizing life transitions (Chaney & Whitman, 2020; Fullen,
2018). Consequently, older LGBTQ+ adults of color experience a heightened sense of disconnection due
to grief and loss, isolation, and lack of social support. Older LGBTQ+ adults of color may likely encounter
disconnections from a society that fails to affirm their identities, which precipitates a disconnection to
self and underutilization of community resources (Kim et al., 2017; Seelman et al., 2017). Older LGBTQ+
adults of color may face a hierarchy of power and privilege that would impair an authentic connection
and movement toward mutuality (Duffey & Somody, 2011; Hammer et al., 2016; Jordan, 2010). One
outcome of this hierarchy is the notion of relational images, in which historically marginalized individuals
feel forced to conform to a privileged identity. For instance, an older lesbian woman of color as a client
may hold controlling relational images of help-seeking when interacting with a White male counselor
possessing multiple privileged identities. In this instance, the client might internalize stereotypes and
biases imposed by the counselor. Using RCT explicitly addresses these controlling relational images to
challenge the dominant discourse, increase authenticity, and empower connection (Hammer et al., 2016;
Haskins & Appling, 2017).
RCT as a Lens for Conceptualization and Intervention
The following hypothetical case example underscores the theoretical underpinnings of RCT and
illustrates applications of RCT in clinical practice. This case example illustrates a variety of RCT principles
to help counselors connect potential experiences of older LGBTQ+ adults of color and the complexity of
intersecting forms of oppression. With the overall case study presented, Table 1 synthesizes key principles
and applications, supplemental literature, and relevant portions of the case example.
Case Formulation
Chris, 72 years old, and Hector, 71 years old, have been partnered for 27 years. Chris is a Mexican
American bisexual male born in the United States with the pronouns he, him, and his. Hector is a
multi-heritage Asian American gay man of Filipino, Norwegian, and Colombian descent with the
pronouns he, him, and his. Both Chris and Hector are Catholic and living without disabilities. Chris
retired as a social worker when he reached 65 years of age while Hector chose to continue working
as a university professor until the previous year at age 70. Chris and Hector recently relocated to
live with Chris?s daughter from a previous marriage, Ella. Ella welcomed both Chris and Hector
into her home as family. Upon the transition to their retirement phase, Chris and Hector began
spending most of their time at home, and Ella has checked in with them regularly. They took on new
hobbies, including painting, and focused more of their time on relaxation and leisure. Recently, Chris
became increasingly concerned with Hector?s forgetfulness. Chris became worried about bringing
him to social events, as Hector was ?absentminded.? Although initially excited about the move,
Chris realized Hector was struggling with all of the new issues that emerged from the transition.
Chris thought about discussing the concerns with his daughter, but he did not want to worry her or
embarrass Hector. Chris has felt conflicted about his own internal and external responses. Over the
past few months, Chris has felt increasingly isolated and disconnected with Hector while recognizing
a decreased lack of enjoyment.
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Table 1
RCT Applications to Case Example
Application
Supporting Literature
Relevance to Case Example
Connection is essential to
existence.
Duffey & Somody, 2011; Practitioners can identify the possible connections Chris and
Lenz, 2016; Walker &
Hector have with each other and with their family. In addition,
Rosen, 2004
practitioners can also cite the connection they have with the
clients Chris and Hector. Practitioners can particularly note the
disconnect they have experienced as society has emerged with
transitions and multiple overlapping forms of oppression.
Growth-fostering
relationships result in the
Five Good Things: clarity of
self and others, creativity,
zest, empowerment, and
connection.
Miller, 1976; Miller &
Stiver, 1997; Duffey,
2007; Duffey et al., 2009;
Duffey & Somody, 2011;
Hammer et al., 2014
Practitioners can work with Chris and Hector to search for
strengths and reinvigorate their energy in each other during this
transition and stage of their lives. Although Chris and Hector
initially struggled with the transition, practitioners can ascertain
new types of hobbies and activities they can create together.
Such creative activities might elicit more nuanced meaning.
Practitioners can also highlight the methods and actions in which
Chris and Hector have been resilient in the face of adversity in
association with societal and interpersonal discrimination.
The central relational paradox
centers around the idea
that people long deeply for
relationships, but fear of what
will happen after engaging in
the vulnerability needed for
connection provokes people
to keep aspects of themselves
out of connection.
Jordan, 2010; Jordan &
Carlson, 2013; Miller &
Stiver, 1997; Walker &
Rosen, 2004
Practitioners can focus on how the transition affected Chris
and Hector?s connection to each other. It is possible that the
transition altered their interpretation of connection, given that
they are now living with Chris?s daughter, Ella. Hector could
have also felt a sense of loss with his retirement, which led to
new ways of thinking and loss of connection. In fact, his job
could have created meaning for him. Additionally, Hector had
also faced instances of discrimination, which decreases the
possibility of a climate of safety.
Central to RCT is the idea
that systems of power and
privilege, which are pillars
in our current society, result
in damage to psychological
health.
Hammer et al., 2014,
2016; Haskins &
Appling, 2017;
Trepal et al., 2012
Practitioners can discuss with Chris and Hector the implications
of discrimination toward their health. Practitioners can highlight
factors and social determinants involved in explicit and implicit
effects of discrimination on wellness and domains of health
(e.g., physical, financial, social). Practitioners can also highlight
instances of subordination, where Chris and Hector may have
been subjugated to another person?s harmful comments.
Exploring relational
Hammer et al., 2014,
connection and equity must 2016; Mereish & Poteat,
include an analysis of social 2015
context and mechanisms
responsible for giving root to
oppression.
Practitioners can accentuate the manner in which Chris and Hector
bring their own responses to stigma from affectional, sexual,
and racial discrimination on individual and intimate partner
levels. Similarly, practitioners can highlight how their own social
identities play a role in power differentials with Chris and Hector
together as a couple and as individuals. Practitioners can also
understand their own responses to oppression and how they might
transfer the experience to professional counseling relationships
(e.g., internalized oppression). In some cases, practitioners might
eschew from broaching cultural factors and discriminatory
experiences due to internalized oppression. Practitioners can
also use themselves as a model or tool when considering power
differentials or uneven tensions of privilege and oppression.
Note. Table 1 demonstrates applications of RCT principles supplemented by conceptual and empirical literature. The
principles are directly linked to potential avenues in the case example.
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As demonstrated in the case example and Table 1, professional counselors can use RCT to
strengthen an awareness of structural and interpersonal forms of oppression affecting older LGBTQ+
adults of color. With the combination of life transitions and convergent forms of oppression, Chris
and Hector may become more disconnected from each other, society, or other personal relationships.
The effects of oppression can culminate in a longstanding experience of disconnection. Under the RCT
lens, professional counselors can identify how oppression (e.g., racism, heterosexism) exacerbates
feelings of disconnection and impacts the overall health of relationships (Singh et al., 2020; Singh &
Moss, 2016). It is possible that Chris might be contending with prior experiences of relational images
that potentially invoke stigma and familial histories with discrimination. Consistent with Table 1,
professional counselors can demonstrate how prior interpersonal experiences of marginalization can
result in feelings of isolation within Chris and Hector?s relationship and silence around their concerns.
As Chris and Hector navigate life transitions and aging, professional counselors can illustrate how
physical and mental health draw upon the strength of relationships, especially for communities facing
social isolation (Mereish & Poteat, 2015; Woody, 2014, 2015). Tenets of RCT also focus on relational
growth and resilience, which reflect how professional counselors can use strengths, growth, and
creativity to ameliorate the cumulative effects of marginalization (Comstock et al., 2008; Hammer et al.,
2014, 2016). By infusing these elements in practice, professional counselors invoke the Five Good Things
(Miller, 1976; Miller & Stiver, 1997), which can apply to Chris and Hector?s relationship and transfer
to other personal relationships. Although professional counselors can contextualize the experience of
oppression, focusing on the strengths of Chris and Hector?s relationship can highlight how they have
historically relied on each other and other community members for support. Reflecting on experiences
of resilience and oppression can elicit more nuanced meaning in their relationship and identify
possibilities for growth.
Future Research Directions for RCT With Older LGBTQ+ Adults of Color
Considering the overall framework of RCT in application to older LGBTQ+ adults of color,
gerontological counseling researchers can explore a variety of avenues to advance research agendas
and bridge the gap across these intersecting social identities. Counseling researchers can employ
quantitative and qualitative analyses pertaining to older LGBTQ+ adults of color to challenge relational
images perpetuated by society (Duffey & Somody, 2011; Hammer et al., 2016). More importantly,
research framed within principles of RCT can also yield more in-depth understanding of how older
LGBTQ+ adults of color navigate resilience, empowerment, and incidents of oppression, which are
foundational to intersectionality and the RCT approach (Duffey & Trepal, 2016; Haskins & Appling,
2017; Singh et al., 2020). This emphasis is especially critical for older LGBTQ+ adults of color who are
less likely to seek counseling that fails to affirm their identity (Kim et al., 2017; Singh & Moss, 2016).
As researchers have continued to emphasize a stronger focus on resilience with multiply marginalized
communities (Bostwick et al., 2014; Bower et al., 2021; Singh, 2013), RCT presents a useful framework
for identity affirmation because of its focus on authenticity and growth-fostering connections (Flores &
Sheely-Moore, 2020; Mereish & Poteat, 2015). As several gerontological and health equity researchers
have documented, identity affirmation and culturally responsive care are crucial for buffering negative
health care experiences that prevent historically marginalized clients from seeking help (Flynn et al.,
2020; Fredriksen-Goldsen et al., 2017; Howard et al., 2019; Kim et al., 2017). Associated with advances
of research in intersectionality, RCT continues to demonstrate promising opportunities for the critical
examination of linked social identities that mirror multiple overlapping forms of oppression (Addison
& Coolhart, 2015; Chan & Erby, 2018; Singh & Moss, 2016). As a theoretical framework, RCT can
contextualize how structural forms of oppression (e.g., racism, ageism, heterosexism) converge for
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older LGBTQ+ adults of color, given RCT?s underpinnings in equity, social context, action, and a
social justice agenda (Singh et al., 2020). As researchers have noted, oppression relates to physical and
mental health disparities, covers a number of social experiences (e.g., social isolation, help-seeking,
caregiving), and is connected to relational well-being (Correro & Nielson, 2020; Jones et al., 2018; Kim
et al., 2017; Seelman et al., 2017).
Infusing RCT Constructs in Research
Gerontological counseling researchers can apply many of the RCT constructs to foster research
questions to expand RCT?s applicability beyond a theoretical framework, such as feelings of
empowerment and attitudes toward relationships and growth. Additionally, research has not
predominantly involved RCT for empirical use, although RCT is consistently taken up through
theoretical applications in practice (Haskins & Appling, 2017; Jordan & Carlson, 2013; Kress et al.,
2018), education (Hammer et al., 2014), supervision (Lenz, 2014), and advising (Purgason et al.,
2016). It has been used particularly as a rich theoretical framework to reform critical thinking in
practice. However, the implementation of RCT can immensely benefit from furthering an empirical
base to create more accessibility with applying such methods in counseling practice (Lenz, 2016). If
counseling practitioners implement RCT as part of their clinical approaches, research studies would
be particularly useful if research questions targeted how RCT is successful specifically with older
LGBTQ+ adults of color. Because RCT is relationally driven, researchers can integrate measures on
relationships as outcome variables that might explain a moderated effect, particularly if identity
disaffirmation or specific forms of oppression (e.g., racism, ageism) are contributing to lower
outcomes of wellness. In this case, the strength of relational outcomes may weaken the relationship
between multiple measures of oppression and wellness. This information would continue to highlight
which RCT factors need further intervention and effectiveness research to inform its utility as a
culturally responsive practice model.
RCT in Quantitative Desi
