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Therapists on the Front Line

Therapists on the Front Line
Psychotherapy With Gay Men in the Age of AIDS

Edited by Steven A. Cadwell, Ph.D., Robert A. Burnham, Jr., Ph.D., and Marshall Forstein, M.D.
1994
646 pages
ISBN 978-0-88048-558-6
Hardcover
Item #8558



Despite lessening media attention, AIDS is still the leading cause of death among gay men in the United States. Although research and medical discoveries are producing vast amounts of biological information, less is known about the complex psychosocial pattern involved in preventing transmission of HIV, or about coping with the diagnosis of HIV infection and the development of disease.

Therapists on the Front Line: Psychotherapy With Gay Men in the Age of AIDS explores how the AIDS epidemic has affected psychotherapists, their patients, and the therapeutic relationship. The book uses a multidimensional approach that includes psychodynamic, social, cultural, medical, and political factors.

Therapists on the Front Line: Psychotherapy With Gay Men in the Age of AIDS is divided into five sections:


  • General Issues
  • Treatment Modalities
  • Specific Treatment Populations
  • Impact on the Therapist
  • When the Therapist Has HIV Disease

Preface. General Issues. Twice removed: the stigma suffered by gay men with AIDS by Steven A. Cadwell, PhD. Impact of AIDS on adult gay male development: implications for psychotherapy by Rhonda Linde, PhD. Mourning within a culture of mourning by R. Dennis Shelby, PhD. The psychotherapist as spiritual helper by Rev. Jennifer M. Phillips, DMin. Suicidality and HIV in gay men by Marshall Forstein, MD. Neuropsychiatric dysfunction: impact on psychotherapy with HIV-infected gay men by Alexandra Beckett, MD, and Peter Kassel, PsyD. Taking a sexual history with gay patients in psychotherapy by Joel C. Frost, EdD. Testing for HIV: psychological and psychotherapeutic considerations by Marshall Forstein, MD. Treatment Modalities. The psychodynamics of AIDS: a view from self psychology by Sharone Abramowitz, MD, and Jeffrey Cohen, MD. The HIV-infected gay man: group work as a rite of passage by Shelley B. Brauer, PhD. Special issues in group psychotherapy for gay men with AIDS by Gil Tunnell, PhD. AIDS, sexual compulsivity, and gay men: a group treatment approach by Michael D. Baum, MA, MFCC, and James M. Fishman, LICSW. Home to die: therapy with HIV-infected gay men in smaller urban areas by Bruce J. Thompson, MSW, PhD. Psychotherapy with gay male couples: loving in the time of AIDS by Marshall Forstein, MD. Specific Treatment Populations. African American gay men and HIV and AIDS: therapeutic challenges by Shani A. Dowd, LCSW. Issues in the psychosocial care of Latino gay men with HIV infection by Jos A. Pars-Avila, MA, and Rubn Montano-Lopez, MA. Negotiating HIV infection in rural America: breaking through the isolation by Jane K. O’Rourke, LMSW, and Perry S. Sutherland, ACSW. Trauma revisited: HIV and AIDS in gay male survivors of early sexual abuse by Robert A. Burnham, Jr., PhD. HIV and substance abuse in the gay male community by Robert P. Cabaj, MD. Seronegative gay men and considerations of safe and unsafe sex by Walt Odets, PhD. Survivor guilt in seronegative gay men by Walt Odets, PhD. Impact on the Therapist. Empathic challenges for gay male therapists working with HIV-infected gay men by Steven A. Cadwell, PhD. Countertransference, the therapeutic frame, and AIDS: one psychotherapist’s response by James M. Fishman, LICSW. Peer supervision and HIV: one group’s process by Abraham Feingold, PsyD. When the Therapist Is HIV Infected. Necessary and unnecessary disclosure: a therapist’s life-threatening illness by Claire E. Phillip, LISW. Therapists’ disclosure of HIV status and the decision to stop practicing: an HIV-positive therapist responds by Michael Shernoff, CSW, ACSW. The process of closing a practice when the therapist has AIDS: a case study by Linda E. Hutton, PsyD. Epilogue: Where We Are Now by Steven A. Cadwell, PhD, Robert A. Burnham, Jr., PhD, and Marshall Forstein, MD. Index.

"This book is well-suited for several purposes; it is an excellent reference text for a course by the same title; a trove of qualitative ideas for researchers interested in studying the mental health aspects of HIV, particularly as they apply to gay men; and a source document for those concerned about renewing prevention efforts in the second decade of this epidemic. More experienced clinicians working in this field will find the 27 chapters variably useful; the chapters emphasizing the ethical and existential dilemmas of HIV-infected persons (and HIV-infected therapists) are the most informative and, even better, the most provocative."—The Journal of Nervous and Mental Disease


"At last, a comprehensive guide to working with this distinct and often neglected population. This book, with its multidimensional approach to specific treatment concerns, will be an asset to psychotherapists of all traditions."—READINGS: A Journal of Reviews and Commentary in Mental Health


"The book is a comprehensive compendium of information that is vitally important for all therapists, physicians, nurses, and other health care professionals who are taking care of individuals at risk or living with HIV/AIDS. . . . In short, the monograph is a tour-de-force; it contains information that I have never seen in print before, after more than 13 years working in the epidemic. I found it extremely enlightening and highly recommend it to all my medical and psychosocial colleagues."—Kenneth H. Mayer, M.D., Chief, Infectious Disease Division, Memorial Hosp of Rhode Island, Professor of Medicine & Community Health, Brown Univ School of Medicine, Director, Brown Univ AIDS Program

Steven A. Cadwell, Ph.D., is a Clinical Social Worker in private practice and Past Chair of the Massachusetts AIDS Action Mental Health Subcommittee. He has also served as consultant to Fenway Health Center and the group program of AIDS Action Committee of Massachusetts in Boston and the faculty of Smith College School of Social Work.

Robert A. Burnham, Jr., Ph.D., is a Clinical Psychologist in private practice in Brookline, Massachusetts, and has served on the faculty of the Massachusetts School of Professional Psychology. He is on the training faculty of the Family Institute of Cambridge in Cambridge, Massachusetts.

Marshall Forstein, M.D., is Director of HIV Mental Health Services for the Department of Psychiatry at The Cambridge Hospital, and Instructor in Psychiatry at Harvard Medical School. He is the Chair of the American Psychiatric Association’s Commission on AIDS. He is also Medical Director of Mental Health and Addiction Services for the Fenway Community Health Center in Boston.