Drawing on contemporary relational thinking and new perspectives on gender and sexuality, Goldstein and Horowitz describe and illustrate an affirmative approach to clinical work with lesbians at various stages of the life cycle. Adolescent, young adult and family issues are all brought within their compass. Making ample use of case vignettes, they demonstre the ways in which therapists can elicit their patients’ personal narratives of self-acceptance as lesbians and coming out experiences; work with the transference and countertransference dynamics subsequent to such disclosures; and finally explore the collaborative process through which therapist and patient seek to understand their therapeutic interaction. A range of life circumstances are brought within the authors’ hands-on clinical approach. They include the lesbian patients’ struggles with parenting, with physical illness, with the care-taking of parents, and with aging. Special consideration is given to issues arising when lesbians date and initiate romantic relationships and to the relationship problems that develop in ongoing partnerships during the middle and later years. The book concludes by discussing the issues faced by lesbian therapists in treating lesbian patients and in interacting with heterosexual colleagues.