As the aging population rapidly rises in the United States, so does the need for social workers who are competent to practice with older adults. Social workers must also be prepared to serve subpopulations within their generational context that may have unique needs and histories of inequality and oppression. The LGBT elder community has historically been overlooked in generalist and clinical practice with older adults. The purpose of this qualitative research study was to explore how mental health practitioners create and maintain the therapeutic relationship with LGBT elders. Individual interviews were conducted with nine mental health practitioners holding LICSW, LISW, and LGSW degrees. The major themes that emerged from the data were: 1) definition of the therapeutic relationship, 2) the importance of avoiding assumptions, 3) the importance of cultural competency, 4) the validation and recognition of life experience, 5) the development of trust, 6) the importance of safety and acceptance, and 7) challenges in developing the therapeutic relationship. Implications for social work, future research, and policy are discussed
