Gender Minority Clients Research Articles

성별 소수자에 대한 상담이론별 개입 실제

This study is driven by the recognition of a lack of research on counseling interventions andpractices tailored to gender minority clients, despite the prevalence of such clients in real-lifecounseling settings. As a result, this study aims to explore and summarize studies on theoreticalcounseling approaches for gender minority clients based on overseas research. To achieve thisresearch goal, this study summarizes results of studies published in academic journals from 2012to 2022. Research on counseling interventions for gender minority clients can be broadlycategorized into two main groups: affirmative counseling and traditional counseling theoriesculturally adapted to gender minority clients. This study presents the specifics of interventionsbased on the classification of affirmative counseling and traditional counseling theories. Finally,implications for counseling for gender minority clients are provided.

A thematic analysis of social workers’ practices with sexual and gender minority clients

Introduction Sexual and gender minority (SGM) people use therapists at high rates, emphasizing the importance of understanding of clinical practice behaviors and drivers of practice behaviors with these clients. Method Data were collected from social workers approved as Field Instructors at a Mid-Atlantic university (N = 198) via web-based surveys. Result Data themes are Beliefs About Practice with SGM Clients; Beliefs About SGM Clients’ Stressors, Shame, and Safety; Reported External Barriers to Practice with SGM Clients; and Reported Personal Barriers to Practice with SGM Clients. Conclusion Themes highlight the importance of personal beliefs and provide details on barriers to effective practices.

Strengthening HIV Prevention Services Through an Implementation Science Approach: Perspectives From the HIV Testers in Philadelphia.

Strengthening HIV prevention services is a key priority of the Ending the HIV Epidemic plan. Informed by the Consolidated Framework for Implementation Research, we examined HIV testers' perceived barriers and facilitators to implementing HIV prevention services, including testers' strengths and weaknesses; enabling factors within the inner and outer settings; and willingness to adopt potential implementation strategies. In 2019, the Penn Center for AIDS Research (CFAR) partnered with the Philadelphia Department of Public Health (PDPH) to examine system-level challenges and opportunities experienced by PDPH-funded HIV testers (individuals conducting HIV testing) in Philadelphia. We recruited HIV testers to complete 2 web surveys (n ≈ 40 each) and in-depth interviews (n = 11). Testers self-reported high HIV testing self-efficacy and competence, despite identifying gaps in their knowledge of STI testing, reporting moderate willingness to recommend pre-exposure prophylaxis, and having insufficient cultural competency when working with priority populations. Testers indicated that educational materials and policies within their agencies might require realignment to affirm sexual and gender minority clients. In qualitative interviews, testers noted challenges to implementing PDPH priorities because limited funding fueled competition between local agencies, deterred interagency partnerships, and limited their ability to serve key populations locally. HIV testers are critical partners in addressing agency-level barriers to HIV prevention service provision through multilevel implementation strategies. In partnership with PDPH, we will create and implement a train-the-trainers program consisting of skill-building activities, technical assistance, and capacity-building for all agency personnel to address missed opportunities in HIV prevention. These activities will reinforce scalability and sustainability of PDPH-supported HIV prevention programs.

Measuring the attitudes of midwives toward sexual and gender minority clients: Results from a Cross-Sectional survey in Ontario.

In Canada, Ontario midwives provide care to sexual and gender minority (SGM) people. Published literature shows how midwives' attitudes shape the experiences of lesbians, but research examining midwives' attitudes toward SGM people is lacking. Our study measured the attitudes of Ontario midwives toward SGM clients, hypothesizing that attitudes would be positive overall and that there would be no difference in attitudes across practice settings. Paper surveys (n=926) with an option to respond online were sent to Ontario midwifery practices. We measured midwives' attitudes toward sexual minorities (11 questions, scores ranged from 11 to 55) and gender minorities (9 questions, scores ranged from 9 to 45), with higher scores indicating more positive attitudes. Overall and subgroup analyses were performed. The 268 completed surveys indicated that midwives' attitudes were positive toward both sexual (mean score 49.2, maximum possible score of 55, ie, 89.4%) and gender minorities (mean score 38.9, maximum possible score of 45, ie, 86.4%). Analyses showed that attitudes toward SGM were associated with midwives' sexual identity and route of entry into the profession (ie, university-based vs bridging programs), but not practice setting. Although attitudes of this subset of midwives toward SGM clients were positive, volunteer bias could account for this finding since 32.6% of respondents identified as sexual minorities. Since the attitudes of midwives who entered the profession through the university-based education program were significantly more positive than those who entered through international bridging programs, future research should examine how SGM-related content is integrated into midwifery education and training curricula.

Mental health providers’ biases, knowledge, and treatment decision making with gender-minority clients.

Mental health providers’ biases, knowledge, and treatment decision making with gender-minority clients.

Affirmative Stances in Training Programs Toward Sexual and Gender Minority Clients: Views From Clinical and Counseling Psychology Graduate Students

ABSTRACT Despite training recommendations to address mental health disparities among sexual and gender minority (SGM) individuals, the current state of SGM affirmative training in clinical and counseling doctoral psychology programs remains unclear. The present study surveyed 147 clinical and counseling psychology graduate students in the United States. Participants completed surveys on affirmative training stances in their graduate program for sexual minority clients, gender minority clients, and self-reported perceptions of their attitudes, knowledge, and skills related to SGM clients. Results revealed that current graduate students reported more affirmative stances for sexual minority clients compared to gender minority clients. SGM graduate students reported fewer affirmative stances in their programs for both sexual and gender minority clients compared to their heterosexual cisgender peers. Lastly, SGM identity was a significant predictor of perceived SGM clinical competency beyond years of training, program model, or type of graduate program. Implications for training and future research are discussed.

Dialectical behaviour therapy skills group including stigma management: a pilot with sexual and gender minority veterans

AbstractAs a principle-driven treatment, dialectical behaviour therapy (DBT) offers concepts and strategies that can be flexibly applied to address unique types of invalidation, such as stigma experienced by marginalized groups. A pilot DBT skills training group that included material on using skills to dialectically manage the effects of stigma was conducted with four sexual and gender minority (SGM) veterans. The group included standard DBT skills along with explicitly teaching about stigma commonly faced by SGM individuals and ways to apply DBT skills to the experiences of stigma. This pilot group was conducted to determine the acceptability of such a group as well as its effects on symptoms (depression, emotion regulation), use of DBT skills in daily living, and the psychological burden of stigma-related experiences. The group was well-received by participants; outcomes suggest promising trends in reducing psychological distress and increasing use of DBT skills to cope. Implications for clinical practice using a dialectical approach to stigma management and future directions are provided.Key learning aims(1)Readers will learn about how dialectical behaviour therapy can be used to help sexual and gender minority clients effectively manage the effects of minority stress.(2)Readers will learn how taking a dialectical perspective on managing minority stress can be effective.(3)Readers will learn how delivering dialectical behaviour therapy in a manner contextualized within the clients’ experience can be effective in managing mental health symptoms.

Listening to identity: Transference, countertransference, and therapist disclosure in psychotherapy with sexual and gender minority clients.

Listening to identity: Transference, countertransference, and therapist disclosure in psychotherapy with sexual and gender minority clients.

Evidence-based relationship variables when working with affectional and gender minority clients: A systematic review.

Evidence-based relationship variables when working with affectional and gender minority clients: A systematic review.

Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling’s Best Practices in Addressing Conscience Clause Legislation in Counselor Education and Supervision

The amount of various, state-level legislation allowing the denial of counseling services to individuals with values that conflict with those of the professional counselor continues to increase. Such laws are in direct conflict with the values, principles, and ethical standards of the counseling profession. These “conscience clause” legislations are of concern due to the ability of the counseling profession to safeguard and protect the welfare of clients seeking counseling services. Potently, however, much of the focus of conscience clause legislation centers around the legal sanctioning of bias and refusal to provide services to affectional and gender minority clients, and the intersection of sexual/affectional orientation to spiritual and religious values. Provided is a review of these laws and the way they clash with the counseling profession. To assist profession counselors in navigating appropriate ethical behavior, specific counseling-appropriate and lesbian, gay, bisexual, trans, and queer affirming recommendations are provided. Each layer of professional counseling, direct work with clients, supervision, and counselor education, is addressed.

The Impact of Cumulative Minority Stress on Cognitive Behavioral Treatment With Gender Minority Individuals: Case Study and Clinical Recommendations

For sexual minority individuals (i.e., lesbian, gay, and bisexual [LGB] persons), minority stress includes experiences of discrimination, expectations of rejection, internalized negativity, and concealment of identity. Sexual minority stress has been linked to various negative mental health outcomes (e.g., depression, anxiety), and levels of psychiatric comorbidity are high among LGB people. However, little is known about the extension of minority stress models to gender minority individuals (i.e., transgender and gender nonconforming persons) and its impact on mental health in this particular group. Further, the influence of gender minority stress on the delivery and outcome of traditional cognitive behavioral therapy (CBT) approaches is unclear. A case study of CBT for chronic depression with a young, transgender individual is presented. This case study highlights potential barriers that may arise with gender minority clients when implementing evidence-based clinical interventions in the context of an individual’s minority stress history. Implications for cognitive-behavioral treatments with gender minority individuals and recommendations for clinicians and researchers are discussed.

Internalized Stigma Within Sexual and Gender Minorities: Change Strategies and Clinical Implications

Internalized stigma (including internalized homophobia/ heterosexism and internalized transphobia/genderism) negatively affects lesbian, gay, bisexual, and transgender individuals' mental health and well-being. Early writings framed internalized stigma as a reaction provoked by a susceptibility to external stigma that should be addressed within the person. However, recent writers have drawn sustained connections between internalized stigma and heterosexist and transphobic sociopolitical atmospheres. Research on the experience of internalized stigma and its negative outcomes are reviewed and evidence-based therapeutic guidelines applicable across various theoretical orientations are presented for counselors working with sexual and gender minority clients.

DCP Update: Guidelines for psychologists working therapeutically with sexual and gender minority clients

DCP Update: Guidelines for psychologists working therapeutically with sexual and gender minority clients

Sexual and gender minority therapy and systemic practice

While there has been an increase in papers addressing working with lesbian and gay clients over the past two decades, this paper builds on this historical context to combine the latest developments in therapy with sexual and gender minority clients with principles of systemic theory and practice. Clear guidelines are provided on how to apply sexual and gender minority therapy within a systemic frame. Specific issues relating to sexual and gender minority couple and family work are addressed, with the provision of further suggestions and resources.