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Applying dialectical behaviour therapy to structural and internalized stigma with LGBTQ+ clients

Published online by Cambridge University Press:  10 January 2019

Kim Skerven ,
Dane R. Whicker  and
Kelly L. LeMaire
Kim Skerven
Affiliation:
Center for Behavioral Medicine, 250 N. Sunnyslope Road, #203, Brookfield, WI 53005, USA
Dane R. Whicker
Affiliation:
Duke University Medical Center, Cognitive Behavioral Research and Treatment Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2213 Elba Street, Office 105, Durham, NC 27705, USA
Kelly L. LeMaire
Affiliation:
Duke University Medical Center, Cognitive Behavioral Research and Treatment Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2213 Elba Street, Office 105, Durham, NC 27705, USA
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Abstract

Delivering research-supported intervention is increasingly important, given the growing emphasis on evidence-based practice in mental health treatment. When working with clients who hold marginalized identities, however, therapists may have questions about how to best tailor interventions, as treatments may not yet have demonstrated efficacy with under-represented populations. This paper describes potential strategies for using dialectical behaviour therapy (DBT) skills to help LGBTQ+ clients, guided by a theoretical model for understanding sexual stigma. Joining these two paradigms, suggestions are made for applications of skills that can help LGBTQ+ clients who are in DBT effectively interact with invalidating environments characterized by structural stigma. DBT-based strategies aimed at buffering clients from environmental invalidation and enhancing their skills in self-validation can help provide them with pathways towards affirming their own sexual orientation and gender identity. Examples from clinical cases are used to enhance understanding of skills application in practice.

Keywords

DBTheterosexisminternalized stigmaLGBTQstructural stigma

Information

Type
Special Issue: Cultural Adaptations of CBT
Information
the Cognitive Behaviour Therapist , Volume 12 , 2019 , e9
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2019 

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Footnotes

*

Authors’ note: Dane R. Whicker, PhD and Kelly L. LeMaire, PhD contributed equally and share second authorship; the order listed was chosen randomly.

References

Suggested follow-up reading

Herek, GM, Gillis, JR, Cogan, JC (2009). Internalized stigma among sexual minority adults:insights from a social psychological perspective. Journal of Counseling Psychology 56, 32–43.Google Scholar
Koerner, K (2012). Doing Dialectical Behavior Therapy. New York: The Guilford Press.Google Scholar
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Millar, BM, Wang, K, Pachankis, JE (2016). The moderating role of internalized homonegativity on the efficacy of LGB-affirmative psychotherapy: results from a randomized controlled trial with young adult gay and bisexual men. Journal of Consulting and Clinical Psychology 84, 565.Google Scholar
Pachankis, JE, Hatzenbuehler, ML, Rendine, HJ, Safren, SA, Parsons, JT (2015). LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: a randomized controlled trial of a transdiagnostic minority stress approach. Journal of Consulting and Clinical Psychology 83, 875–889.Google Scholar

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