Toward a Queer Affirmative DBT-a-Informed Group for SGM Invalidation-Related Distress and Dysfunction: A Reflexive Thematic Analysis on Clinician Experiences

• Main Author: Bennett, Daniel J
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2024
• Subjects: Clinical psychology; Developmental psychology; Gender studies; Sexuality; Therapy
• ISBN: 9798383611043

There is a demand for culturally specific treatments for minority populations, including Sexual and Gender Minority (SGM) adolescents (Budge et al., 2017; Cardona et al., 2022). Research indicates minority stress contributes to elevated rates of stress-related psychopathology among SGM persons (Meyer, 2003) and that minority stressors can invalidate them (Cardona et al., 2022). Dialectical Behavior Therapy (DBT) treats life problems arising from invalidation (Linehan & Wilks, 2015; Cardona et al., 2022). A program based on DBT for Adolescents (DBT-A) may help SGM adolescents experiencing identity invalidation-related distress and dysfunction (Cardona et al., 2022). Limited research exists on adapting such an intervention (Cardona et al., 2022; Tilley et al., 2022; Camp et al., 2023). To generate suggestions for adaptations, a literature review on Affirmative Care (Mendoza et al., 2020), Queer theory (Butler, 1990; Phelan, 1997), and SGM-specific psychotherapies (e.g. Pachankis, 2018; Pachankis et al., 2022a) was conducted. This study hypothesized the experiences and opinions of clinicians providing DBT-informed treatment to SGM adolescents may inform the development of the aforementioned intervention. Four semi-structured interviews were held with clinicians who met these criteria. A Reflexive Thematic Analysis was conducted on their responses, generating 12 themes: Validating SGM Clients because of Their Invalidating Environment and Relationships, Radical Acceptance of a Cis-Heteronormative World, Interpersonal Effectiveness for Advocacy, Separately and Skillfully Processing Parental Emotions (They are Valid), Emphasizing Trust and Safety, Cognitive Work, Intersectionality and Intercultural Concerns, Compiling Community Resources, Clinicians Need SGM-Specific Training, Clinician Stress Management, Prejudice may Prevent Implementation, and Measures Required for SGM Populations and Problems. The implications of these themes for clinical practice are discussed.