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Sexual minority youth need specialized treatment from therapists

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Lesbian girlPresident Obama officially declared June as Lesbian, Gay, Bisexual and Transgender (LGBT) Pride Month. However, despite advances in civil rights, sexual minority youth are still at greater risk for suicide than their heterosexual peers, according to the Suicide Prevention Resource Center.

A University of Missouri psychology graduate student recently published recommendation to improve psychologists’ treatment of sexual minority youth, which could help improve psychological functioning and reduce depression and suicide rates.

“Psychologists sometimes face a particular dilemma when treating sexual minority youth, many of whom are still in the process of developing their sexual identity,” said Alex Dopp, doctoral student in psychological sciences in MU’s College of Arts and Science. “Serious mental strain can result if a core piece of a young person’s emerging identity is unacceptable to his or her family. Parents may observe this anguish and want to know what is troubling their children. However, when therapists share that information with parents, they may reveal a youth’s sexual identity, which may exacerbate the problem.”

For example, parents may bring a depressed and suicidal adolescent in for therapy, Dopp explained. The youth may then confide in the psychologist that they are suicidal because they fear their family won’t accept their identity as a sexual minority. The therapist faces an ethical dilemma: on the one hand, bringing the youth and parents closer together is critical to the youth’s adjustment, but on the other hand, opening up to the parents  could exacerbate the youth’s suffering and suicide risk (if revealing their sexual minority status leads to increased conflict in the home, parental rejection, etc.).

“There is no single recommendation for what the psychologist should do in this situation,” said Dopp. “Instead a therapist must be well prepared and educated in the best ways to treat sexual minority youth.” The necessary background will include, but is not limited to, familiarity with the development of and variation within human sexuality and gender, detailed understanding of ethical issues, competence in affirmative psychotherapy, and clinical skills for managing suicide risk.

In his paper, published in Ethics and Behavior, Dopp made recommendations on how psychologists can best prepare to meet LGBTQ youth’s needs, including:

  • Broadly disseminate and continue to update professional guidelines and training resources,

such as the American Psychological Association’s Guidelines for Psychotherapy With Lesbian, Gay, and Bisexual Clients and the American Counseling Association’s Competencies for Counseling With Transgender Clients.

  • Actively advocate for affirmative psychotherapy and reject therapies that treat sexual minority identity as a disease
  • Continue to build knowledge regarding sexual orientation and identity development in youth
  • Develop reliable diagnostic tools to assess and treat transgender youth

Dopp’s paper, “Treatment of Sexual Minority Youth: Ethical Considerations for Professionals in Psychology,” was published in the journal Ethics and Behavior. The paper resulted from an assignment in an MU course taught by Nan Presser. The paper won an honorable mention in the American Psychological Association’s Graduate Student Ethics Prize competition.

“Required ethics courses can be mundane requirements,” Dopp said. “Dr. Presser turned her ethics class at MU into a dynamic learning experience and an excellent opportunity to develop and publish a paper.”

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