A Framework for Incorporating Minority Stress Theory into Treatment with Sexual Minority Clients

Abstract

Empirical research has consistently demonstrated the negative mental health consequences of minority stress among lesbian, gay, and bisexual (LGB) populations; however, there is little understanding of how minority stress should be addressed in the actual clinical situation. This article discusses how to incorporate minority stress theory into clinical practice with LGB clients. A proposed framework begins with a two-part clinical assessment. The first part, based on Meyer's (2003) minority stress model, examines the effects of prejudice events, stigma, internalized homophobia, and sexual orientation concealment. The second part, grounded in Hatzenbuelher's (2009) work, examines the client's coping/emotional regulation, social/interpersonal, and cognitive processes, which can be elevated by minority stress. Following the assessment process, the framework suggests using a LGB-affirmative treatment approach. To demonstrate the clinical utility of the framework it will be applied to the treatment of a client identifying as lesbian.

KEYWORDS:

• lesbian
• gay
• bisexual (LGB)
• minority stress
• clinical practice
• LGB-affirmative psychotherapy
• prejudice and discrimination

Acknowledgments

Part of this manuscript was adapted from a dissertation by the author. Also, the author thanks Ilan H. Meyer and Maria Beatriz Alvarez for their helpful comments on earlier versions of this manuscript.

Notes

1. Identifying information was changed to protect the client's privacy.