A unified framework for addressing sexual minority stress in psychotherapy
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Sexual Minority Stress (SMS) is a persistent concern for lesbian, gay, and bisexual (LGB) people. SMS has been studied extensively as an important factor in health disparities between LGB individuals and heterosexuals. Within the literature of psychology, the conceptual framework of SMS is well established, including a good understanding of the mechanisms through which sexual minority stressors affect mental health. In contrast, ideas about treatment of SMS are preliminary and fragmented in the literature. While there has been some discussion in the literature about how to address SMS treatment, clinicians do not have a comprehensive model of psychotherapy that addresses the biological/physical, cognitive, affective, behavioral, cultural, and interpersonal/systemic factors that are affected by and affect SMS. Given the high prevalence of mental health disorders among the LGB community and the high rate at which LGB individuals seek psychotherapy, scholars have noted a strong need for the development of a comprehensive model to address SMS in psychotherapy. The author of this dissertation used a critical literature review to construct a unified framework for the treatment of SMS in psychotherapy. Current literature was reviewed in order to identify propositions about causes and consequences of SMS, hypotheses about treatments, and operational definitions of interventions. Specific treatment interventions validated in general populations were adapted to LGB clients. Lastly, a five-step unified treatment planning method was developed. The author of this dissertation lays the theoretical groundwork for developing a treatment manual that can be tested using applied research methods.