1st Edition

Contextual Behavior Therapy for Sexual and Gender Minority Clients A Practical Guide to Treatment

By Matthew D. Skinta Copyright 2021
    166 Pages 3 B/W Illustrations
    by Routledge

    166 Pages 3 B/W Illustrations
    by Routledge

    Combining theory, research, and case studies, this book shows clinicians how to apply transdiagnostic contextual behavioral approaches when working with sexual and gender minority (SGM) clients.

    The text first examines minority stress theory through the lens of contextual behavior analysis. Subsequent chapters illustrate the application of therapeutic techniques drawn from acceptance and commitment therapy, functional analytic psychotherapy, and compassion-focused therapy. The book concludes with a close look at special areas of consideration, including pre-surgical evaluation, the impact of HIV on SGM communities, ethical considerations, and future directions in therapy with SGM clients. Every chapter provides a series of diverse vignettes that illustrate how each aspect of treatment might build upon the last along with a list of recommended books for further exploration of that topic.

    This book offers a unique, integrated approach that can be used for case conceptualization and followed as a treatment manual for professionals or graduate students with a foundation in SGM psychology.

    Author Biography; Introduction; Chapter 1: A Contextual Behavioral Analysis of Minority Stress; Chapter 2: The Therapeutic Relationship and Clinician Self-Work; Chapter 3: Mindfulness and Perspective Taking; Chapter 4: Acceptance and Defusion; Chapter 5: Values and Committed Action; Chapter 6: Vulnerability and Intimacy; Chapter 7: Compassion and Community; Chapter 8: Complex Trauma and Post-Traumatic Stress among SGM Clients; Chapter 9: Health Considerations among SGM Clients; Chapter 10: Special Ethical Considerations for SGM Therapists; Chapter 11: Future Directions in SGM Therapy; Index


    Matthew D. Skinta, PhD, ABPP, is a board-certified clinical health psychologist and an assistant professor in the Department of Psychology at Roosevelt University.

    "In this groundbreaking book, Matthew Skinta, PhD, ABPP, approaches the use of Minority Stress Theory (MST), intersectionality, and process-based approaches to work with sexual and gender minorities (SGM). To this point, what is known about MST are the many ways it impacts the lives of SGM people. Skinta is the first to incorporate MST in clinical practice. This book is ideal for trainees and practicing mental health providers who are working with SGM clients. MST and intersectionality are theoretical approaches that have been used to understand the challenges faced by people with marginalized identities. Skinta eloquently describes how to apply process-based techniques to work with SGM clients. Rooted in sound theoretical design, Skinta has developed a work that will likely be considered a seminal work in years to come."

    lore m. dickey, PhD, North Country HealthCare, Bullhead City, Arizona

    "This volume beautifully summarizes relevant research regarding minority stress and uses this to guide a functional contextual approach to treatment when working with SGM clients. The volume’s introduction thoughtfully lays a foundation for its contents, highlighting specific themes and key concepts. It effectively illustrates the integration of science into clinical practice through a minority stress lens, utilizing case vignettes and concrete examples that will support and enhance the work of even seasoned mental health professionals. Therapeutic approaches notwithstanding, the concept of contextualism is embedded within its content, as it includes material related to evolving language, intragroup dynamics, intersectionality, and the landscape of SGM professionals, including ethical considerations when working with SGM communities. Unlike many other sources, these topics are not just mentioned, but thoughtfully explored and integrated throughout the entire book. This volume also explicitly and repeatedly communicates the important point regarding necessity of intervention both with SGM individuals in therapy and within the larger environment that negatively impacts them. As such, this volume will be exceptionally valuable to mental health professionals, as well as trainees."

    Colleen A. Sloan, PhD, VA Boston Healthcare System and Assistant Professor of Psychiatry, Boston University School of Medicine

    "Dr. Matthew Skinta is the leading figure in ACT and contextual science, focused on work with sexual and gender minorities. This book is like having a private course with Dr. Skinta, as he shares his profound perspective and deep compassion with you, the reader. Among books in this area, I give Dr. Skinta’s book my unreserved and highest recommendation."

    Dennis Tirch, PhD, author of The Compassionate-Mind Guide to Overcoming Anxiety

    "Until now, there have been limited resources for therapists seeking to understand and help their sexual and gender minority clients within a contextual behavioral framework. This book is packed full of useful information and case examples, undergirded by the most current science and theory in these important and rapidly evolving areas of psychological scholarship. As a clinical supervisor and diversity educator, I plan to make this required reading in my graduate courses."

    Monnica T. Williams, PhD, ABPP, Canada Research Chair in Metal Health Disparities, University of Ottawa

    "Contextual behavioral theories hold much promise to facilitate the integration of social identities, contextual experiences, and histories of people who are sexual and gender orientation minorities into clinical theory. However, in the psychological literature, the specific needs and experiences of SGM people have only recently been integrated into clinical contextual behavioral theory. This text does much to specifically outline how the social identities and social experiences of SGM people might be incorporated into these existing theoretical treatment models and key CBT constructs and practices. The intersectional approach used by this text is particularly beneficial to address the real-world complexity of experiences, social backgrounds, and salient identities that reflect the individuality of each client, and how the client’s background and identities might influence their functioning. This texts builds upon existing models of minority stress, cultural humility, risk and resilience, and considerations of power and privilege for SGM people to describe how these multicultural frameworks might be utilized across a range of CBT therapies in an innovative, practical, supportive, and clinically useful way. The framework presented in this book will be helpful for seasoned practitioners as well as for students and beginning therapists who wish to build a culturally affirmative clinical practice that integrates empowering strategies when working with SGM clients."

    Susan Torres-Harding, PhD, professor, Roosevelt University

    "Matthew Skinta has provided all of us with a much-needed book. Packed with vignettes, practical examples, and descriptions of applied skills, the book is an incredibly useful tool for clinicians who already work with SGM clients and want to deepen their understanding of how identity-based oppression impacts on mental health. It is also a precious resource for students in clinical trainings who really want to learn how to conceptualize and alleviate the suffering derived from rejection, shame, interpersonal bias or discrimination. A timely book infused with human and clinical wisdom that greatly enhanced my understanding of what it means to be compassionate toward my vulnerability and intimate with myself and others, as a clinician and a human."

    Nicola Petrocchi, PhD, Professor of Psychology, John Cabot University and founder of Compassionate Mind – ITALIA

    "This book is an essential SGM psychology reference and must read for any clinician or in therapist in training! Dr. Skinta’s expert approach in this well written and highly informed resource is on the cutting edge of evidence based SGM-affirming psychotherapies. This important book is a guide for those therapists and researchers who already have a basic foundation in SGM psychology and are looking to enhance and advance their work and provide treatment that is process based, individually focused, and centered on the most current research and effective therapeutic interventions."

    Laura Silberstein-Tirch, PsyD, author of How to Be Nice To Yourself