Skip to main content
SpringerLink
Log in

Evidenced-Based Programming for LGBTQ Young Adults: An Intensive Outpatient Model

  • Chapter
  • First Online:
Handbook of Evidence-Based Day Treatment Programs for Children and Adolescents

Part of the book series: Issues in Clinical Child Psychology ((ICCP))

  • 554 Accesses

Abstract

The Right Track/LGBTQ Specialty Track was designed to meet the unique developmental needs to young adults struggling with mental illness and who also identify on the lesbian, gay, bisexual, transgender, questioning (LGBTQ) spectrum. This chapter outlines the process of designing this unique Intensive Outpatient Program from rationale to addressing specific risk factors as well as clinical conceptualization and day-to-day program details. Specific group topics are shared.

Understanding stigma management and the role of family are important elements that are discussed. The authors provide insight into lessons learned in designing a program from scratch and next steps with a vision for the future of specialized programmings.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 329.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Almeida, J., Johnson, R. M., Corliss, H. L., Molnar, B. E., & Azrael, D. (2009). Emotional distress among LGBT youth: The influence of perceived discrimination based on sexual orientation. Journal of Youth and Adolescence, 38, 1001–1014.

    Article  Google Scholar 

  • American Psychological Association, APA Task Force on Psychological Practice with Sexual Minority Persons. (2021). Guidelines for psychological practice with sexual minority persons. Retrieved from www.apa.org/about/policy/psychological-practice-sexual-minority-persons.pdf

  • Aranmolate, R., Bogan, D. R., Hoard, T., & Mawson, A. R. (2017). Suicide risk factors among LGBTQ youth. JSM Schizophrenia, 2(2), 1011.

    Google Scholar 

  • Batra, S. (2013). The psychosocial development of children: Implications for education and society – Erik Erikson in context. Contemporary Education Dialogue, 10(2), 249–278. https://doi.org/10.1177/0973184913485014

    Article  Google Scholar 

  • Bilodeau, B. L., & Renn, K. A. (2005). Analysis of LGBT identity development models and implications for practice. New Directions for Student Services, 2005(111), 25–39.

    Article  Google Scholar 

  • Birkett, M., Espelage, D. L., & Koenig, B. (2009). LGB and questioning students in schools: The moderating effects of homophobic bullying and school climate on negative outcomes. Journal of Youth and Adolescence, 38(7), 989–1000.

    Article  Google Scholar 

  • Blosnich, J. R., Marsiglio, M. C., Gao, S., Gordon, A. J., Shipherd, J. C., Kauth, M., Brown, G. R., & Fine, M. J. (2016). Mental health of transgender veterans in US states with and without discrimination and hate crime legal protection. American Journal of Public Health, 106(3), 534–540. https://doi.org/10.2105/AJPH.2015.302981

    Article  Google Scholar 

  • Broderick, P. C., & Blewitt, P. (2006). The life span: Helping development for helping professionals (2nd ed.) Pearson Education.

    Google Scholar 

  • Burgess, C. (2000). Internal and external stress factors associated with the identity development of transgendered youth. Journal of Gay & Lesbian Social Services, 20(3), 35–47.

    Google Scholar 

  • Carlson, J., & Dermer, S. B. (2017). The SAGE encyclopedia of marriage, family, and couples counseling. SAGE Publications, Inc.

    Book  Google Scholar 

  • Cochran, S. D., Sullivan, J. G., & Mays, V. M. (2006). Estimating prevalence of mental and substance use disorders among lesbians and gay men from existing national health data. In A. Omoto & H. Kurtzman (Eds.), Sexual orientation and mental health, examining identity and development in lesbian, gay and bisexual people (pp. 143–165). American Psychological Association.

    Chapter  Google Scholar 

  • Cochran, B. N., Peavy, K. M., & Robohm, J. S. (2007). Do specialized services exist for LGBT individuals seeking treatment for substance misuse? A study of available treatment programs. Substance Use & Misuse, 42(1), 161–176. https://doi.org/10.1080/10826080601094207

    Article  Google Scholar 

  • Co-Counseling International - USA. (n.d.). Co-Counseling International. Retrieved from https://www.cci-usa.org/index_2014.php

  • Collins, M., & Collins, D. (2017). At the broken places: A mother and trans son pick up the pieces. Beacon Press.

    Google Scholar 

  • D’Augelli, A. R. (1994). Identity development and sexual orientation: Toward a model of lesbian, gay and bisexual development. In E. J. Trickett, R. J. Watts, & D. Birman (Eds.), Human diversity: Perspectives on people in context. Jossey-Bass.

    Google Scholar 

  • Devor, A. (2004). Witnessing and mirroring: A fourteen stage model of transsexual identity formation. Journal of Gay & Lesbian Psychotherapy, 8, 41–67. https://doi.org/10.1300/J236v08n01_05

    Article  Google Scholar 

  • Dhejne, C., Lichtenstein, P., Boman, M., Johansson, A. L. V., Långström, N., & Landén, M. (2011). Long-term follow-up of transsexual persons undergoing sex reassignment surgery: Cohort study in Sweden. PLoS One, 6(2), e16885. https://doi.org/10.1371/journal.pone.0016885

    Article  Google Scholar 

  • Fassinger, R. E., & Miller, B. A. (1996). Validation of an inclusive model of an inclusive model of homosexual identity formation in a sample of gay men. Journal of Homosexuality, 32(2), 53–78.

    Article  Google Scholar 

  • Fergusson, D. M., Horwood, L. J., & Beautrais, A. L. (1999). Is sexual orientation related to mental health problems and suicidality in young people? Archives of General Psychiatry, 56, 876–880.

    Article  Google Scholar 

  • Fergusson, D. M., Horwood, J., Ridder, E. M., & Beautrais, A. L. (2005). Sexual orientation and mental health in a birth cohort of young adults. Psychological Medicine, 35, 971–981.

    Article  Google Scholar 

  • Fisher, S. K. E., Poirier, J. M., & Blau, G. M. (2012). Improving emotional and behavioural outcomes for LGBT youth: A guide for professionals. Paul H. Brookes Publishing.

    Google Scholar 

  • Friedman, R. C., & Downey, J. I. (2002). Sexual orientation and psychoanalysis: Sexual science and clinical practice. Columbia University Press.

    Google Scholar 

  • Germer, C. K., & Neff, K. (2019). Teaching the mindful self-compassion program: A guide for professionals. The Guilford Press.

    Google Scholar 

  • GLAAD. (2016). Debunking the bathroom bill myth-accurate reporting of LGBT nondiscrimination: A guide for journalists. Retrieved from http://www.glaad.org/sites/default/files/Debunking_the_Bathroom_Bill_Myth_2016.pdf

  • Goldblum, P., Testa, R., Pflum, S., Hendricks, M. L., Bradford, J., & Bongar, B. (2012). The relationship between gender-based victimization and suicide attempts in transgender people. Professional Psychology: Research and Practice, 43(5), 468–475.

    Article  Google Scholar 

  • Gunderson, J. G., & Links, P. (2014). Handbook of good psychiatric management for borderline personality disorder. American Psychiatric Publishing, Inc.

    Google Scholar 

  • Haas, A. P., Eliason, M., Mays, V. M., Mathy, R. M., Cochran, S. D., D’Augelli, A. R., … Clayton, P. J. (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: Review and recommendations. Journal of Homosexuality, 58(1), 10–51. http://dx.doi.org.ezproxylocal.library.nova.edu/10.1080/00918369.2011.5340

  • Hatchel, T., Valido, A., De Pedro, K. T., Huang, Y., & Espelage, D. L. (2019). Minority stress among transgender adolescents: The role of peer victimization, school belonging, and ethnicity. Journal of Child and Family Studies, 28(9), 2467–2476.

    Article  Google Scholar 

  • Health considerations for lgbtq youth. (2019). Retrieved February 26, 2021, from https://www.cdc.gov/healthyyouth/disparities/health-considerations-lgbtq-youth.htm

  • Hershberger, S. L., Pilkington, N. W., & D’Augelli, A. R. (1997). Predictors of suicide attempts among gay, lesbian, and bisexual youth. Journal of Adolescent Research, 12(4), 477–497.

    Article  Google Scholar 

  • Hetrick, E. S., & Martin, A. D. (1987). Developmental issues and their resolution for gay and lesbian adolescents. Journal of Homosexuality, 14(1–2), 25–43. https://doi.org/10.1300/J082v14n01_03

    Article  Google Scholar 

  • Hill, C. E., & Knox, S. (2001). Self-disclosure. Psychotherapy: Theory, Research, Practice, Training, 38(4), 413–417. https://doi.org/10.1037/0033-3204.38.4.413

    Article  Google Scholar 

  • Johns, M. M., Poteat, V. P., Horn, S. S., & Kosciw, J. (2019). Strengthening our schools to promote resilience and health among LGBTQ youth: Emerging evidence and research priorities from The State of LGBTQ Youth Health and Wellbeing Symposium. LGBT Health, 6(4), 146–155.

    Article  Google Scholar 

  • Kelleher, C. (2009). Minority stress and health: Implications for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) young people. Counselling Psychology Quarterly, 22(4), 373–379. https://doi.org/10.1080/09515070903334995

    Article  Google Scholar 

  • Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21(3), 169–184.

    Article  Google Scholar 

  • Kort, J. (2018). LGBTQ clients in therapy: Clinical issues and treatment strategies. W.W. Norton & Company, Inc.

    Google Scholar 

  • Kosciw, J. G., Greytak, E. A., Bartkiewicz, M. J., Boesen, M. J., & Palmer, N. A. (2012). The 2011 National School Climate Survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation’s schools. GLSEN.

    Google Scholar 

  • Lady Gaga. (2011). Born this way [Song]. On Born this way [Album]. Interscope Records.

    Google Scholar 

  • Lewis, R., Derlega, V., Clarke, E., & Kuang, J. (2006). Stigma consciousness, social constraints, and lesbian well-being. Journal of Counseling Psychology, 53(1), 48–56.

    Article  Google Scholar 

  • Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. The Guilford Press.

    Google Scholar 

  • Linehan, M. (2015a). DBT skills training manual. The Guilford Press.

    Google Scholar 

  • Linehan, M. (2015b). DBT skills training handouts and worksheets. The Guilford Press.

    Google Scholar 

  • Liu, R. T., & Mustanski, B. (2012). Suicidal ideation and self-harm in lesbian, gay, bisexual, and transgender youth. American Journal of Preventive Medicine, 42(3), 221–228. http://dx.doi.org.ezproxylocal.library.nova.edu/10.1016/j.amepre.2011.10.023

  • Lombardi, E. L., Wilchins, R. A., Priesing, D., & Malouf, D. (2002). Gender violence: Transgender experiences with violence and discrimination. Journal of Homosexuality, 42, 89–101. https://doi.org/10.1300/J082v42n01_05

    Article  Google Scholar 

  • Lukes, C., & Land, H. (1990). Biculturality and homosexuality. Social Work, 35, 155–161.

    Google Scholar 

  • Malyon, A. K. (1982). Psychotherapeutic implications of internalized homophobia in gay men. Journal of Homosexuality, 7(2–3), 59–69. https://doi.org/10.1300/J082v07n02_08

    Article  Google Scholar 

  • Martin, H. P. (1991). The coming-out process for homosexuals. Hospital and Community Psychiatry, 42, 158–162.

    Google Scholar 

  • Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674

    Article  Google Scholar 

  • Meyer, I. (2015). Resilience in the study of minority stress and health of sexual and gender minorities. Psychology of Sexual Orientation and Gender Diversity, 2(3), 209–213. https://doi.org/10.1037/sgd0000132

    Article  Google Scholar 

  • Meyer, I. H., & Frost, D. M. (2013). Minority stress and the health of sexual minorities. In C. J. Patterson & A. R. D’Augelli (Eds.), Handbook of psychology and sexual orientation (pp. 252–266). Oxford University Press.

    Google Scholar 

  • Meyer, I. H., Schwartz, S., & Frost, D. M. (2008). Social patterning of stress and coping: Does disadvantaged social statuses confer more stress and fewer coping resources? Social Science & Medicine (1982), 67(3), 368–379. https://doi.org/10.1016/j.socscimed.2008.03.012

    Article  Google Scholar 

  • Moradi, B., & Budge, S. L. (2018). Engaging in LGBQ+ affirmative psychotherapies with all clients: Defining themes and practices. Journal of Clinical Psychology, 74(11), 2028–2042. https://doi.org/10.1002/jclp.22687

    Article  Google Scholar 

  • Moses, A., & Hawkins, R. (1982). Counseling lesbian women and gay men. Mosby.

    Google Scholar 

  • Movement Advancement Project. (2016). State Non-Discrimination Laws [map]. Retrieved from http://www.lgbtmap.org/equality-maps/non_discrimination_laws

  • Nealy, E. C. (2017). Transgender children and youth: Cultivating pride and joy with families in transition. W.W. Norton & Company, Inc.

    Google Scholar 

  • Neff, K. (2011). Self-compassion. William Morrow.

    Google Scholar 

  • Neff, K. (2018, March 6). Self-compassion. https://self-compassion.org/

  • Neff, K., & Germer, C. K. (2018). The mindful self-compassion workbook: A proven way to accept yourself, build inner strength, and thrive. The Guilford Press.

    Google Scholar 

  • Nock, M. K., Green, J. G., Hwang, I., McLaughlin, K. A., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: Results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry, 70(3), 300–310. https://doi.org/10.1001/2013.jamapsychiatry.55

    Article  Google Scholar 

  • Norton, A. T., & Herek, G. M. (2013). Heterosexuals’ attitudes toward transgender people: Findings from a national probability sample of US adults. Sex Roles, 68, 738–753. https://doi.org/10.1007/s11199-011-0110-6

    Article  Google Scholar 

  • Olson, K. R. (2016). Prepubescent transgender children: What we do and do not know. Journal of the American Academy of Child and Adolescent Psychiatry, 55(3), 155–156. https://doi.org/10.1016/j.jaac.2015.11.015

    Article  Google Scholar 

  • Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137(3), e20153223. https://doi.org/10.1542/peds.2015-3223

    Article  Google Scholar 

  • Pelton-Sweet, L. M., & Sherry, A. (2008). Coming out through art: A review of art therapy with LGBT clients. Journal of the American Art Therapy Association, 25(4), 170–176.

    Article  Google Scholar 

  • PFLAG. (2021, October 29). Retrieved November 5, 2021, from https://pflag.org/

  • Reisner, S. L., White, J. M., Bradford, J. B., & Mimiaga, M. J. (2014). Transgender health disparities: Comparing full cohort and nested matched-pair study designs in a community health center. LGBT Health, 1, 177–184. https://doi.org/10.1089/lgbt.2014.0009

    Article  Google Scholar 

  • Ryan, C. (2009). Supportive families, healthy children: Helping families with lesbian, gay, bisexual & transgender children. Family Acceptance Project, San Francisco State University.

    Google Scholar 

  • Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in White and Latino lesbian, gay, and bisexual young adults. Pediatrics, 123(1), 346–325. https://doi.org/10.1542/peds.2007-3524

    Article  Google Scholar 

  • Ryan, C., Russell, S. T., Huebner, D., Diaz, R., & Sanchez, J. (2010). Family acceptance in adolescence and the health of LGBT young adults. Journal of Child and Adolescent Psychiatric Nursing: Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc, 23(4), 205–213. https://doi.org/10.1111/j.1744-6171.2010.00246.x

    Article  Google Scholar 

  • SAMHSA’s Trauma and Justice Strategic Initiative. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf

  • Shipherd, J. C., Maguen, S., Skidmore, W. C., & Abramovitz, S. M. (2011). Potentially traumatic events in a transgender sample: Frequency and associated symptoms. Traumatology, 72, 56–67.

    Article  Google Scholar 

  • Sloan, C. A., Berke, D. S., & Shipherd, J. C. (2017). Utilizing a dialectical framework to inform conceptualization and treatment of clinical distress in transgender individuals. Professional Psychology: Research and Practice, 48(5), 301–309. https://doi.org/10.1037/pro0000146

    Article  Google Scholar 

  • Snyder, K. V., Kymis, P., & Kessler, K. (1999). Anger management for adolescents: Efficacy of brief group therapy. Journal of the American Academy of Child and Adolescent Psychiatry, 38(11), 1409–1416.

    Article  Google Scholar 

  • Stevens, R. A. (2004). Understanding gay identity development within the college environment. Journal of College Student Development, 45(2), 185–206. Retrieved from ProQuest Psychology Journals database.

    Google Scholar 

  • Sue, D. W., & Sue, D. (2003). Counseling the culturally diverse: Theory and practice (4th ed.). Wiley.

    Google Scholar 

  • Taylor, J. (2019). Mental health in LGBTQ youth: Review of research and outcomes. Communiqué, 48(3), 4–6.

    Google Scholar 

  • Thomas, S. P., Shattell, M., & Martin, T. (2002). What’s therapeutic about the therapeutic milieu. Archives of Psychiatric Nursing, 16(3), 99–107.

    Article  Google Scholar 

  • Vance, S. R., & Rosenthal, S. M. (2018). A closer look at the psychosocial realities of LGBTQ youth. Pediatrics, 141(5), e20180361.

    Article  Google Scholar 

  • Wilson, C., & Cariola, L. A. (2019). LGBTQI+ youth and mental health: A systematic review of qualitative research. Adolescent Research Review, 5(2), 187–211. https://doi.org/10.1007/s40894-019-00118-w

    Article  Google Scholar 

  • Wolford-Clevenger, C., Frantell, K., Smith, P. N., Flores, L. Y., & Stuart, G. L. (2018). Correlates of suicide ideation and behaviors among transgender people: A systematic review guided by ideation-to-action theory. Clinical Psychology Review, 63, 93–105. https://doi.org/10.1016/j.cpr.2018.06.009

    Article  Google Scholar 

  • Yildiz, E. (2018). Suicide in sexual minority populations: A systematic review of evidence-based studies. Archives of Psychiatric Nursing, 32(4), 650–659. http://dx.doi.org.ezproxylocal.library.nova.edu/10.1016/j.apnu.2018.03.003

Download references

Author information

Authors and Affiliations

  1. Hartford HealthCare/Institute of Living, Young Adult Services, Hartford, CT, USA

    Laura M. I. Saunders & Derek A. Fenwick

Authors
  1. Laura M. I. Saunders
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Derek A. Fenwick
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Laura M. I. Saunders .

Editor information

Editors and Affiliations

  1. Department of Psychiatry, Division of Child and Adolescent Psychology Virginia Commonwealth University, Children’s Hospital of Richmond and Virginia Treatment Center for Children, Richmond, VA, USA

    Jarrod M. Leffler

  2. Department of Psychiatry and Human Behavior, Bradley Hospital/Brown University, Providence, RI, USA

    Elisabeth A. Frazier

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Saunders, L.M.I., Fenwick, D.A. (2022). Evidenced-Based Programming for LGBTQ Young Adults: An Intensive Outpatient Model. In: Leffler, J.M., Frazier, E.A. (eds) Handbook of Evidence-Based Day Treatment Programs for Children and Adolescents. Issues in Clinical Child Psychology. Springer, Cham. https://doi.org/10.1007/978-3-031-14567-4_15

Download citation

Publish with us

Policies and ethics

Search

Navigation