(PS7-A10) Therapy Should Be Highly Individualized: Qualitative Exploration of Sexual and Gender Minority Adults' Perceptions of the Ideal Affirming Therapy

While a growing body of research has amassed examining affirmative mental health intervention with sexual and gender minority (SGM) individuals, few studies have queried SGM individuals directly to provide their perspectives on the ideal treatment. The present study sought to utilize a qualitative, community-informed approach to analyze common themes in SGM individuals’ desires for therapy, in order to ultimately reduce barriers to treatment and inform affirming interventions. In this way, a better understanding of the unique needs of SGM individuals as they seek affirming mental healthcare provides a pathway for promoting joy in therapy.

As part of a large online survey of SGM adults (M_age = 30.64, SD = 10.02) self-identifying as a diverse range of sexual orientations and gender identities, participants were asked to describe the qualities that they deem most important in a therapist and in mental health treatment for SGM individuals. Of this sample, 154 participants responded to these questions. Participants’ qualitative responses were coded and thematically analyzed in order to better understand common desires for the ideal therapeutic intervention for SGM individuals.

Three overarching themes emerged to describe ideal qualities in therapy: 1) Direct affirmation (unconditional support/acceptance, openness to discussing/exploring SGM identity, clear indicators of allyship or SGM identity), 2) Knowledge of SGM issues and experiences (identity terminology, intersectionality, systems of oppression, evidence-based practices, willingness to educate oneself), and 3) General therapeutic qualities (empathy, warmth, honesty, nonjudgment).

Regarding the ideal therapeutic intervention, participants’ indicated an emphasis on self-acceptance and understanding, examination of core beliefs, coping skills, trauma-informed care, and appropriate focus on the client’s SGM identity. Several clients indicated preferences in treatment modality, such as CBT or ACT. However, while participants expressed diverse preferences for their ideal treatment, the most common response emphasized that treatment should be tailored to the individual.

Results of the present analysis indicate that the “ideal therapy” for many SGM adults has a great deal in common with effective therapy for non-SGM individuals. However, it contains several features that emphasize the unique, intersectional needs of SGM individuals. In order to optimize affirmative therapeutic intervention for SGM individuals, therapists must strive to be aware these areas. Future research in affirmative intervention for SGM individuals should continue to integrate community perspectives.