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Addressing Trauma While Treating LGBTQ+ Individuals

Post-traumatic stress disorder (PTSD) is pervasive in the LGBTIQA+ community. This is primarily because individuals that identify as LGBTIQA+ are at greater risk of childhood maltreatment, witnessing deadly violence, witnessing the trauma of a close friend or relative, and experiencing the unexpected death of someone close to them, than are individuals who identify as heterosexual. The number of people battling mental health problems is higher in the LGBTIQA+ community, mostly developed during the teenage years.

Distinct Stressors in the LGBTIQA+ Community

Like many other marginalized groups, the LGBTIQA+ community is vulnerable to stressors that are caused by both microaggressive experiences and systemic or institutional inequity. Common stressors include:
  • Experiences or encounters with work, school, housing, legal, marriage, religious, and adoption discrimination.
  • Exposure to violence, including life-threatening assault, hate crimes, childhood abuse, sexual assault, or intimate partner violence.
  • Psychological or verbal abuse.
  • Homelessness or toxic living situations.
  • Internalized homophobia or bias; feelings of self-hatred.
  • Fear of, or negative experience, with being discovered as LGBTIQA+.
  • Harassment and bullying (in-person as well as online).
  • Religious persecution.
  • Sexual exploitation.
  • Persistent feelings of guilt or shame about one’s identity.
  • Parental and familial abandonment.
  • Intercommunity discrimination.
Knowing how to address trauma-induced PTSD in a way that encourages identity is imperative to provide effective treatment in this group. The following treatment modalities and interventions can help providers address both the trauma that LGBTIQA+ individuals may face, and promote recovery through the use of trauma-informed interventions.

Treating PTSD in the LGBTIQA+ Community

According to the National Institute of Health, there is an urgent need for public health interventions and follow-up care aimed at reaching individuals with minority sexual orientations to confront and minimize the consequences of violent victimization.

Trauma-Informed Treatment for PTSD in Sexual Minorities

The most effective way to address trauma-based PTSD in the LGBTIQA+ community is by using minority stress-focused treatment methods to treat psychiatric disorders, substance abuse, and suicide ideation. Minority stress theory states that, like other minority groups, the LGBTIQA+ population suffers from the stress that is caused by experiences of stigma and discrimination, which increases the risk of developing negative physical and mental health issues.

Interventions and Examples

There are four types of trauma-informed treatment methods that can successfully reduce, or even eliminate, symptoms of PTSD in LGBTIQA+ clients: structural, interpersonal, individual, and multilevel. All four methods are commonly used to minimize the severity and reduce the frequency of sexual minority stressors. #1. Structural interventions seek to change structural features that leave clients vulnerable to discriminatory behaviors or anti-LGBTIQA+ sentiments. Structural level interventions will reduce discriminatory behaviors and encourage LGBTIQA+ affirming behaviors. Providers that use structural interventions might:
  • Encourage LGBTIQA+ activism on local, state, and government levels.
  • Support clients in starting or joining gay-straight alliance groups.
  • Refer clients to LGBTIQA+-friendly spaces (such as support groups) to connect with peers.
#2. Interpersonal interventions lessen the frequency and severity of sexual minority stressors by increasing intergroup contact that assists clients and their loved ones in developing and practicing nondiscriminatory behaviors. These interventions are centered around the contact effect, which states that heterosexuals are more likely to adopt LGBTIQA+ affirming behaviors when they know and can sympathize with sexual minorities. Providers that employ interpersonal interventions might:
  • Encourage participation in family therapy.
  • Assign homework or distribute resources that help clients and their loved ones increase their knowledge and understanding of sexual minorities.
  • Help parents process religious beliefs about same-sex relationships and refer them to compassionate clergy.
#3. Individual interventions are used to combat discriminative, homophobic, or prejudicial attitudes and behaviors. These interventions are applied in more intimate settings where treatment is done on a one-on-one basis, unlike structural and interpersonal interventions, which are applied in more structural or institutional settings. Providers that utilize individual interventions could:
  • Ask the client to identify 10 myths about LGBTIQA+ individuals and, on a scale from 1 to 5, rate how firmly they believe in each.
  • Use Cognitive Behavioral treatment methodologies to replace negative, self-disparaging thoughts and behaviors with positive ones.
  • Remind the client of those positive beliefs about homosexuality or their gender preference to reinforce their sexual identity.
  • Assist the client with creating a list of pros and cons of disclosing sexual orientation or gender identity.
#4. Multilevel interventions combine two or more of the aforementioned interventions. Providers that use multilevel interventions can:
  • Support and guide clients through creating a sexual identity disclosure plan, and assist parents with processing reactions to that disclosure.
  • Direct clients and loved ones to attend a webinar that discusses sexual majority privilege and allyship.
  • Refer clients that are homeless or in dangerous living situations to community programs that will assist them with obtaining adequate housing.
Casa Recovery is an LGBTIQA+ affirmative treatment setting where individuals can overcome PTSD in a safe, inclusive space. Our mission is to provide each client with coping skills that put them on a path to long-term success in recovery, regardless of their sexual and gender identity. Although Post Traumatic Stress Disorder is a common occurrence in the LGBTIQA+ community, many individuals still do not receive help-seeking services. Instead, they live with feelings of guilt, shame, isolation, worthlessness, and uncertainty that often eventually lead to the development of mental health and substance use disorders. Consequentially, providers have a responsibility to support and encourage clients to express their feelings concerning their sexual and gender identity. At Casa Recovery, our mental health professionals foster a non-judgmental atmosphere where clients can express, evaluate, and accept feelings about their sexuality and gender identity. Our staff is highly trained in treatment methods that are LGBTIQA+ affirming, and our programs and services have been highly successful in reducing the symptoms of trauma-induced PTSD in marginalized populations. If you have an LGBTIQA+ client that you would like to refer to one of our programs, contact us today at (888) 928-2272

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