Working Alliance with Transgender and Gender Nonbinary Clients

Presenter: Cadyn Cathers, PsyD

2 CEs

Recorded Webinar

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Transgender and nonbinary people seek out therapy at higher rates than cisgender people, but frequently report that they struggle to find an affirmative therapist (Singh & dickey, 2017). The working alliance, also called the therapeutic alliance, is one of the most important factors in predicting positive therapeutic outcomes (Krause et al., 2011). The working alliance includes agreement around therapeutic goals and therapeutic tasks and the quality of the bond between the therapist and the client (Bordin, 1979). Based on Cathers (2019) and more current research, this course will explore some of the factors that impact the therapeutic alliance with transgender or nonbinary clients. By exploring how the working alliance may be affected by the client’s transition status, client’s experiences with gender minority stress, therapist’s perceived gender, the client’s perception of the therapist’s experience and training, and other factors, therapists can work towards building stronger therapeutic alliances with their gender expansive clients.

Learning Objectives:

  1. Describe the factors of the gender minority stress model
  2. Describe at least 2 ways gender minority stress factors may affect the working alliance
  3. Describe how the factors impacting therapeutic alliance for those living in their affirmed gender may be different than those not living in their affirmed gender




Cadyn Cathers, PsyD smiling and standing in front a rainbow brick wall. He is wearing a light blue button down, blue slacks, and brown belt. Photo Credit: Crystal Lily PhotographyAbout the Presenter

Cadyn Cathers, PsyD (he/him/his) has been teaching courses on human sexuality, psychotherapy with LGBTQIA+ communities, and psychodynamic theory for over 10 years, and serves as teaching faculty at Antioch University Los Angeles in the LGBT Specialization. He is the founder and CEO of The Affirmative Couch, which provides online continuing education on clinical work with LGBTQIA+, CNM, and kink communities. He is a licensed psychologist in private practice at the Out Couch Psychoanalytic Psychotherapy, P.C., where he focuses on psychoanalytic psychotherapy with transgender and nonbinary patients.





$50 for licensed

Buy Now

$40 for licensed in non-profit organization (use code WATGNP40)

$25 for pre-licensed (use code WATGPL25)

This course is included in the annual and lifetime memberships.

Annual Membership


Lifetime Membership


Additional Information

Instruction Level
This course is meant for an intermediate to advanced audience.

Who should Attend
Psychologists, counselors, and marriage and family therapists and social workers.

Recorded webinar recorded in June 2022.

Completion Requirements

To get CE credit, you will need to take the post-test with at least a 80% score in order to receive your certificate for a homestudy course.

Financial Support

The Affirmative Couch pays course presenters for their teaching. There is no other financial support for this course.

Conflict of Interest

There is no reported conflict of interest or outside commercial support for this course.

Contact Information

For any inquiries related to subject matter, problem resolution, corrections, grievances, or anything else, please contact us.


The Affirmative Couch will work to accommodate reasonable accommodations requests. Requests can be emailed with “accommodation request” in the subject line. Requests will be evaluated on a case-by-case basis.

Testimonials from the Live Event

"It was excellent."

"The course was done well, held my interest and all of the things. I was not well informed of the course content prior to attending the course. I appreciated the training a great deal."

"I thought the structure and organization were easy to follow and were cohesive."

"Dr. Cadyn is clearly very knowledgeable."

"Course was clear, informative, and concise."

"I enjoyed the course, it was informative and educational."

"It was very easy to understand. I came away feeling like my questions as to how to be a more effective therapist for these populations were answered."

"I truly appreciated the rupture and repair being broken down so well. Usable examples throughout the session were also helpful."

"Most of this information was new to me. And all of it will be useful on both personal and professional levels."

"As a therapist, it made me reflect on my interactions with my clients who identify as non-binary. This will inform my practice through bringing in conversations of sexuality and identity for my clients and being able to hold the space for them."

"I learned about rupture repair and how responses of client really indicate underlying learned coping skills in conflict."

"I appreciated the rupture portion and will implement these concepts moving forward."

"Thank you for all of the qualitative and quantitative data! That really kept my interest and I appreciate all of the effort Cadyn put into that, as well as in sharing it."


Testimonials Regarding the Presenter in Other Courses

"Identity development around sexuality, gender, and relationships presented by Cadyn Cathers, PsyD 5 CE Course" under a rainbow image of several silhouettes with a magnifying glass to denote identity development in LGBTQIA+, CNM, and kink communities

Identity Development around Sexuality, Gender and Relationships

"Cadyn's mastery of knowledge combined with his personable and approachable style made for a welcoming space for learning."

"Cadyn is amazing! He is a wealth of knowledge and provides such a rich tapestry of understanding, perspective taking, and case conceptualization. It was so informative and I am excited to share this information not only with clients but also with fellow clinicians."

"Psychological preparation for medical transition presented by Cadyn Cathers, PsyD 12 CE course." underneath a stethoscope with trans flag colors on a black background.

Psychological Preparation for Medical Transition

"Dr. Cathers/Cadyn was such a rockstar. I can't even imagine teaching a 6 hour training, much less a 12-hour. He's incredible and I hope he enjoyed teaching it as much as we loved learning about the info."

Continuing Education Approvals

APA ApprovedThe Affirmative Couch, LLC is approved by the American Psychological Association to sponsor continuing education for psychologists. The Affirmative Couch, LLC maintains responsibility for this program and its content.


$50 for licensed

Buy Now

$40 for licensed in non-profit organization (use code WATGNP40)

$25 for pre-licensed (use code WATGPL25)

This course is included in the annual and lifetime memberships.

Annual Membership


Lifetime Membership


Module 1 Module 1
Unit 1 Recorded Webinar  
Unit 2 Course Quiz  
Unit 3 After Course Survey