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Out On The Couch

The Courage to Care for the Transitioning Self

Posted: 5-22-23 | Karina Schneidman

How It Begins

Any life transition is hard. The human condition is a complicated one at best. It is riddled with pain, sorrow, confusion, darkness, and the unknown. However, that also comes with the gift of growth, beauty, love, happiness, peace and of course courage to live the life each of us deserves. As these [...]

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Managing Conflict in Affirmative Therapy

Posted: 12-7-22 | The Affirmative Couch

Relationships between therapists and clients can involve vulnerability. Exploring topics related to identity is delicate work.  Both client and therapist may be impacted by their education, knowledge, and preconceptions. Moreover, therapy often requires discomfort. None of this is news but: but managing conflict while centering your client’s experiences takes skill and experience.

Affirmative therapy requires [...]

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Gender Pronouns: Key Things Therapists Should Know

Posted: 7-20-22 | Andrew Kravig

Gender pronouns are an essential part of understanding how an individual identifies and communicating with them appropriately. As a therapist, using the correct gender pronouns for your clients will elevate your practice by helping them feel both seen and heard. If you don’t identify as trans or gender non-binary (TGNB) yourself, it can be hard [...]

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5 Challenges Facing the LGBTQ+ Community

Posted: 6-29-22 | Andrew Kravig

The fight for LGBTQ+ rights has come a long way, but the battle for acceptance is far from over. Therapists working with clients who are members of the LGBTQ+ community commonly see elevated rates of mental health challenges in this population, including anxiety, depression, trauma, disordered eating, and even suicidal ideation (Young & Fisher-Borne, 2018). Many [...]

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4 ways affirmative therapists can support transgender teens

Posted: 4-1-22 | Melissa Dellens

Approximately 1.9 million youth across the United States between the ages of 13 and 17 identify as lesbian, gay, bisexual, or transgender (Williams Institute, 2020). Nearly 70 percent of homeless transgender teens are homeless due to family exclusion (Williams Institute, 2020). Even when LGBTQIA+ youth have stable housing and family life, there are unique stressors [...]

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The Trauma Impact of Cancel Culture

Posted: 3-30-22 | Amelia Ortega

 

 Over the last two years of the COVID-19 pandemic, community relationships have shifted  to a location primarily online. The centrality and importance of technology-mediated relationships is now an established interest within the fields of social work and psychology (Trepte et al., 2017, Okdie et al., 2018) along with social and relational conflicts like cancel [...]

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How online self-disclosure benefits LGBTQIA+ therapists with lived experience

Posted: 2-18-22 | Teresa Theophano

Self-Disclosure and Community Building

We know that LGBTQIA+ community members are resourceful and resilient. We also know about startling disparities in the mental health of queer and trans individuals v. that of cisgender and heterosexual ones. As a queer femme clinical social worker who has spoken openly and published about my own lived experience of [...]

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Non-binary Microaggressions in Psychotherapy

Posted: 9-24-21 | Nicholas Moran

COVID-19 & (Re)claiming Gender

As a non-binary, genderqueer, and trans femme therapist myself, I have encountered my own fair share of microaggressions related to gender identity. During the pandemic, I have witnessed many people for the first time in their lives take a break from performing gender in a way society deems acceptable. As [...]

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Defining Power for Affirmative Therapists

Posted: 8-4-21 | Melissa Dellens

Clinics, treatment centers, and group practices play an important role in the communities they serve. Power flows through every relationship from the individual dyad in treatment to a community clinic’s relationship with federal policy (Hess & Schultz, 2008).  Moreover, these dynamics can be seen as both a commodity and resource (Peterson & Zimmerman, 2004) in [...]

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4 Barriers to Affirmative Clinic Change

Posted: 6-9-21 | Melissa Dellens

Gerald Caplan is seminal in developing some of the early theories of consulting work (Caplan, 1960). Caplan worked in Israel after World War II providing mental health support to 16,000 displaced and orphaned teens in overwhelmed residential and refugee facilities (Mendoza, 1993). Caplan’s resources were limited, and his team had no way of serving the [...]

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Clinician Resources for Internalized Transphobia

Posted: 5-11-21 | Mikey Anderson

(Re)imagining gender through stories 

In my first article in this two-part series, I explored and reviewed works created by queer and trans clinicians who approached internalized transphobia from a clinical perspective, and offered actionable steps to dismantle it in the therapeutic space with clients. In this second and final installment, I explore memoirs from [...]

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Decolonizing Your Practice with Trans Clients: Actions Steps and Resources

Posted: 3-17-21 | addyson tucker, Psy.D.

As a reminder, my goal in writing this two-part series is to reflect on the ways in which TGNB-affirming* clinicians contribute to colonization (Part 1), while also offering, in this article, actionable ways of moving toward decolonization and gender liberation.

You may be familiar with what is now called the Multicultural & Social Justice [...]

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Misgendering a Client in Therapy

Posted: 3-4-21 | The Affirmative Couch

Ask Us Anything: How to navigate moments of rupture and repair in the therapeutic relationship when a therapist missteps re: a client’s gender identity or expression? Important to acknowledge and apologize to the client and strive to do better – other things to keep in mind if/when this happens?

Wonderful question! You are definitely on [...]

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Why LGBTQIA+-Affirmative Primary Care Matters

With the global COVID-19 pandemic continuing into its second year, the conversation around access to healthcare has never been more relevant. For many people, going to a doctor for an annual physical was not feasible before the pandemic, whether due to lack of insurance coverage, financial cost, taking time off from work, transportation issues, or [...]

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Therapists Facing Internalized Transphobia

Posted: 1-20-21 | Mikey Anderson

Moving Towards Trans and Nonbinary-Affirmative Therapy Practice

As psychotherapists, we know that transphobia’s pervasive social impact affects our clients and our own internal worlds. This results in transgender and gender nonbinary (TGNB) folx internalizing society’s gender-normative attitudes and lays the groundwork for them to develop negative attitudes about themselves and their communities, which can ultimately [...]

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13 Signs You Need to Decolonize Your Practice with Trans Clients:  Paying Attention to Your Colonization-Connected Behaviors

Posted: 1-7-21 | addyson tucker, Psy.D.

This two-part series is intended to first reflect on the ways in which transgender and gender nonbinary (TGNB)-affirming clinicians perpetuate harm connected to colonization, then to present actionable ways of moving toward decolonization and gender liberation. I am a queer, white, able-bodied, and “cis-ish” person (i.e., I do not feel discomfort in my [...]

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Psychotherapy with Unsupportive Parents of Transgender and Gender Nonbinary Clients

Posted: 12-9-20 | The Affirmative Couch

Ask Us Anything: How should I handle the pronouns of and name for adolescent trans clients when their parents refuse to use the correct ones? Obviously I want to support my client by using their pronouns and name, but I also feel like it is a fine line between that and making parents angry so [...]

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Why LGBTQIA+ Affirmative Therapy is Critical During the Pandemic

Posted: 11-25-20 | The Affirmative Couch

LGBTQIA+ Affirmative Mental Health During the Pandemic

The stress and anxiety wrought by the COVID-19 pandemic may be universal–so many of us face fears of the virus itself, not to mention job loss, illness striking our loved ones, and myriad missed social, professional, and financial opportunities–but all of us experience these differently. Just as everyone’s [...]

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Substance Abuse Treatment Needs to Affirm LGBTQIA+ Clients

Posted: 11-18-20 | Madeline Hodgman-Korth, LISW

“Grant me the serenity to accept the things I cannot change, the courage to change the things that I can, and the wisdom to know the difference.”

In 12-step treatment settings, the Serenity Prayer often makes an appearance at the beginning or end of a group session in substance abuse treatment. Drawn from the Christian [...]

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How to Help Clients with Queer Impostor Syndrome

Keywords: queer, LGBTQ, LGBTQIA, impostor syndrome, impostor, cognitive behavioral therapy, CBT, core beliefs

I thought I identified one way, but now I’m not sure. What if this really was just a phase?

I’m afraid I won’t like all of the changes medical transition will cause to my body. What if I’m not really trans?

Can [...]

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A COVID-Era Review of Five Fabulous LGBTQIA+ Adult Coloring Books

Posted: 7-11-20 | Stephanie Sullivan

Coloring Books in Therapy

Coloring books aren’t just for children anymore: adult coloring books have gained great popularity in the last few years. They have been found to reduce symptoms of anxiety and depression; increase perseverance; and provide short-term stress relief (Eaton & Tieber, 2017; Flett et al., 2017; Rajendran et al., 2020; Simmons, 2016). [...]

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