Responding to gender and sexual minority stress with functional analytic psychotherapy.

Despite an overwhelming literature detailing the impact of societal bias on the well-being and relationships of gender and sexual minority clients, as well as greater rates of help-seeking from mental health professionals, recent advances in minority stress research have not been fully incorporated into clinical practice. Minority stress factors such as internalized stigma, rejection sensitivity, and concealment interfere with vulnerable and intimate relationships, and likely contribute to the transdiagnostic challenges that GSM clients report, such as loneliness and social isolation (Mereish & Poteat, 2015). Further, behavioral patterns emphasizing inauthentic self-presentation are common interpersonal styles of stigma management (Pachankis & Hatzenbuehler, 2013). Functional analytic psychotherapy is interpersonal therapy grounded in a behavior analytic approach to the therapeutic relationship, which was developed to promote generalizable change in intimate and vulnerable behaviors with meaningful others (Kohlenberg & Tsai, 1991). Functional analytic psychotherapy emphasizes the role of contingent responding by the therapist to clinically relevant behaviors, to increase vulnerable, interpersonal risks that can be responded to in a warm and compassionate way. FAP is ideal for adaptation to target the interpersonal aspects of minority stress on gender and sexual minority clients that often include histories of punishment in response to vulnerable authenticity, possibly even by past therapists (e.g., Flentje, Heck, & Cochran, 2014; Garnets, Hancock, Cochran, Goodchilds, & Peplau, 1991). (PsycINFO Database Record