Weinberg Jillian R, Cooper Jennifer McGrory
Ferkauf Graduate School of Psychology, School-Clinical Child Psychology Program, Yeshiva University.
Graduate School of Education, Fordham University.
Sch Psychol. 2025 Mar;40(2):159-172. doi: 10.1037/spq0000665. Epub 2024 Sep 12.
Despite growing concerns related to the youth mental health crisis and the well-being of sexual and gender minority youth, specifically, most mental health interventions fail to meet the unique needs of this population. Research and clinical guidance have recommended that approaching mental health treatments through a lens of minority stress and intersectionality can be particularly helpful in addressing the mental health concerns of LGBTQIA+ (lesbian, gay, bisexual, transgender, questioning/queer, intersex, and asexual, with the '+' capturing other identities within the gender and sexually diverse population) youth. Because many adolescents do not have access to mental health care, schools have an important role to play in meeting the mental health needs of LGBTQIA+ youth. To address these issues, we propose LGBTQIA+ affirming adaptations to the dialectical behavior therapy (DBT) Skills Training for Emotional Problem Solving for Adolescents (STEPS-A) curriculum using Pachankis et al.'s (2023) Adaptation Model to provide practitioners with a culturally affirming model of this social-emotional curriculum, while highlighting the utility of this framework in adapting other evidence-based interventions in schools. We walk readers through each module of DBT STEPS-A and provide rationale for adapting these skills for LGBTQIA+ youth. We offer specific adaptations that facilitators can make through psychoeducation and skills training. For example, we provide sample dialectics that mirror the experience of minority stress and propose examples of coping skills that are relevant for LGBTQIA+ youth (e.g., distracting and self-soothing to tolerate distress). Finally, the role of school psychologists in meeting the mental health needs of LGBTQIA+ youth is discussed along with implications for practice and future research. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
尽管人们越来越关注青少年心理健康危机，尤其是性少数和性别少数青少年的福祉，但大多数心理健康干预措施未能满足这一人群的独特需求。研究和临床指导建议，从少数群体压力和交叉性的角度来进行心理健康治疗，对于解决 LGBTQIA+（女同性恋、男同性恋、双性恋、跨性别者、性取向存疑/酷儿、双性人以及无性恋者，“+”涵盖了性别和性取向多样化群体中的其他身份）青少年的心理健康问题可能特别有帮助。由于许多青少年无法获得心理健康护理，学校在满足 LGBTQIA+ 青少年的心理健康需求方面可以发挥重要作用。为了解决这些问题，我们提议对青少年情绪问题解决辩证行为疗法（DBT）技能训练课程（STEPS-A）进行LGBTQIA+ 肯定性改编，采用帕钱基斯等人（2023年）的改编模型，为从业者提供这一社会情感课程的文化肯定性模型，同时强调该框架在改编学校中其他循证干预措施方面的效用。我们引导读者了解 DBT STEPS-A 的每个模块，并为将这些技能改编用于 LGBTQIA+ 青少年提供理由。我们提供了促进者可以通过心理教育和技能训练进行的具体改编。例如，我们提供反映少数群体压力经历的示例辩证法，并提出与 LGBTQIA+ 青少年相关的应对技能示例（例如，分散注意力和自我安抚以忍受痛苦）。最后，讨论了学校心理学家在满足 LGBTQIA+ 青少年心理健康需求方面的作用以及对实践和未来研究的启示。（PsycInfo 数据库记录 (c) 2025 美国心理学会，保留所有权利）
