Matthew Skinta, Ph.D and Aisling Curtin, MSc are the editors of a new volume which aims to provide clinicians with evidence-based strategies for working with and treating gender and sexual minorities. Their approach is based in a contextual behavioral science framework that includes mindfulness and acceptance-based interventions, compassion-focused therapy, acceptance and commitment therapy, relational frame theory and more.
Your new edited volume “Mindfulness and Acceptance for Gender and Sexual Minorities: A Clinician’s Guide to Fostering Compassion, Connection, and Equality Using Contextual Strategies” just hit shelves. Why did you decide to create this book?
MS: I feel like there’s such a natural fit between approaches like acceptance and commitment therapy (ACT), functional analytic psychotherapy (FAP), and compassion-focused therapy (CFT), and the needs of gender and sexual minority clients, though I didn’t see specific guidance out for clinicians. Research has been moving so quickly lately, and I wanted to create the book I’d want to read.
AS: Similarly to Matthew, I wanted to create a book that I would have wanted to read, both as a clinician and as a sexual minority myself. I came out later in life and I know that wasn’t always a straightforward process for me.
One of my biggest goals in life is aiming to channel my own hurts and pain into purpose, so I wanted to channel these painful experiences that so many gender and sexual minorities feel into this book.
This book is for clinicians, but can you be a bit more specific about who might benefit from reading and using the information in this book?
MS: It’s funny, I thought of it as just a book for clinicians, clinical researchers and psychology students, though I’ve already heard from laypeople who have picked up copies and found it readable and moving. Because so many clinicians who work with gender and sexual minority (GSM) clients are members of the community themselves, I encouraged a lot of disclosure and personal experience in the book, which really comes through.
AS: I think this book can be incredibly useful as a guide for clinicians, educators, allies, family, friends and gender and sexual minorities themselves.
The book’s chapters are based upon a contextual behavioral science framework, which utilizes mindfulness- and acceptance-based practices as a way of approaching the issues facing the gender and sexual minority community. How are mindfulness and acceptance so well-suited to the needs of this particular community and other oppressed groups?
MS: This is one of the parts I’m most excited about. There has been an explosion of research on the types of vulnerabilities brought about by minority stress, rejection sensitivity, etc., and the way that emotion dysregulation lies at the heart of it. Contextual behavioral science (CBS) approaches specifically target those underlying factors.
AS: One of the things I love about acceptance-based approaches is that we start where we are. Many of the thoughts and emotions that gender and sexual minorities face are based on real-life experiences they have had. CBS is an ideal fit as it takes a pragmatic yet compassionate approach that allows validation at the same time as challenging gender and sexual minorities to change patterns that may inadvertently be harmful to the self.
Does the research support mindfulness and acceptance-based interventions with gender and sexual minorities?
MS: This is a tough question. There have been a number of pilots and correlational studies bridging the variables, the techniques and strongly suggesting this is the case, and it’s harder than ever to attain funding to answer these questions with a strong, randomized design. I think this book may serve as a touchstone and signpost, though, as funding for GSM health-related research becomes more available.
In the US, it is legal in some states for psychotherapists to turn away LGBTQ clients. How do you think mindfulness- and acceptance-based approaches may help address social and systemic inequalities like these?
MS: Policies that allow providers to do harm in this way occur when the compassionate majority do not recognize their ability to change the field. We close our book with a chapter on advocacy; both the science in how to motivate ourselves as well as the work that is being done to support activists.
AS: Mindfulness- and acceptance-based strategies can greatly help us develop and fine-tune our perspective taking skills and capabilities. It’s also clear from the data that shame can reinforce discrimination further. I believe that perspective taking taught through mindfulness and acceptance strategies could help reduce the “othering” that leads to such discrimination.
What are some highlights or particularly compelling chapters/parts from the book?
MS: Some of the nicest surprises for me were in the unexpected. There is a chapter on couples, for instance, that over the course of editing unfolded into a beautiful exploration of how to respond after behaving in a heterocentric or transphobic way in therapy, as a straight, cisgender therapist.
There’s also a chapter on “coming out,” where Danny Ryu presents a meditation on the discomfort with uncertainty that therapists must learn to hold, alongside the discomfort of not feeling clear about one’s gender identity.
AC: Wow, this is a tough one as I loved so much of the book. Overall, I loved the personal experiences and clinical examples that people brought in to compliment the research and theoretical conversations. I also loved that functional analytic psychotherapy (FAP) and advocacy had such a strong presence in this volume.
For more about mindfulness and acceptance with gender and sexual minorities, check out Skinta and Curtin’s new edited volume.