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Dec 5, 2023

by Jordan Werner

Affirmative Therapy: Navigating LGBTQ+ Mental Health with Cultural Competence and Resilience

QueerPsych spoke with Jordan Werner to discuss working as an LGBTQ+ therapist, specific techniques that have benefited clients, and helping clients navigate trauma and mental health struggles related to their identities.

How do you tailor your therapeutic approach to specifically address LGBTQ+ mental health, and the unique challenges that LGBTQ+ individuals may encounter in their lives? What techniques do you use to help clients build resilience and confidence?


Techniques and key considerations that I use in my practice to help address challenges that LGBTQIA+ people may encounter in their lives include the following: cultural competence, creating a safe space, identity exploration, addressing minority stress and intergenerational trauma, building resilience by helping them develop healthy coping strategies, self-esteem, a support network, using my lived experience as representation, affirmative therapy, intersectionality, education and advocacy, family and relationship support, community involvement, trauma informed care, and collaboration and referrals. It’s important to remember that every LGBTQIA+ person is unique, and therapy should be tailored to their specific needs and goals. A client-centered approach where their voice is central to the therapeutic process is crucial.

In your experience, what role does self-acceptance and self-compassion play in building resilience and confidence for LGBTQ+ individuals, and how do you help clients cultivate these qualities during therapy as they navigate their mental health?


Self-acceptance and self-compassion are necessary in building resilience and confidence for LGBTQIA+ people. Self-acceptance involves recognizing and embracing one’s authentic identity which can be particularly challenging in a society that isn’t always accepting and at some points can be downright hateful.

Self-acceptance contributes to resilience and confidence by assisting with identify affirmation, coping with prejudice, and improved mental health which will hopefully help lead to improved life circumstances. Self-compassion involves treating oneself with kindness and understanding especially when facing adversity. Self-compassion contributes to resilience and confidence by helping to build emotional resilience by teaching LGBTQIA+ people to respond to difficult situations with self-care rather than self-criticism. Reduced perfectionism can help many LGBTQIA+ to let go to the ‘perfect’ expectations or standards they may have for themselves and embrace their imperfections which can boost confidence. Self-compassion can also foster empowerment as clients learn to advocate for themselves without guilt or shame.

Techniques that I use to help clients cultivate these qualities in therapy are mindfulness and mind body connection. Mindfulness helps individuals observe their thoughts and emotions without judgement. Cognitive restructuring can help clients identify and challenge negative self-talk and internalized biases related to their identity and replace these with self-affirming and self-compassionate thoughts and concepts.

Can you explain how your integrative mental health approach combining attachment and systems-based modalities with DBT benefits LGBTQ+ clients specifically? How do these modalities work together to address the unique challenges and experiences faced by members of the LGBTQ+ community?


I would outline my integrative approach in the following way by highlighting certain aspects:

– Understanding Unique LGBTQ+ Experiences:
  • Acknowledging and validating the unique challenges faced by LGBTQ+ individuals, such as discrimination, stigma, and identity-related stress.
  • Recognizing the diversity within the LGBTQ+ community and tailoring therapy to address the specific needs of each client based on their intersecting identities.

Attachment-Based Approach:
  • Exploring how early attachment experiences may influence an individual’s sense of self and relationships, considering the potential impact of societal norms and family dynamics on the development of LGBTQ+ identities.
  • Helping clients explore and develop secure attachment patterns, fostering self-acceptance, and building supportive relationships within and outside the LGBTQ+ community.

Systems-Based Modalities:
  • Understanding the influence of larger social systems, such as family, friends, work, and society, on the individual’s mental health.
  • Addressing systemic issues, such as discrimination, microaggressions, and lack of societal acceptance, and collaboratively working with clients to navigate and challenge these dynamics.

DBT Skills Training:
  • Integrating Dialectical Behavior Therapy skills to address emotional dysregulation, distress tolerance, interpersonal effectiveness, and mindfulness.
  • Recognizing and validating the emotional intensity that may arise from navigating the challenges of being LGBTQ+ and providing practical tools to cope with these intense emotions.

Cultural Competence and Affirmation:
  • Cultivating cultural competence to understand the unique cultural and historical contexts of the LGBTQ+ community.
  • Providing an affirming and supportive environment where clients feel safe discussing their identities, relationships, and experiences without fear of judgment or misunderstanding.

– Empowerment and Resilience Building:
  • Focusing on strengths and resilience within the LGBTQ+ community, emphasizing the client’s ability to thrive despite adversity.
  • Empowering clients to advocate for themselves, set boundaries, and navigate both supportive and challenging environments.

– Collaborative and Inclusive Approach:
  • Collaborating with clients to co-create treatment goals that align with their values and aspirations.
  • Encouraging open communication and feedback to ensure the therapeutic approach remains relevant and responsive to the client’s evolving needs.

LGBTQ+ individuals may experience trauma related to their sexual orientation, gender identity, or experiences of discrimination. How do you create a safe and inclusive therapeutic environment for clients to explore their mental health and heal from trauma while promoting self-acceptance and resilience?


Creating a safe space for LGBTQ+ individuals in therapy involves active listening, affirming their identities, and acknowledging the impact of discrimination. Tailoring therapeutic approaches to address their unique experiences fosters trust and understanding. Emphasizing self-acceptance and resilience encourages clients to explore their trauma while empowering them to embrace their identities. It’s crucial to stay informed about LGBTQ+ issues, use inclusive language, and advocate for their well-being. This collaborative and affirming approach promotes healing and growth, fostering a therapeutic environment where clients feel validated and supported on their journey to recovery.

Building and maintaining meaningful relationships can be complex for LGBTQ+ individuals, especially those struggling with their mental health, due to potential societal stigmatization and rejection. How do you help your clients navigate these challenges and develop healthier patterns of relating and connecting with others?


I support LGBTQ+ clients in navigating relationship complexities by fostering a safe space for exploration. Addressing societal stigma, we work on building resilience, self-acceptance, and effective communication. Together, we identify and challenge negative beliefs, promoting authentic self-expression. Utilizing attachment and relational strategies, I guide clients in forming healthier connection patterns. Emphasizing self-worth, we navigate rejection fears and develop coping skills.

Through this process, clients gain confidence, empowering them to cultivate and sustain meaningful relationships while navigating societal challenges with resilience and authenticity. Additionally – in my case, using self-disclosure about my own sexual identity and experiences related to that is an important therapeutic tool because representation is an integral part of LGBTQIA+ identity formation and processing trauma.

Intersectionality, Mental Health

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