La adaptación afirmativa de los tratamientos psicológicos para minorías sexuales: una revisión sistemática

  1. Antonio Bazán 1
  2. María Mansilla 1
  1. 1 Universidad Complutense de Madrid, España
Revista:
Clínica Contemporánea: revista de diagnóstico psicológico, psicoterapia y salud

ISSN: 1989-9912

Ano de publicación: 2022

Volume: 13

Número: 1

Tipo: Artigo

DOI: 10.5093/CC2022A1 DIALNET GOOGLE SCHOLAR lock_openAcceso aberto editor

Outras publicacións en: Clínica Contemporánea: revista de diagnóstico psicológico, psicoterapia y salud

Resumo

Since the declassification of homosexuality as a mental disorder and the proliferation of research about stigma and its outcomes in mental health, a significant number of papers have been published to study how sexual minorities respond to psychological treatment and whether adapted treatment or affirmative interventions are necessary, as is done with other minority groups. The objective of this review of the available literature is to determine if sexual minorities have the same response to standard treatments as their heterosexual erparts, and whether adapted or affirmative interventions offer them better outcomes than standard treatment.

Referencias bibliográficas

  • Alessi, E. J. (2014). A framework for incorporating minority stress theory into treatment with sexual minority clients. Journal of Gay and Lesbian Mental Health, 18, 47–66. https://doi.org/10.1080/19359705.2013.789811
  • Alessi, E. J. y Kahn, S. (2017). A framework for clinical practice with sexual and gender minority asylum seekers. Psychology of sexual orientation and gender diversity. 4(4). 383-391. https://doi.org/10.1037/sgd0000244
  • Alessi, E. J., Dillon, F. R. y Van Den Horn, R. (2019). The therapeutic relationship mediates the association between affirmative practice and psychological well-being among lesbian, gay, bisexual and queer clients. Psychotherapy, 56(2), 229-240. https://doi.org/10.1037/pst0000210
  • Allen, J. L. y Mowbray, O. (2016). Sexual orientation, treatment utilization, and barriers for alcohol related problems: Findings from a nationally representative sample. Drug and alcohol dependence, 161, 323–330. doi: https://doi.org/10.1016/j.drugalcdep.2016.02.025
  • Alto Comisionado de las Naciones Unidas Para los Refugiados (2018). Tendencias Globales. Desplazamiento forzado en 2018. Recuperado de https://www.acnur.org/5d09c37c4.pdf
  • American Psychological Association (1998). Resolution on appropriate therapeutic responses to sexual orientation. American Psychologist, 43, 934-935.
  • American Psychological Association (2000). Guidelines for psychotherapy with lesbian, gay, and bisexual clients. American Psychologist, 55, 1440-1451.
  • American Psychological Association (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060-1073.
  • American Psychological Association Task Force on Appropriate Therapeutic Responses to Sexual Orientation (2009). Report of the Task Force on Appropriate Therapeutic Responses to Sexual Orientation. American Psychological Association.
  • American Psychological Association (2012). Guidelines for psychological practice with lesbian, gay, and bisexual clients. American Psychologist, 67(1), 10-42. https://doi.org/10.1037/a0024659
  • American Psychological Association (2015). Guidelines for psychological practice with transgender and gender nonconforming people. American Psychologist, 70, 832–864. https://doi.org/10.1037/a0039906
  • Anhalt, K., Morris, T., Scotti, J. y Cohen, S. (2003). Student perspectives on training in gay, lesbian, and bisexual issues: A survey of behavioral clinical psychology programs. Cognitive and Behavioral Practice, 10(3), 255-263. https://doi.org/10.1016/S1077-7229(03)80038-X
  • Bariola, E., Lyons, A. y Lucke, J. (2017). Flourishing among sexual minority individuals: application of the dual continuum model of mental health in a sample of lesbians and gay men. Psychology of sexual orientation and gender diversity, 4(1), 43-53. https://doi.org/10.1037/sgd0000210
  • Barker, M. (2015). Depression and/or oppression? Bisexuality and mental health. Journal of Bisexuality, 15, 369–384. https://doi.org/10.1080/15299716.2014.995853
  • Baugher, A. R., Beer, L., Fagan, J. L., Mattson, C. L., Freedman, M., Skarbinski, J. y Shouse, R.L. (2017). Prevalence of internalized HIV-related stigma among HIV-infected adults in care, United States, 2011– 2013. AIDS Behavior, 1-9. https://doi.org/10.1007/s10461-017-1712-y
  • Beard, C., Kirakosian, N., Silverman, A. L., Winer, J. P., Wadsworth, L. P. y Björgvinsson, T. (2017). Comparing treatment response between LGBQ and heterosexual individuals attending a CBT- and DBT-skills-based partial hospital. Journal of Consulting and Clinical Psychology, 85, 1171–1181. https://doi.org/10.1037/ccp0000251
  • Beck, A. T., Steer, R. A. y Brown, G. K. (1996). Beck depression lnventory Second Edition manual (BDI-II). The Psychological Corporation.
  • Beckstead, A. y Morrow, S. L. (2004). Mormon clients’ experiences of conversion therapy: The need for a new treatment approach. The Counseling Psychologist, 32, 651-690. https://doi.org/10.1177/0011000004267555
  • Berg, R. C., Munthe-Kaas, H. y Ross, M. W. (2016). Internalized homonegativity: A systematic mapping review of empirical research. Journal of Homosexuality, 63, 541–558. https://doi.org/10.1080/00918369.2015.1083788
  • Berghe, W., Dewaele, A., Cox, N. y Vincke, J. (2010). Minority-specific determinants of mental well-being among lesbian, gay, and bisexual youth. Journal of Applied Social Psychology, 40(1), 153–166. https://doi.org/10.1111/j.1559-1816.2009.00567.x
  • Bidell, M. P. (2013). Addressing disparities: The impact of a lesbian, gay, bisexual, and transgender graduate counselling course. Counselling and Psychotherapy Research, 13(4), 300–307. https://doi.org/10.1080/14733145.2012.741139
  • Bidell, M. P. (2005). The sexual orientation counselor competency scale: Assessing attitudes, skills, and knowledge of counselors working with lesbian, gay, and bisexual clients. Counselor Education and Supervision, 44(4), 267-279. https://doi.org/10.1002/j.1556-6978.2005.tb01755.x
  • Bränström, R. (2017). Minority stress factors as mediators of sexual orientation disparities in mental health treatment: A longitudinal population-based study. Journal of Epidemiology and Community Health, 71, 446–452. https://doi.org/10.1136/jech-2016-207943
  • Bränström, R., Hatzenbuehler, M. L., Tinghög, P. y Pachankis, J. E. (2018). Sexual orientation differences in outpatient psychiatric treatment and antidepressant usage: Evidence from a population-based study of siblings. European Journal of Epidemiology, 33, 591–599. https://doi.org/10.1007/s10654-018-0411-y
  • Brubaker, M. D., Garrett, M. T. y Dew, B. J. (2009). Examining the relationship between internalized heterosexism and substance abuse among lesbian, gay, and bisexual individuals: A critical review. Journal of LGBT Issues in Counseling, 3(1), 62–89. https://doi.org/10.1080/15538600902754494
  • Bry, L. J., Mustanski, B., Garofalo, R. y Burns, M. N. (2017). Resilience to discrimination and rejection among young sexual minority males and transgender females: A qualitative study on coping with minority stress. Journal of Homosexuality. Advance online publication. https://doi.org/10.1080/00918369.2017.1375367
  • Byrd, A. D. y Nicolosi, J. (2002). A meta-analytic review of treatment of homosexuality. Psychological Reports, 90, 1139-1152. https://doi.org/10.2466/pr0.2002.90.3c.1139
  • Chang, S. C. y Singh, A. A. (2018). A clinician’s guide to gender-affirming care: Working with transgender and gender nonconforming clients. New Harbinger.
  • Chaudoir, S. R., Wang, K. y Pachankis, J. E. (2017). What reduces sexual minority stress? A review of the intervention “toolkit.” Journal of Social Issues, 73, 586–617. https://doi.org/10.1111/josi.12233
  • Cochran, S. D., Björkenstam, C. y Mays, V. M. (2017). Sexual orientation differences in functional limitations, disability, and mental health services use: Results from the 2013–2014 National Health Interview Survey. Journal of Consulting and Clinical Psychology, 85, 1111–1121. https://doi.org/10.1037/ccp0000243
  • Coker, T. R., Austin, S. B. y Schuster, M. A. (2010). The health and health care of lesbian, gay and bisexual adolescents. Annual Review of PublicHealth, 31, 457–477. https://doi.org/10.1146/annurev.publhealth.012809.103636
  • Consejo General de la Psicología de España. (2017). Comunicado del COP sobre las “terapias de conversión” de la homosexualidad. Recuperado de http://www.infocop.es/view_article.asp?id=6660
  • Consejo General de la Psicología del Reino Unido. (2017). Memorandum of Understanding on Conversion Therapy in the U.K. https://www.bacp.co.uk/media/2274/memorandum-of-understanding-v2-oct17.pdf
  • Craig, S. L., Austin, A. y Alessi, E. (2013). Gay affirmative cognitive behavioral therapy for sexual minority youth: A clinical adaptation. Clinical Social Work Journal, 41, 258–266. https://doi.org/10.1007/s10615-012-0427-9
  • Craig, S. L., McInroy, L. B., Eaton, A. D., Iacono, G., Leung, V. W., Austin, A. y Dobinson, C. (2019). An Affirmative Coping Skills Intervention to Improve the Mental and Sexual Health of Sexual and Gender Minority Youth (Project Youth AFFIRM): Protocol for an Implementation Study. Journal of Medical Internet Research research protocols, 8(6). https://doi.org/10.2196/13462
  • Crenshaw, K. W. (1989). Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 140, 139–167.
  • Derogatis, L. R. y Savitz, K. L. (1999). The SCL-90-R, Brief Symptom Inventory, and Matching Clinical Rating Scales. En M. E. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment (pp. 679–724). Lawrence Erlbaum Associates Publishers.
  • Diamond, G. M., Diamond, G. S., Levy, S., Closs, C., Ladipo, T. y Siqueland, L. (2012). Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: A treatment development study and open trial with preliminary findings. Psychotherapy, 49, 62–71. https://doi.org/10.1037/a0026247
  • Diamond, G. M. y Shpigel, S. (2014). Attachment-based family therapy for lesbian and gay young adults and their persistently nonaccepting parents. Professional Psychology: Research and Practice, 45(4), 258-268. https://doi.org/10.1037/a0035394
  • Dillon, F. y Worthington, R. L. (2003). The Lesbian, Gay and Bisexual Affirmative Counseling Self-Efficacy Inventory (LGB-CSI): Development, validation, and training implications. Journal of Counseling Psychology, 50(2), 235–251. https://doi.org/10.1037/0022-0167.50.2.235
  • Dodge, B., Herbenick, D., Friedman, M. R., Schick, V., Fu, T. J., Bostwick, W., Bartelt, E., Muñoz-Laboy, M., Pletta, D., Reece, M. y Sandfort, T. G. (2016). Attitudes toward bisexual men and women among a nationally representative probability sample of adults in the United States. PLoS ONE, 11, Artículo e0164430. https://doi.org/10.1371/journal.pone.0164430
  • Doty, N., Willoughby, B., Lindahl, K. y Malik, N. (2010). Sexuality related social support among lesbian, gay, and bisexual youth. Journal of Youth and Adolescence, 39, 1134–1147. https://doi.org/10.1007/s10964-010-9566-x
  • Duarté-Vélez, Y., Bernal, G. y Bonilla, K. (2010). Culturally adapted cognitive-behavior therapy: Integrating sexual, spiritual, and family identities in an evidence-based treatment of a depressed Latino adolescent. Journal of Clinical Psychology, 66, 895–906. https://doi.org/10.1002/jclp.20710
  • El-Sadr, W. M., Mayer, K. H., Rabkin, M. y Hodder, S. L. (2019). AIDS in America-Back in the headlines at long last. The New England Journal of Medicine, 380, 1985-1987. https://doi.org/10.1056/NEJMp1904113
  • Ellis, S. J., Bailey, L. y McNeil, J. (2015). Trans people’s experiences of mental health and gender identity services: A UK study. Journal of Gay and Lesbian Mental Health, 19, 4-20. https://doi.org/10.1080/19359705.2014.960990
  • Espada, J. P., Morales, A., Orgilés, M. y Ballester, R. (2012). Autoconcepto, ansiedad social y sintomatología depresiva en adolescentes españoles según su orientación sexual. Ansiedad Y Estrés, 18(1), 31-41.
  • Feinstein, B. A. y Dyar, C. (2017). Bisexuality, minority stress, and health. Current Sexual Health Reports, 9, 42–49. https://doi.org/10.1007/s11930-017-0096-3
  • Fergusson, D. M., Horwood, L. J. y Beautrais, A. L. (1999). Is sexual orientation related to mental health problems and suicidality in young people? Archives of General Psychiatry, 56, 876-880. https://doi.org/10.1001/archpsyc.56.10.876
  • Fernández-Garrido, S. y Romaní, O. (2017). Diagnóstico participativo de las problemáticas que presentan las personas TLGBQI en salud sexual, reproductiva y derecho al ejercicio de la identidad en el municipio de Madrid. Medical Anthropology Research Center.
  • Friedman, M. S., Marshal, M. P., Guadamuz, T. E., Wei, C., Wong, C. F., Saewyc, E. y Stall, R. (2011). A meta-analysis of disparities in childhood sexual abuse, parental physical abuse, and peer victimization among sexual minority and sexual nonminority individuals. American Journal of Public Health, 101, 1481–1494. https://doi.org/10.2105/AJPH.2009.190009
  • Gibbs, J. J. y Goldbach, J. (2015). Religious Conflict, Sexual Identity, and Suicidal Behaviors among LGBT Young Adults. Archives of Suicide Research, 19(4), 472-488. https://doi.org/10.1080/13811118.2015.1004476
  • Gonsiorek, J. C. (1982). Homosexuality & psychotherapy: A practitioner’s handbook of affirmative models. Haworth Press.
  • Graham, S. R., Carney, J. S. y Kluck, A. S. (2012). Perceived competency in working with LGB clients: Where are we now? Counselor Education and Supervision, 51(1), 2-16. https://doi.org/10.1002/j.1556-6978.2012.00001.x
  • Haldeman, D. (1994). The practice and ethics of sexual orientation conversion therapy. Journal of Consulting and Clinical Psychology, 2, 221-227.
  • Hart, T. A., Tulloch, T. G. y O’Cleirigh, C. (2014). Integrated cognitive behavioral therapy for social anxiety and HIV prevention for gay and bisexual men. Cognitive and Behavioral Practice, 21, 149-160. https://doi.org/10.1016/j.cbpra.2013.07.001
  • Hatzenbuehler, M. L. (2009). How does sexual minority stigma “get under the skin”? A psychological mediation framework. Psychological Bulletin, 135, 707-730. https://doi.org/10.1037/a0016441
  • Hatzenbuehler, M. L., O’Cleirigh, C., Grasso, C., Mayer, K., Safren, S., Bradford, J. (2012). Effect of same- sex marriage laws on health care use and expenditures in sexual minority men. A quasi-natural experiment. American journal of public health, 102(2), 285-291. https://doi.org/10.2105/AJPH.2011.300382
  • Hatzenbuehler, M. L. Y Keyes, K. M. (2013). Inclusive anti-bullying policies and reduced risk of suicide attempts in lesbian and gay youth. Journal of adolescent heatlh, 53(1), S21-S26. https://doi.org/10.1016/j.jadohealth.2012.08.010
  • Heck, N. C., Mirabito, L. A., LeMaire, K., Livingston, N. A. y Flentje, A. (2017). Omitted data in randomized controlled trials for anxiety and depression: a systematic review of the inclusion of sexual orientation and gender identity. Journal of Consulting and Clinical Psychology, 85, 72–76. https://doi.org/10.1037/ccp0000123
  • Herek, G. M. (2009). Hate crimes and stigma-related experiences among sexual minority adults in the United States: Prevalence estimates from a national probability sample. Journal of interpersonal violence, 24(1), 54-74. https://doi.org/10.1177/0886260508316477
  • Hergenrather, K. C., Emmanuel, D., Durant, S. y Rhodes, S. D. (2016). Enhancing HIV prevention among young men who have sex with men: A systematic review of HIV behavioral interventions for young gay and bisexual men. AIDS Education and Prevention, 28, 252–271. https://doi.org/10.1521/aeap.2016.28.3.252
  • Herrell, R., Goldberg, J., True, W. R., Ramakrishnam, V., Lyons, M., Eisen, S. y Tsuang, M. T. (1999). Sexual orientation and suicidality: A co-twin control study in adult men. Archives of General Psychiatry, 56, 867–874. https://doi.org/10.1001/archpsyc.56.10.867
  • Hobaica, S., Alman, A., Jackowich, S. y Kwon, P. (2018). Empirically based psychological interventions with sexual minority youth: a systematic review. Psychology of Sexual Orientation and Gender Diversity, 5(3), 313. https://doi.org/10.1037/sgd0000275
  • Hooker, E. (1957). The adjustment of the male overt homosexual. Journal of Projective Techniques, 21, 18–31. https://doi.org/10.1080/08853126.1957.10380742
  • Iacono, G. (2019). An affirmative mindfulness approach for lesbian, gay, bisexual, transgender and queer youth mental health. Clinical social work journal, 47, 156-166. https://doi.org/10.1007/s10615-018-0656-7
  • Israel, T., Choi, A. Y., Goodman, J. A., Matsuno, E., Lin, Y. J., Kary, K. G. y Merrill, C. R. (2019). Reducing internalized binegativity: Development and efficacy of an online intervention. Psychology of sexual orientation and gender diversity, 6(2), 149. : http://dx.doi.org/10.1080/15538605.2019.1662358
  • Israel, T., Gorcheva, R., Burnes, T. R. y Walther, W. A. (2008). Helpful and unhelpful therapy experiences of LGBT clients. Psychotherapy Research, 18(3), 294-305. https://doi.org/10.1080/10503300701506920
  • Itaborahy, P. L. y Zhu, J. (2014). State-sponsored homophobia: A world survey of laws: Criminalisation, protection and recognition of same-sex love. Brussels: International Lesbian, Gay, Bisexual. Trans and Intersex Association.
  • Johnson, S. D. (2012). Gay affirmative psychotherapy with lesbian, gay, and bisexual individuals: Implications for contemporary psychotherapy research. American Journal of Orthopsychiatry, 82, 516–522. https://doi.org/10.1111/j.1939-0025.2012.01180.x
  • Kelley, F. A. (2015). The therapy relationship with lesbian and gay clients. Psychotherapy, 52, 113–118. http://doi.org/10.1037/a0037958
  • King, M., Semlyen, J., Killaspy, H., Nazareth, I. y Osborn, D. (2007). A systematic review of research on counselling and psychotherapy for lesbian, gay, bisexual and transgender people. London, UK: British Association for Counselling & Psychotherapy.
  • Langdridge, D. (2007). Gay affirmative therapy: A theoretical framework and defence. British Lesbian, Gay, and Bisexual Psychologies, 11, 27-43. http://doi.org/10.1300/J236vlln01_03
  • Lefevor, G. T., Janis, R. A., y Park, S. Y. (2017). Religious and sexual identities: An intersectional, longitudinal examination of change in therapy. The Counseling Psychologist, 45, 387-413. http://doi.org/10.1177/0011000017702721
  • Lewis, R. J., Derlaga, V. J., Griffin, J. L. y Korwinski, A. C. (2003). Stressors for gay men and lesbians: Life stress, gay-related stress, stigma consciousness, and depressive symptoms. Journal of Social and Clinical Psychology, 22(6), 716–729. https://doi.org/10.1521/jscp.22.6.716.22932
  • Li, Z., Purcell, D. W., Sansom, S. L., Hayes, D. y Hall, H. I. (2019). Vital signs: HIV transmission along the continuum of care-United States, 2016. Morbidity and Mortality Weekly Report, 68(11), 267. http://doi.org/10.15585/mmwr.mm6811e1
  • Lin, Y. J. e Israel, T. (2012). A computer-based intervention to reduce internalized heterosexism in men. Journal of Counseling Psychology, 59, 458-464. http://doi.org/10.1037/a0028282
  • Lin, Y. J., Israel, T. y Ryan, W. S. (2019). Releasing internalized stigma for empowerment: development of theory-driven interventions for sexual and gender minorities. Journal of LGBT Issues in Counseling, 13(4), 276-292. https://doi.org/10.1080/15538605.2019.1662358
  • Lingiardi, V., Nardelli, N. y Tripodi, E. (2015). Reparative attitudes of Italian psychologists toward lesbian and gay clients: Theoretical, clinical, and social implications. Professional Psychology: Research and Practice, 46(2), 132-139. https://doi.org/10.1037/pro0000016
  • MacLeod, M., Martinez, R. y Williams, C. (2009). Cognitive Behaviour Therapy self-help: Who does it help and what are its drawbacks? Behavioural and Cognitive Psychotherapy, 37, 61–72. http://doi.org/10.1017/S1352465808005031
  • Malyon A. K. (1981). Psychotherapeutic implications of internalized homophobia in gay men. Journal of homosexuality, 7(2-3), 59-69. https://doi.org/10.1300/j082v07n02_08
  • Martell, C. R. (2014). The hybrid case study of “Adam”: Perspectives from behavioral activation and the influence of heteronormativity on LGB-affirmative therapy. Pragmatic Case Studies in Psychotherapy, 10(2), 11.
  • Martxueta, A. y Etxeberria, J. (2014). Análisis diferencial retrospectivo de las variables de salud mental en lesbianas, gais y bisexuales víctimas de bullying homofóbico en la escuela. Revista de psicopatología y psicología clínica, 19(1), 23-35. https://doi.org/10.5944/rppc.vol.19.num.1.2014.12980
  • McCabe, S. E., West, B. T., Hughes, T. L. y Boyd, C. J. (2013). Sexual orientation and substance abuse treatment utilization in the United States: results from a national survey. Journal of substance abuse treatment, 44(1), 4–12. https://doi.org/10.1016/j.jsat.2012.01.007
  • Medley, B. (2018). Recovering the True Self: Affirmative Therapy, Attachment, and AEDP in Psychotherapy with Gay Men. Journal of Psychotherapy Integration. (Advance online publication). http://doi.org/10.1037/int0000132
  • Meidlinger, P. C. y Hope, D. A. (2014). Differentiating disclosure and concealment in measurement of outness for sexual minorities: The Nebraska Outness Scale. Psychology of Sexual Orientation and Gender Diversity, 1(4), 489–497. https://doi.org/10.1037/sgd0000080
  • Meyer, I. H. (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior, 36, 38-56. https://doi.org/10.2307/2137286
  • Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674-697. https://doi.org/10.1037/0033-2909.129.5.674
  • Meyer, I. H., Rossano, L., Ellis, J. M. y Bradford, J. (2002). A brief telephone interview to identify lesbian and bisexual women in random digit dialing sampling. Journal of Sex Research, 39(2), 139-144. https://doi.org/10.1080/00224490209552133
  • Millar, B. M., Wang, K. y Pachankis, J. E. (2016). The moderating role of internalized homonegativity on the efficacy of LGB-affirmative psychotherapy: Results from a randomized controlled trial with young adult gay and bisexual men. Journal of Consulting and Clinical Psychology, 84, 565–570. https://doi.org/10.1037/ccp0000113
  • Mohr, J. y Fassinger, R. (2000). Measuring dimensions of lesbian and gay male experience. Measurement and evaluation in counseling and development, 33(2), 66-90. https://doi.org/10.1080/07481756.2000.12068999
  • Moradi, B. y Budge, S. L. (2018). Engaging in LGBQ+ affirmative psychotherapies with all clients: Defining themes and practices. Journal of clinical psychology, 74(11), 2028-2042. https://doi.org/10.1002/jclp.22687
  • Moradi, B. y Grzanka, P. R. (2017). Using intersectionality responsibly: Toward critical epistemology, structural analysis, and social justice activism. Journal of Counseling Psychology, 64(5), 500–513. https://doi.org/10.1037/cou000020
  • Moradi, B., Mohr, J. J., Worthington, R. L. y Fassinger, R. E. (2009). Counseling psychology research on sexual (orientation) minority issues: Conceptual and methodological challenges and opportunities. Journal of Counseling Psychology, 56(1), 5–22. https://doi.org/10.1037/a0014572
  • Mustanski, B. y Liu, R. T. (2013). A longitudinal study of predictors of suicide attempts among lesbian, gay, bisexual, and transgender youth. Archives of sexual behavior, 42(3), 437-448. https://doi.org/10.1007/s10508-012-0013-9
  • Nadal, K. L., Whitman, C. N., Davis, L. S., Erazo, T. y Davidoff, K. C. (2016). Microaggressions toward lesbian, gay, bisexual, transgender, queer, and genderqueer people: A review of the literature. The Journal of Sex Research, 53(4-5), 488-508. https://doi.org/10.1080/00224499.2016.1142495
  • Newcomb, M. E. y Mustanski, B. (2011). Moderators of the relationship between internalized homophobia and risky sexual behavior in men who have sex with men: a meta-analysis. Archives of sexual behavior, 40(1), 189-199. https://doi.org/10.1007/s10508-009-9573-8
  • National Health Survey Digital. (2017). Psychological therapies: Annual report on the use of IAPT services—England, 2015–16. Recuperado de https://files.digital.nhs.uk/pdf/1/0/psyc-ther-ann-rep-2015-16_v2.pdf
  • Nicolosi, J. (1991). Reparative therapy of male homosexuality: a new clinical approach. Jason Aronson, Inc.
  • O’Shaughnessy, T. y Spokane, A. R. (2013). Lesbian and gay affirmative therapy competency, self-efficacy, and personality in psychology trainees. The Counseling Psychologist, 41(6), 825-856. https://doi.org/10.1177/0011000012459364
  • O’Shaughnessy, T. y Speir, Z. (2018). The state of LGBQ affirmative therapy clinical research: A mixed- methods systematic synthesis. Psychology of Sexual Orientation and Gender Diversity, 5(1), 82. https://doi.org/10.1037/sgd0000259
  • Pachankis, J. E., Cochran, S. D. y Mays, V. M. (2015). The mental health of sexual minority adults in and out of the closet: A population-based study. Journal of Consulting and Clinical Psychology, 83, 890–901. http://doi.org/10.1037/ccp0000047
  • Pachankis, J. E., Hatzenbuehler, M. L., Rendina, H. J., Safren, S. A. y Parsons, J. T. (2015). LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: A randomized controlled trial of a transdiagnostic minority stress approach. Journal of Consulting and Clinical Psychology, 83, 875–889. http://doi.org/10.1037/ccp0000037
  • Pachankis, J. E., McConocha, E. M., Reynolds, J. S., Winston, R., Adeyinka, O., Harkness, A., Burton, C. L., Behari, K., Sullivan, T. J., Eldahan, A. I., Esserman, D. A., Hatzenbuehler, M. L., y Safren, S. A. (2019). Project ESTEEM protocol: a randomized controlled trial of an LGBTQ-affirmative treatment for young adult sexual minority men’s mental and sexual health. BMC public health, 19(1), 1086. https://doi.org/10.1186/s12889-019-7346-4
  • Pachankis, J. E. y Bränström, R. (2018). Hidden from happiness: Structural stigma, sexual orientation concealment, and life satisfaction across 28 countries. Journal of Consulting and Clinical Psychology, 86, 403–415. http://doi.org/10.1037/ccp0000299
  • Pachankis, J. E. y Goldfried, M. R. (2004). Clinical issues in working with lesbian, gay, and bisexual clients. Psychotherapy: Theory, Re- search, Practice, Training, 41, 227–246. http://doi.org/10.1037/0033-3204.41.3.227
  • Paul, R., Smith, N. G., Mohr, J. J. y Ross, L. E. (2014). Measuring dimensions of bisexual identity: Initial development of the Bisexual Identity Inventory. Psychology of Sexual Orientation and Gender Diversity, 1(4), 452–460. https://doi.org/10.1037/sgd0000069
  • Pearson, J. y Wilkinson, L. (2013). Family relationships and adolescent well-being: Are families equally protective for same-sex attracted youth? Journal f Youth and Adolescence, 42(3), 376–393. https://doi.org/10.1007/s10964-012-9865-5
  • Pepping, C. A., Lyons, A. y Morris, E. M. J. (2018). Affirmative LGBT psychotherapy: Outcomes of a therapist training protocol. Psychotherapy, 55(1), 52–62. https://doi.org/10.1037/pst0000149
  • Perez, R. M. (2007). The “boring” state of research and psychotherapy with lesbian, gay, bisexual, and transgender clients: Revisiting Barón (1991). In K. J. Bieschke, R. M. Perez y K. A. DeBord (Eds.), Handbook of counseling and psychotherapy with lesbian, gay, bisexual, and transgender clients (pp. 399–418). American Psychological Association. http://doi.org/10.1037/11482-017
  • Pineda Roa, C. A. (2013). Factores asociados con riesgo de suicidio de adolescentes y jóvenes autoidentificados como lesbianas, gays y bisexuales: estado actual de la literatura. Revista Colombiana de Psiquiatría, 42(4), pp. 333–349.
  • Plöderl, M., Kunrath, S., Cramer, R. J., Wang, J., Hauer, L. y Fartacek, C. (2017). Sexual orientation differences in treatment expectation, alliance, and outcome among patients at risk for suicide in a public psychiatric hospital. BMC Psychiatry, 17, 184. https://doi.org/10.1186/s12888-017-1337-8
  • Plöderl, M. y Tremblay, P. (2015). Mental health of sexual minorities. A systematic review. International Review of Psychiatry, 27, 367–385. http://doi.org/10.3109/09540261.2015.1083949
  • Proujansky, R. A. y Pachankis, J. E. (2014). Toward Formulating Evidence-Based Principles of LGB- Affirmative Psychotherapy. Pragmatic case studies in psychotherapy, 10(2), 117–131.
  • Puckett, J. A. (2019). An Ecological Approach to Therapy with Gender Minorities. Cognitive and Behavioral Practice, 26(4), 647-655. https://doi.org/10.1016/j.cbpra.2019.08.002
  • Reback, C. J. y Shoptaw, S. (2014). Development of an evidence-based, gay-specific cognitive behavioral therapy intervention for methamphetamine-abusing gay and bisexual men. Addictive behaviors, 39(8), 1286-1291. https://doi.org/10.1016/j.addbeh.2011.11.029
  • Riggle, E. D. B., Rostosky, S. S. y Horne, S. G. (2010). Psychological distress, well-being, and legal recognition in same-sex couple relationships. Journal of Family Psychology, 24(1), 82-86. https://doi.org/10.1037/a0017942
  • Rimes, K. A., Broadbent, M., Holden, R., Rahman, Q., Hambrook, D., Hatch, S. L., y Wingrove, J. (2018). Comparison of treatment outcomes between lesbian, gay, bisexual and heterosexual individuals receiving a primary care psychological intervention. Behavioural and Cognitive Psychotherapy, 46, 332–349. http://doi.org/10.1017/S1352465817000583
  • Rimes, K. A., Ion, D., Wingrove, J. y Carter, B. (2019). Sexual orientation differences in psychological treatment outcomes for depression and anxiety: National cohort study. Journal of Consulting and Clinical Psychology, 87(7), 577–589. https://doi.org/10.1037/ccp0000416
  • Rock, M., Carlson, T. S. y McGeorge, C. R. (2010). Does affirmative training matter? Assessing CFT students’ beliefs about sexual orientation and their level of affirmative training. Journal of marital and family therapy, 36(2), 171-184. https://doi.org/10.1111/j.1752-0606.2009.00172.x
  • Rosenberg, M. (1965). Rosenberg self-esteem scale (RSE). Acceptance and commitment therapy. Measures package, 61(52), 18.
  • Ross, L. E., Salway, T., Tarasoff, L. A., MacKay, J. M., Hawkins, B. W. y Fehr, C. P. (2018). Prevalence of depression and anxiety among bisexual people compared to gay, lesbian, and heterosexual individuals: A systematic review and meta-analysis. Journal of Sex Research, 55, 435–456. http://doi.org/10.1080/00224499.2017.1387755
  • Saewyc, E. M. (2011). Research on adolescent sexual orientation: Development, health disparities, stigma, and resilience. Journal of research on adolescence, 21(1), 256-272. http://doi.org/10.1111/j.1532-7795.2010.00727.x
  • Satterfield, J. M. y Crabb, R. (2010). Cognitive-behavioral therapy for depression in an older gay man: A clinical case study. Cognitive and behavioral practice, 17(1), 45-55. https://doi.org/10.1016/j.cbpra.2009.04.008
  • Semlyen, J., King, M., Varney, J. y Hagger-Johnson, G. (2016). Sexual orientation and symptoms of common mental disorder or low wellbeing: combined meta-analysis of 12 UK population health surveys. BMC psychiatry, 16, 67. https://doi.org/10.1186/s12888-016-0767-z
  • Shidlo, A. y Schroeder, M. (2002). Changing sexual orientation: A consumers’ report. Professional Psychology: Research and Practice, 33(3), 249-259. https://doi.org/10.1037/0735-7028.33.3.249
  • Shoptaw, S., Reback, C. J., Peck, J. A., Yang, X., Rotheram-Fuller, E., Larkins, S. y Hucks-Ortiz, C. (2005). Behavioral treatment approaches for methamphetamine dependence and HIV-related sexual risk behaviors among urban gay and bisexual men. Drug and Alcohol Dependence, 78, 125–134. http://doi.org/10.1016/j.drugalcdep.2004.10.004
  • Shoptaw, S., Reback, C. J., Larkins, S., Wang, P. C., Rotheram-Fuller, E., Dang, J. y Yang, X. (2008). Outcomes using two tailored behavioral treatments for substance abuse in urban gay and bisexual men. Journal of Substance Abuse Treatment, 35, 285–293. http://doi.org/10.1016/j.jsat.2007.11.004
  • Skinta, M. D., Hoeflein, B., Muñoz-Martínez, A. M. y Rincón, C. L. (2018). Responding to gender and sexual minority stress with functional analytic psychotherapy. Psychotherapy, 55(1), 63. https://doi.org/10.1037/pst0000157
  • Smith, N. G., Hart, T. A., Kidwai, A., Vernon, J. R., Blais, M. y Adam, B. (2017). Results of a pilot study to ameliorate psychological and behavioral outcomes of minority stress among young gay and bisexual men. Behavior therapy, 48(5), 664-677. https://doi.org/10.1016/j.beth.2017.03.005
  • Smith, T. B., Rodríguez, M. M. D. y Bernal, G. (2011). Culture. En J. C. Norcross (Ed.), Psychotherapy relationships that work: Evidence-based responsiveness (pp. 316-335). Oxford University Press.
  • Snapp, S. D., Watson, R. J., Russell, S. T., Diaz, R. M. y Ryan, C. (2015). Social support networks for LGBT young adults: Low cost strategies for positive adjustment. Family Relations, 64(3), 420-430. https://doi.org/10.1111/fare.12124
  • Spengler, E. S. y Ægisdóttir, S. (2015). Psychological help-seeking attitudes and intentions of lesbian, gay, and bisexual individuals: The role of sexual minority identity and perceived counselor sexual prejudice. Psychology of Sexual Orientation and Gender Diversity, 2, 482-491. http://doi.org/10.1037/sgd0000141
  • Spitzer, R. (2003). Can Some Gay Men and Lesbians Change Their Sexual Orientation? 200 Participants Reporting a Change from Homosexual to Heterosexual Orientation. Archives of Sexual Behavior, 32(5), 403-417. https://doi.org/10.1023/A:1025647527010
  • Sun, S., Pachankis, J. E., Li, X. y Operario, D. (2020). Addressing minority stress and mental health among men who have sex with men (MSM) in China. Current Hiv/aids Reports, 17(1), 35-62. https://doi.org/10.1007/s11904-019-00479-w
  • Szymanski M. y Chung B. (2001). The Lesbian Internalized Homophobia Scale, Journal of Homosexuality, 41(2), 37-52. https://doi.org/10.1300/J082v41n02_03
  • Szymanski, D. M., Kashubeck-West, S. y Meyer, J. (2008). Internalized heterosexism: A historical and theoretical overview. The Counseling Psychologist, 36(4), 510-524.
  • Urrutia, J y Bonfill, X. (2010). Declaración PRISMA: una propuesta para mejorar la publicación de revisiones sistemáticas y metaanálisis. Medicina Clínica, 135(11), 507-511. https://doi.org/10.1016/j.medcli.2010.01.015
  • Walsh, K. y Hope, D. A. (2010). LGB-affirmative cognitive behavioral treatment for social anxiety: A case study applying evidence-based practice principles. Cognitive and Behavioral Practice, 17(1), 56-65. https://doi.org/10.1016/j.cbpra.2009.04.007
  • Willoughby, B. L. y Doty, N. D. (2010). Brief cognitive behavioral family therapy following a child’s coming out: A case report. Cognitive and Behavioral Practice, 17(1), 37-44. https://doi.org/10.1016/j.cbpra.2009.04.006
  • Woodward, E. N. y Willoughby, B. (2014). Family therapy with sexual minority youths: A systematic review. Journal of GLBT Family Studies, 10, 380–403. http://doi.org/10.1080/1550428X.2013.828248
  • Zapor, H. y Stuart, G. L. (2016). Affirmative cognitive behavioral therapy for a male with depression following sexual orientation discrimination. Clinical Case Studies, 15(2), 143-15