therapist meeting with client

How does affirmative therapy work?

Therapy for LGBTQIA+ patients has a long, biased history. However, affirmative therapy practices embrace a wide range of patient identities.

People identifying as LGBTQIA+ may experience higher rates of mental health issues than non-identifying individuals. Unfortunately, the need for quality LGBTQIA+ mental health care has been met with many barriers, including long-standing personal and professional biases. Affirmative therapy offers a solution––providing therapists with tools to assist a wide range of patients and identities.


What is affirmative therapy?

Affirmative therapy works to validate and advocate for those with minority identities surrounding sexuality, gender identity, gender expression, and more.

While LGBTQIA+ individuals attend therapy for reasons not unlike anyone else, their experiences are often shaped by their identities. In affirmative therapy practices, these identities are celebrated and taken into account when offering treatment.

In many cases, specializing in affirmative therapy requires mental health professionals to address their own internal biases and educate themselves on myriad LGBTQIA+ specific issues and terms. This knowledge base is especially crucial given the exclusionary history of LGBTQIA+ identities in psychology.

Homosexuality was listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) until 1973. Even after removing homosexuality from its “disorder” classification, the DSM continued to list “gender identity disorder” in their diagnoses before replacing it with “gender dysphoria” in 2013.

Affirmative counseling and therapy work in opposition to these historical practices and instead help clients embrace their identities—not “cure” them.


How does affirmative therapy work?

Affirmative therapists will work with patients to achieve their mental health goals, all while actively uplifting their identities. Also embedded in the practice is an effort to help patients struggling with prejudices such as homophobia or transphobia.

An effective affirmative therapy practice can manifest in a lot of different ways. For one, the staff may make an effort to create a physical environment supporting LGBTQIA identities. This may include providing diverse readings or information in the lobby or ensuring the presence of gender-neutral bathrooms in the office.

It could also manifest in word choice, such as using a patient’s preferred pronouns or asking questions in gender-neutral terms (“do you have a partner?” versus “do you have a boyfriend/girlfriend?”).

In affirmative therapy as a whole, the overarching focus is on the psychological impact of culture, history, heteronormativity, trauma, and intersectionality within the LGBTQIA+ community.


Who benefits from affirmative therapy?

While developed with LGBTQIA+ patients’ needs in mind, everyone can benefit from affirmative therapy practices. In fact, the positive outcomes can have an even wider reach when affirmative therapists maintain their practices with heterosexual or cisgender clients––broadening their patients’ understanding of ideas like gender expectations or heteronormativity.

While everyone can find success in therapy with affirmative practices, certain groups benefit in different ways. Here are a few key groups that benefit from affirmative therapy.

LGBTQIA+ Individuals

Affirmative therapy grows in response to our understanding of gender and sexuality. Minority stress theory shows how living in a society that normalizes heterosexual and cisgender identities results in mental health issues for minority identities. Affirmative therapy provides a positive space to work through these issues.


Families with LGBTQIA+ members can benefit from affirmative therapy, particularly in the time after an individual comes out. Many families struggle with their own pre-existing biases or ideas surrounding a loved one’s identity. Affirmative practices in a marriage and family therapy (MFT) setting help families work through these biases and issues in communication, leading to greater acceptance.


Many LGBTQIA+ couples looking to attend couples’ therapy may wish to work specifically with counselors with who practice affirmative therapy. This removes any fear of a mental health professional exhibiting biases in their practice. Affirmative couples’ therapy also brings an understanding of different couples’ dynamics across genders and sexualities. This better informs treatments and overall care.


Affirmative practices in marriage and family therapy

Marriage and family therapy is a field of psychotherapy focusing on helping couples, families, and individuals deal with mental health issues in a relational context. Every family unit is different, from the number of members to the type of inter-familial relationships. An affirming family therapist can integrate an understanding of multiple diverse identities into their practice.

This is especially important in families who have children, parents, or other members of their unit that identify as LGBTQIA+. At Pacific Oaks, the LGBTQIA+ Studies specialization in the Marriage and Family Therapy program teaches professionals foundations of marriage and family therapy while also focusing on the diverse mental health needs of LGBTQIA+ individuals, children, and families.

Having a clinician specialized in LGBTQIA+ issues and their relation to everyday experiences can make a huge difference in all forms of therapy. When a therapist is armed with affirming practices, more patients can be treated effectively without the risk of bias––something everyone deserves in their journey to mental wellness.

Marriage and family therapy programs

All our MFT programs prepare you to sit for the LMFT exams—and they help you establish a strong foundation for a fulfilling and successful Marriage and Family Therapy career.

If you would like to learn more about the academic programs available at Pacific Oaks, like our Marriage and Family Therapy program, request more information or apply today!

Do you need information on supporting your LGBTQIA+ child? Check out our blog.

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