Conclusions

Therapists may not always know that the sexual orientation of the patients with whom they work. This is particularly true if questions are asked about sexual orientation rather than behavior. Many patients may engage in intimate sexual or emotional relationships with partners of the same sex without identifying as LGB. This is particularly relevant when cultural backgrounds and customs preclude such labeling. The emphasis on behavioral analysis and specificity in CT makes it an ideal therapeutic orientation for this population of people. Those who identify as LGB can also benefit from CT. The impact of bias, intolerance, and open hostility predispose sexual minority populations to anxiety, depression, and stress reactions. These are the very disorders for which CT has demonstrated efficacy. Treating LGB depressed patients is not so very different than treating heterosexual patients. Cognitive therapists who work with this population need to be aware of their own biases, the pressures from the cultural milieu in which patients exist, and the impact of the internalization of negative beliefs that may have shaped the perceptions and behaviors of men and women in a sexual minority.

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