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Written by An. B | Behaviour Support Practitioner, PsychPhys™

Adolescence is a life stage that is marked by significant developmental changes that occur biologically, psychologically and socially (Headspace 2022; Rofofsky et al. 2016). It is also a period of time where young people experience challenges with exploring and understanding their own identities (Headspace 2022; Rofofsky et al. 2016). Adolescents who find that their sexuality or gender does not conform with the heteronormativity of society experience greater challenges (Rofofsky et al. 2016). Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, and Asexual (LGBTQIA+) adolescents often feel ostracised from the wider community and, as a result, are more vulnerable to isolation and mental health concerns (Beyond Blue 2022; Van Der Pol-Harmy & McAloon 2018).

When working with LGBTQIA+ adolescents, it is important to acknowledge the unique challenges that they experience in a heteronormative society, and to carefully explore how these challenges can be addressed in a therapeutic space (Lytle et al. 2015). There are a wide variety of frameworks that can be employed in therapy; therefore, it is important to understand the therapeutic frameworks and practice principles that can be effectively applied to LGBTQIA+ adolescents (Lytle et al. 2015). One framework that can work with LGBTQIA+ adolescents is group-work therapy (Rofofsky et al. 2016; Telfer et al. 2018; Turner et al. 2013).

Group-work therapy is a form of therapy where one or two practitioners work with a group of clients in one setting (Cherry 2021; Ezhumalai et al. 2018). Everyone in the group typically shares one thing in common or works towards a common goal (Cherry 2021; Ezhumalai et al. 2018). The common practice principles that underpin group-work therapy are as follows (Cherry 2021; Ezhumalai et al. 2018):

  • Creating an inclusive environment
  • Normalisation
  • Confrontation and change
  • Education
  • Shared growth

Effective application of these practice principles can empower LGBTQIA+ adolescents and produce positive outcomes (Rofofsky et al. 2016; Telfer et al. 2018; Turner et al. 2013). First, a group environment provides LGBTQIA+ adolescents with a safe setting where they can freely express themselves and share experiences (Rofosky et al. 2016; Turner et al. 2013). LGBTQIA+ adolescents often have to hide their identities, which impacts the way they can relate and connect with other peers (Beyond Blue 2022). Indeed, when LGBTQIA+ adolescents are given the opportunity to openly express their thoughts on something that they have actively hidden or suppressed from others, they may find it difficult to make sense of what they had shared (Rofofsky et al. 2016; Turner et al. 2013); however, when such thoughts are expressed in a group setting, others can choose to join the conversation to share their thoughts, which gives an opportunity for all members of the group to develop a shared understanding of their experiences. Thus, creating an inclusive environment can help normalise the experiences of LGBTQIA+ adolescents, as well as support them to appreciate what makes their narrative unique from others (Rofofsky et al. 2016; Turner et al. 2013).

Another benefit of creating an inclusive group environment is that it can support LGBTQIA+ adolescents to feel connected and gain a sense of belonging (Rofosky et al. 2016). Although some groups aim to promote heterogeneity to enrich group discussions, it is recommended that homogeneity is promoted instead for a group of LGBTQIA+ adolescents (Rofofsky et al. 2016; Toseland & Rivas 2017). As noted in Rofofsky et al. (2016), in a world where LGBTQIA+ adolescents are already outed as ‘different’, it is better to promote group cohesion through member homogeneity to foster connectedness and belonging between each adolescent – this way, adolescents in the group can create a support network with each other, which can become a protective factor long after group-work therapy has ceased (Telfer et al. 2018; Turner et al. 2013).

Finally, a group setting can support LGBTQIA+ adolescents to confront thoughts and behaviours in a safe environment. Society perpetuates gender norms and queer stigma that adolescents may either conscously or unconsciously internalise into their belief system, which may lead to self-hate (DeLay 2018; Kantor 2009). Due to this, LGBTQIA+ adolescents may engage in thought-patterns or behaviours that continue to perpetuate this self-hate, which puts them in a greater position of vulnerability (Beyond Blue 2022; Rofofsky et al. 2016). Although confronting an LGBTQIA+ adolescent’s thoughts and behaviours may place them in an uncomfortable position, if done with care and consideration, confrontation can support adolescents to challenge their thoughts and behaviours that may be obstructing meaningful change (Toseland & Rivas 2017).

Confrontation can be used as an opportunity for growth and change, which can support an LGBTQIA+ adolescent both on the individual and group level (Kantor 2009; Rofofsky et al. 2016); on an individual level, internal belief systems can change, and on a group level, gender norms and stigmas can be challenged (Kantor 2009; Rofofsky et al. 2016).

 

References

  • Beyond Blue (2022) The impact of discrimination, viewed 25 January 2022, https://www.beyondblue.org.au/who-does-it-affect/lesbian-gay-bi-trans-and-intersex-lgbti-people/the-impact-of-discrimination
  • Cherry (2021) What is group therapy?, Very Well Mind, viewed 25 January 2022, https://www.verywellmind.com/what-is-group-therapy-2795760
  • DeLay, D, Martin, CL, Cook, RE & Hanish, LD (2018), ‘The influence of peers during adolescence: Does homophobic name calling by peers change gender identity?’, Journal of Youth and Adolescence, vol. 47, no. 3, pp. 636-649, (online ProQuest)
  • Ezhumalai, S, Muralidhar, D, Dhanasekarapandian, R & Nikketha, BS (2018), ‘Group interventions’, Indian Journal of Psychiatry, vol. 60, no. 4, pp. 514-521, (NCBI)
  • Headspace (2022) Understanding adolescence, viewed 25 January 2022, https://headspace.org.au/explore-topics/supporting-a-young-person/adolescence/
  • Kantor, M (2009), ‘Homophobia in gays and lesbians: Internalised or interal/self-homophobia’, in M Kantor (ed.), Homophobia: The state of sexual bigotry today, e-book,
  • Praeger Publishers, Westport, viewed 24 January 2022, pp. 53-60, https://ebookcentral.proquest.com/lib/monash/reader.action?docID=554296
  • Rofofsky, M, Kalyanam, A, Berwald, A & Krishnakumar, A (2016), ‘LGBTQ adolescents’, in
  • C Haen & S Aronson (eds.), Handbook of child and adolescent group therapy: A practitioner’s reference, Routledge, New York, viewed 24 January 2022, pp. 453-46, https://ebookcentral.proquest.com/lib/monash/detail.action?docID=4717875
  • Lytle, MC, Vaughan, MD, Rodriguez, EM & Schmerler, DL (2015), ‘Working with LGBT individuals: Incorporating positive psychology into training and practice’, Psychology of Sexual Orientation and Gender Diversity, vol. 1, no. 4, pp. 335-347, (NCBI)
  • Telfer, MM, Tollit, MA, Pace, CC & Pang, KC (2018), ‘Australian standards of care and treatment guidelines: For trans and gender diverse children and adolescents’, The Royal Children’s Hospital Melbourne, viewed 24 January 2022, https://rainbownetwork.com.au/content/3-resources/0-australian-standards-of-care-and-treatment-guidelines-for-trans-and-gender-diverse-children-and-adolescents/australian-standards-of-care-and-treatment-guidelines-for-trans-and-gender-diverse-children-and-adolescents.pdf
  • Toseland, RW & Rivas, RF (2017), ‘Leadership’, in RW Toseland & Rivas RF (eds), An introduction to group work practice, Pearson, Essex, pp. 114-152.
  • Turner, L, Leonard, L, Ward, R, Scott, M, Birkinshaw, Z & Stevens, D (2013), ‘Guidelines for establishing same sex attracted, trans and gender diverse youth groups in Victoria’, Rainbow Network, viewed 24 January 2022, http://www.rainbownetwork.com.au/content/3-resources/0-guidelines-for-establishing-a-social-and-support-group/guidelines_for_establishing_youth_groups_online_version_1-1.pdf
  • Van Der Pol-Harney, E & McAloon, J (2019), ‘Psychosocial interventions for mental health illness among LGBTQIA youth: A PRISMA-based systematic review’, Adolescent Research Review, vol. 4, no. 2, pp. 149-168, (OPUS)