Psychotherapy for the Spectrum of Sexual Minority Stress: Application and Technique of the ESTEEM Treatment Model

Converging evidence points to minority stress as a risk factor that predisposes sexual minority individuals to a variety of negative psychosocial health outcomes, particularly depression and anxiety, substance use, and sexual risk-taking. This paper outlines the techniques and theoretical underpinnings for implementing an emerging empirically supported psychotherapy designed to target the transdiagnostic mechanisms linking sexual minority stress with these outcomes. We outline the essential therapeutic principles, psychoeducation content, as well as session- and homework-based activities that can be adapted for a variety of presenting problems that originate from, and are exacerbated by, minority stress via transdiagnostic minority stress processes. As the development and dissemination of this therapeutic model is still within its early stages, we review the intervention’s empirical support thus far and outline potential directions for future development and dissemination via individual, clinic-based, and societal channels.