Toward Cognitive-Behavioral Therapy for Sexual Minority Women: Voices From Stakeholders and Community Members

Sexual minority women (SMW) experience an elevated risk of mental health problems compared to heterosexual women. However, knowledge gaps remain regarding whether cognitive-behavioral therapy (CBT) interventions meet SMW’s mental health needs. Further, virtually no studies have integrated stakeholder (i.e., researchers with content expertise in SMW’s health and clinical providers who work with SMW) and community member (i.e., SMW) perspectives to identify CBT approaches that address SMW-specific issues. This study used qualitative data gathered from 39 SMW who reported depression, anxiety, suicidality, and heavy drinking in the past 3 months and 16 content experts and clinical providers to obtain information relevant to enhancing CBT for SMW. In addition, we used thematic analysis to identify themes related to the adaptation and delivery of CBT for SMW. Building on prior literature, this study’s findings revealed seven considerations for delivering mental health services to SMW: (1) attending to SMW’s diverse gender identities and expressions; (2) focusing on SMW’s nonbinary stressors; (3) formulating SMW’s gender-based stressors within a feminist framework; (4) applying intersectionality frameworks; (5) incorporating issues of diversity, multiculturalism, and social justice; (6) addressing the role of trauma exposure; and (7) addressing the role of alcohol use in SMW’s lives. These considerations are reviewed in terms of their implications for clinical practice, with a focus on enhancing applications of existing CBT interventions to best respond to the unique needs of this population.     

“Shame: The Misplaced Debt of Structural Sin”

Although sexual violence and economic distress are often understood and responded to as individual problems, they are rooted in and must be understood within the social systems of patriarchy and advanced global capitalism, both of which normalize these traumas. The problem is that social systems divert guilt for structural sin onto individuals in the form of shame, which I argue is the misplaced debt of structural sin. Through narrative and analysis, I demonstrate the problems of silence, judgement, and death associated with the misplaced debt of shame in structural sin. Preliminarily, I suggest that the theology of the cross enables Christians to name structural sin for what it actually is; judge who or what is truly guilty; and remove shame and guilt from survivors to foster flourishing.     

Refusing to be Marginalized: Groupwork in Mental Health Services for Women Survivors of Childhood Sexual Abuse

Childhood sexual abuse is a major aetiological factor in the development of mental health difficulties experienced by women. Although this conclusion is supported by two decades of extensive research, it has had little impact on the provision of mainstream mental health services. It remains exceptional for there to be specialist therapy or counselling provision for women survivors of childhood sexual abuse within statutory mental health services. This represents a serious gap in service provision and, it is argued, results in extended and inappropriate treatment for women survivors using mental health services. In this article, the development of a multi-agency approach to the provision of groupwork for women survivors of childhood sexual abuse within mental health service is described. A women-centred model of groupwork is outlined. Evaluation and funding are discussed. It is argued that, as a time-limited and effective treatment option, groupwork for women survivors of childhood sexual abuse should form a central part of service provision within statutory adult mental health services.     

无效治疗的概念与道德的争论

现代教学治疗的有效、无效的争论越来越引起社会的关注。随之而引发对医患关系、资源分配、医患对话、自主、知情同意、家长主义等问题的大讨论。现重点对无效治疗判断的四个基本方面进行探讨：（１）建立在医学科学的基础上;（２）价值的判断和有效性的预测;（３）无用与有益的边界区域问题;（４）生理、心理的经济的负担。并就谁来决定和判断无效治疗进行讨论。     

Is sexual-aggressive vocal communication related to asymmetric mechanisms in the brain?

In Mongolian gerbil males, a reliable asymmetric relationship has been discovered between a stereotyped ultrasonic vocalizattion and the volume of a discrete nucleus within the preoptic-anterior hypothalamic area, the sexually dimorphic area, pars compacta (SDApc). The steroid-sensitive ultrasonic, emitted at high levels during courtship interactions, is associated with the absence of aggressive encounters and appears to be necessary for the formation and maintenance of pair-bonds with females. Interactions between unfamilliar, non-pair-bonded adult male and estrous female gerbils result in male aggression, reduction of male ultrasonic calling, and disruption of normal female dartmale follow sociosexual sequences. Castration further reduces ultrasonic calling, inhibits normal sociosexual sequences, and increses aggression in interaction between unfamiliar compared to pair-bonded individuals. Bothg brain structure and lateralization of vocal function in males depend on the action of sex steroids during sexual differentiation and in adulthood. Thus, the gerbil provides a new model to study steroid-dependent lateralization of brain mechanisms of vocal behavior mediating aggressive-sexual relationships. © 1994 Wiley-Liss, Inc.     

Legitimized aggression and sexual coercion: Individual differences in cultural spillover

Correlations between aggressive attitudes and sexual coercion have consistently been found in numerous empirical studies across social science disciplines. Extrapolating from sociological research linking indices of legitimate aggression by state to statewide frequencies of rape, we have extended the investigation of legitimate aggression and coercive sexuality to the individual level. The specific purposes of this research were to index the breadth and level of endorsement of legitimized aggression at the individual level and to measure the association between such an index and coercive sexual behavior. These purposes were achieved across the course of three studies in which we created a new dispositional measure, the Proclivity for Legitimized Aggression Questionnaire (PLAQ), and replicated a sociocultural level correlation with coercive sexual behavior (Study 1); assessed the individual differences level construct validity of the PLAQ (Study 2); and tested whether endorsement of items on the PLAQ were related to content‐relevant behaviors (Study 3). The PLAQ was internally consistent, modestly but significantly correlated with a measure of self‐reported coercive sexual behavior, and characterized by promising construct validity. Aggr. Behav. 27:26–43, 2001. © 2001 Wiley‐Liss, Inc.     

How Do Religion and Sexual Orientation Affect Support for U.S. Presidential Candidates? Evidence from a Survey Experiment

A growing body of research has examined how candidates’ religion or sexual orientation affect voting likelihood among the U.S. public. No systematic study, however, has focused on the combined effect of these traits. We draw on the intersectionality literature to develop and test hypotheses for this neglected, but important, combination. Results from an original survey experiment conducted in late June 2019 demonstrate that all respondents, as well as the Republican subgroup, tend to disapprove of a gay, religious candidate relative to other options (i.e., gay, nonreligious; straight, religious; and straight, nonreligious). Even Democrats expressed little support except when a straight, religious candidate was the alternative. Our findings underscore the need to study how overlapping—rather than discrete—traits influence political views and behaviors. They also raise important questions about the future of U.S. identity politics. Efforts to rally Republican and Democrat voters by mixing particular types of traits may not be a very effective strategy.     

Retrieval inhibition of trauma-related words in women reporting repressed or recovered memories of childhood sexual abuse

Several authors have argued that survivors of childhood sexual abuse (CSA) who report to have repressed their traumatic memories are more skilled in forgetting emotional stimuli than survivors who have always remembered the abuse. The current experiment employed a list-wise directed forgetting task to investigate whether women reporting repressed (n = 16) or recovered (n = 23) memories of CSA are better at forgetting disturbing material, relative to women reporting having always remembered their abuse (n = 55) or reporting no history of abuse (n = 20). We found no support for the hypothesis that women reporting repressed or recovered memories of CSA are especially versed in inhibiting retrieval of trauma-related words. Additional analyses revealed that participants characterized by a repressive coping style did not display a superior retrieval inhibition mechanism for negative material.     

The analysis of the homoerotic and the pursuit of meaning

This paper explores the dynamic tension between an evolving collective phenomenon and the nature of analytic process. Specifically, the focus will be erotic experiences which acquire a meaning through the culture at large, a meaning that may not be supportable when that material is subjected to psychological analysis. This stimulates a conflict between the symbolic attitude and the cultural perspective of the time. While the struggle between the individual and collective consciousness always emerges in analysis, the subject of same-gender sexual relations has become such a controversial and divisive issue in the current political environment that views toward homosexuality demand powerful allegiances and identification with either historic or contemporary ideas. People now identify as 'gay' and tend to see themselves as something akin to a race or perhaps alternative gender. Sexuality and relationship between same gendered people tends to be viewed through the lens of civil rights and the undeniable need for social equality. In this far-reaching and expanding collective phenomenon, psychology, in its support of human rights and accommodation to emerging trends, may be diminished in its capacity to pursue the meaning inherent in these human experiences. The position developed in this paper is that psychological experience, whether in the imaginal realm, dreams or personal consciousness, must be available for full analysis. Clinical experience and dreams are used to amplify this challenge to dynamic analytic practice.