Institute 4 - Practice Adaptations for Affirming CBT for Transgender and Gender Diverse Clients

Thursday, November 14, 2024

1:30 PM – 6:30 PM EST

Location: 411/412, Level 4, Downtown Marriott

Earn 5 Credit

Keywords: Unified Treatment, Community-Based, Resilience
Level of Familiarity: Basic to Moderate
Recommended Readings: Hope, D.A., Holt, N. R., Woodruff, N., Mocarski, R., Meyer, H. Puckett, J. A., Eyer, J., Craig, S., Feldman, J., Irwin, J., Pachankis, J., Rawson, K.J., Sevelius, J., Butler, S. (2022). Bridging the gap between practice guidelines and the therapy room: Community-derived adaptations for psychological services with transgender and gender diverse adults in the Central United States. Professional Psychology: Research and Practice 53, 351-361. doi: 10.1037/pro0000448, dickey, l. m. & Puckett, J. A. (2022). Affirmative Counseling for Transgender and Gender Diverse Clients. Hogrefe Publishing., Holt, N. R., Huit, T. Z., Shulman, G. P., Meza, J. L., Smyth, J. D., Woodruff, N., Mocarski, R., Puckett, J. A., & Hope, D. A. (2019). Trans Collaborations Clinical Check-in (TC 3 ): Initial Validation of a Clinical Measure for Transgender and Gender Diverse Adults Receiving Psychological Services. Behavior Therapy, 50(6), 1136–1149. doi: 10.1016/j.beth.2019.04.001, Holt, N. R., Ralston, A. L., Hope, D. A., Mocarski, R., & Woodruff, N. (2021). A systematic review of recommendations for behavioral health services with transgender and gender diverse adults: The three-legged stool of evidence-based practice is unbalanced. Clinical Psychology: Science and Practice, 28, 186-201. doi.org/10.1037/cps0000006, Holt, N. R., Hope, D. A., Mocarski, R., & Woodruff, N. (2019). First impressions online: The inclusion of transgender and gender nonconforming identities and services in mental healthcare providers' online materials in the USA. International Journal of Transgenderism, 20(1), 49-62, doi.org/10.1080/15532739.2018.1428842

Presenter(s)

Debra A. Hope, Ph.D.

Aaron Douglas Professor
University of Nebraska-Lincoln
Lincoln, Nebraska, United States
Nathan Woodruff, Other

Local Community Board Chair
Trans Collaborations
Lincoln, Nebraska, United States

The recent increase in empirical research on the transgender and gender diverse (TGD) people’s mental health concerns and affirmative mental health services offer CBT therapists an opportunity to serve these clients with an evidence-based approach for the first time. This institute is based on the work of Trans Collaborations, our community-based participatory research (CBPR) collaborative that centers the voices and lived experience of transgender and gender diverse adults, especially in underserved areas. After a brief introduction to terminology and TGD communities’ lived experience, this workshop will emphasize practical applications that clinicians can use immediately to transform their practice and clinical work to be affirming for TGD adults. Presenters will describe the community-based, empirically-derived Trans Collaborations Adaptations for Psychological Services as applied to case-formulation driven CBT for adults. Topics will include incorporating TGD intersectional identities into case formulations, adaptations for common CBT interventions, empirically derviced common themes in cognitive work with TGD clients, affirming use of cognitive restructuring around experiences of marginalization, therapists’ implicit assumptions about gender, and progress monitoring tools. We will also address assessing the practice environment to be TGD-affirming. Consistent with our CBPR approach and the workshop theme of community engagement, presenters represent both the academy and community.Although the emphasis will be on CBT for common outpatient mental health concerns, we will include discussions of the advantages and challenges of community engaged research as well. Teaching methods will include didactics, inventory of participants’ current practice settings, roleplays, video demonstrations, and Q&A.

Outline:

1. Understanding transgender and gender diverse communities: basic terminology, resiliency and health disparities, behavioral health needs.
2. Research base for CBT with transgender and gender diverse communities.
3. Practice adaptations developed through community-based participatory research.
4. Incorporating gender and other identities into CBT case conceptualization.
5. Adapting general aspects of practice to be affirming
6. Adapting common CBT interventions to be affirming
7. Progress monitoring for transgender and gender diverse clients.

Learning Objectives:

At the end of this session, the learner will be able to:

Adapt their own practice of evidence-based CBT to be affirming of transgender and gender diverse older adolescent and adult clients.
Implement cognitive restructuring in an affirming manner with adults who identify as transgender or gender diverse seeking treatment for anxiety, depression, marginalization stress, or other common outpatient concerns.
Adapt at least four common CBT interventions (e.g., exposure, behavioral homework) to be affirming of the lived experience of adultsand older adolescents who identify as transgender or gender diverse.
Assess their website and practice for barriers to care for adults who identify as transgender or gender diverse.
Incorporate gender and other identities within an intersectional framework into case formulation for all clients.
Implement affirming progress monitoring tools.
Identify the challenges and benefits of community-based partnerships to address behavioral health disparities.
Long-term Goal: Participants will be able to adapt their own practice of evidence-based CBT to be affirming of transgender and gender diverse older adolescent and adult clients, including at least four common CBT interventions and progress monitoring.
Long-term Goal: Participants will be able to incorporate gender and other identities into case formulation for all clients using an intersectional framework.