APA’s new guidelines for psychological practice with transgender and gender nonconforming people: A brief summary

APA’s new guidelines for psychological practice with transgender and gender nonconforming people: A brief summary

There is great news coming out of APA this week. (Finally, some good news coming out of APA!) The APA Council of Representatives has finally approved a set of guidelines for psychologists working with transgender and gender nonconforming people (TGNC).  You can read the entire 55 page document here and it is certainly on my “to read” list as well. However, given how important this is and given the fact that my “to read” list is dauntingly long at this point, I wanted to make sure I was familiar with at least the main guidelines until I can have time to read the entire document. And so, I created this cheat sheet of the 16 guidelines outlined in the document.  So if your “to read” list is like mine, here is a summary of the APA guidelines on working with TGNC people.

APA Guidelines for Psychological Practice with Transgender and

Gender Nonconforming People

Guideline 1. Psychologists understand that gender is a non-binary construct that allows for a range of gender identities and that a person’s gender identity may not align with sex assigned at birth.

Guideline 2. Psychologists understand that gender identity and sexual orientation are distinct but interrelated constructs.

Guideline 3. Psychologists seek to understand how gender identity intersects with the other cultural identities of TGNC people.

Guideline 4. Psychologists are aware of how their attitudes about and knowledge of gender identity and gender expression may affect the quality of care they provide to TGNC people and their families.

Guideline 5. Psychologists recognize how stigma, prejudice, discrimination, and violence affect the health and well-being of TGNC people.

Guideline 6. Psychologists strive to recognize  the influence  of  institutional  barriers  on  the  lives of TGNC people  and  to assist in  developing TGNC-affirmative  environments.

Guideline 7. Psychologists understand the need to promote social change that reduces the negative effects of stigma on the health and well-being of TGNC people.

Guideline 8. Psychologists working with gender questioning and TGNC youth understand the different developmental needs of children and adolescents and that not all youth will persist in a TGNC identity into adulthood.

Guideline 9. Psychologists strive to understand both the particular challenges that TGNC elders experience and the resilience they can develop.

Guideline 10. Psychologists strive to understand how mental health concerns may or may not be related to a TGNC person’s gender identity and the psychological effects of minority stress.

Guideline 11. Psychologists recognize that TGNC people are more likely to experience positive life outcomes when they receive social support or trans-affirmative care.

Guideline 12. Psychologists strive to understand the effects that changes in gender identity and gender expression have on the romantic and sexual relationships of TGNC people.

Guideline 13. Psychologists seek to understand how parenting and family formation among TGNC people take a variety of forms.

Guideline 14. Psychologists recognize the potential benefits of an interdisciplinary approach when providing care to TGNC people and strive to work collaboratively with other providers.

Guideline 15. Psychologists respect the welfare and rights of TGNC participants in research and strive to represent results accurately and avoid misuse or misrepresentation of findings.

Guideline 16. Psychologists seek to prepare trainees in psychology to work competently with TGNC people.

American Psychological Association. (2015). Guidelines for Psychological Practice with Transgender and Gender Nonconforming People. Retrieved from http://www.apa.org/practice/guidelines/transgender.pdf.

Why Google+ is Good for Therapists: Respect for Diversity

Why Google+ is Good for Therapists: Respect for Diversity

“Don’t be evil”—Google motto

I just created my new Google+ account yesterday and I’m very pleased. No, it’s not because it’s the latest and greatest social networking tool (though, those circles are pretty cool). And no, it’s not because finally, after holding out from joining Facebook for all these years, my friends and family will finally get off my back about needing to move into the 21st century. Nope. Those things are fine but, what I’m really impressed by though was what I found as I was going through the process of creating my account. Specifically, under the “gender” box you could choose from an option of “male,” “female,” and “other.” Wow! Now that’s not just “not being evil,” (Google’s motto) — that’s pretty darn enlightened! Yes, of course I’d like to see them use a fill-in-the-blank format so people who identify as something other than “male” or “female” don’t have to identify as “other”, but it’s a great start. This is a great example of how something as small as demographic questions can reflect our values. We have come a long way in terms of inclusivity and awareness of the rich diversity of our world when a Fortune 500 company like Google makes a statement like this.

It also got me thinking about ways that we here at Portland Psychotherapy can further advocate for our clinic’s core value to support diversity and inclusivity and to make quality, evidence-based mental health services available to all member of our community. I came across this brochure published by the Gay and Lesbian Medical Association that offers some great suggestions to help make your practice more inclusive and affirmative. I also found this sample of a “culturally competent intake form” from the King County Public Health Department that includes ways to structure your intake forms around issues of relationships and sexuality that are most inclusive.

Ways to Improve Inclusivity in Your Therapy Practice

Here are a few other suggestions of things you might want to consider to make your practice more welcoming to all:

  • Use fill-in-the-blank spaces rather than check boxes on intake forms for categories like “gender,” “sexual orientation,” “relationship status,” and “ethnicity”.
  • If you ask about religion on your forms, be sure to also include an option for “atheist” as a viable choice.
  • If you have brochures or magazines in your waiting room, consider whether or not they represent a diverse range of experiences and lifestyles (e.g. Do you only have “Parenting” magazine in your waiting room or do you also have “The Advocate”?)
  • If it seems clinically appropriate, ask clients which pronoun (e.g., he, she, it, they) they would like to be referred by.
  • When talking about sexual or relationship partners, be cautious about assumptions about gender, legal status (i.e. married versus partnered), monogamy, sexual orientation, etc. Using the term “partner or partners” may be more inclusive than “spouse” for example.

So, take a cue from Google+ and maybe revisit your office forms and practices to see if there are ways in which you could create a more welcoming and inclusive environment for all those you serve. I know we’re going to be revisiting that issue here at the clinic as well.

UPCOMING TRAINING EVENTS

An Introduction to Exposure Therapy for Anxiety Disorders: Traditional and Inhibitory Learning Approaches

Dr. Brian Pilecki
January 29, 2021 from 12:00pm-1:30pm PST
Exposure therapy is the gold-standard treatment for anxiety and obsessive compulsive and related disorders. The aim of this workshop is to provide a solid foundation in theory and knowledge for those newer to exposure therapy. This workshop will include a brief history of exposure therapy, including a description of its roots in classical and operant conditioning. Read More.


Using Acceptance and Commitment Therapy to Guide Flexible Exposure

Dr. Brian Thompson
February 26, 2021 from 1-2:30pm

Drawing from the ACT model, participants will learn to conceptualize and create exposure exercises to maximize flexibility. We will explore common pitfalls in using ACT as a context for exposure and how to create ACT-consistent exposure exercises for clients who are skeptical of “acceptance” and appear disinterested when you try to engage them about values. The presenter will use practice-based data to support these principles (Thompson, Twohig, & Luoma, in press). Read More.


An Introduction to Psychedelic-Assisted Psychotherapy for Clinicians

Dr. Brian Pilecki and Jason Luoma, Ph.D.
March 26, 2021 from 9am-12:10pm

Psychedelic assisted therapy is emerging as a highly effective form of mental health treatment. This workshop will provide health care professionals an overview of this new clinical area. The workshop will highlight the importance of preparation and integration in therapy using a harm reduction approach. The current legal status of psychedelics will be reviewed, including Oregon’s recent passing of an initiative to legalize psilocybin-assisted therapy. Finally, diversity issues around lack of access for underserved and non-majority populations will be explored. Read More.


How to be Experiential in Acceptance and Commitment Therapy

Jason Luoma, Ph.D.
April 23, 2021 from 12-1pm

Acceptance and commitment therapy (ACT) is, at its core, an experiential treatment, but is frequently delivered in a non-experiential way. Experiential learning involves going beyond verbal discussion, insight, and explanations of experience. But how do we do this in ACT and how do we know when we are spending too much time engaged in non-experiential modes of learning? This workshop will outline a simple model you can use to identify when you are in less or more experiential modes during therapy and easy methods to switch to more experiential modes. You will then have a chance to practice it in breakout groups and get feedback. Read More.


Case Conceptualization in Acceptance and Commitment Therapy

Jason Luoma, Ph.D. and Dr. Brian Pilecki
May 21, 2021 from 12-2pm

This workshop provides a chance to learn concrete methods for conceptualizing cases from the perspective of Acceptance and Commitment Therapy. Formulating a useful case conceptualization is a foundational clinical skill that is essential in delivering effective treatment, and one that can be often overlooked in the process of working with clients. Participants will learn several formats for doing formal case conceptualization outside of session as a means to further develop knowledge and skill with ACT theory, as well as to learn a means to enhance treatment planning. The importance of ongoing case conceptualization throughout a course of treatment will be emphasized, as well as common pitfalls in conceptualizing client problems. Participants will also have a chance to practice newly learned skills with a case in breakout groups. Read More.


ACT Precision Training: In-Session Case Conceptualization in Acceptance and Commitment Therapy to Help You be Focused and Strategic in Your Interventions

Jason Luoma, Ph.D. and Jenna LeJeune, Ph.D
June 18, 2021 from 12-2pm

This workshop provides a chance to learn and practice in-session, in-the-moment case conceptualization of cases from the perspective of Acceptance and Commitment Therapy. This workshop focuses on helping you use ACT theory & in-session clinical markers to make more precise and strategic interventions. The main goal of this workshop is to help you become more adept at identifying in-session client behaviors that are indicators for particular ACT processes that are likely to be most relevant. The workshop uses a process we call ACT Circuit Training, which involves intensive analysis of a video of an ACT session and intentional practice in conceptualizing client behavior and generating possible ACT responses, followed by discussion and feedback. Read More.


ACT Agility Training: In-Session Case Conceptualization in Acceptance and Commitment Therapy to Increase Flexible Responding

Jason Luoma, Ph.D. and Jenna LeJeune, Ph.D
July 16, 2021 from 12-2pm

This workshop provides a chance to learn and practice in-session, in-the-moment case conceptualization of cases from the perspective of Acceptance and Commitment Therapy. This workshop is intended to help therapists be more flexible and nimble in their use of ACT processes, strengthening their ability to fluidly shift as needed between processes within sessions. Therapist learning ACT often develop tunnel vision, focusing too much on particular processes or responding rigidly when more flexibility is needed. Read More.


Therapy and Research in Psychedelic Science (TRIPS) Seminar Series

Second Friday of each month from 12:00 PM – 1:00 PM (PT)

TRIPS is an online seminar series that hosts speakers discussing science-informed presentations and discussions about psychedelics to educate healthcare professionals. This series was created to guide healthcare providers and students preparing to be professionals towards the most relevant, pragmatic, and essential information about psychedelic-assisted therapy, changing legal statuses, and harm reduction approaches in order to better serve clients and communities. This seminar series is a fundraiser for our clinical trial of MDMA-assisted psychotherapy for social anxiety disorder that Portland Psychotherapy investigators are preparing for and starting in the Fall of 2021. All proceeds after presenter remuneration will go to fund this clinical trial. Read more.

December 11th, 2020 – Ethical and Legal Considerations in Providing Psychedelic Integration Therapy with Brian Pilecki, Ph.D. & Jason Luoma, Ph.D.
January 8th, 2021 – What’s it Like to Trip? The Patient Experience in Psychedelic-Assisted Therapy with Brian Pilecki, Ph.D.
February 12th, 2021 – 5-MEO-DMT with Rafael Lancelotta, M.S.
March 12th, 2021 – What does Psilocybin-Assisted Therapy for Depression Look Like? A Clinical Case Presentation based on a Recent Clinical Trial from Johns Hopkins with Alan K. Davis, Ph.D.
April 9th, 2021 – Gregory Wells, Ph.D.
May 14th, 2021  Research on MDMA and Psychedelic-Assisted Therapy: An Overview of the Evidence for Clinicians with Jason Luoma, Ph.D.