Sexual minorities (SM) are at a greater risk for experiencing a serious mental illness (SMI) compared to their heterosexual counterparts. Furthermore, SM with a SMI continue to experience stigma and discrimination that leads to more negative outcomes and a greater need for counseling services. Current researchers have not adequately addressed the specific needs of SM with a SMI and how to prepare counselors to work with this population. Furthermore, most SM with a SMI find that counseling services are inadequate and do not meet their unique needs. The purpose of this transcendental phenomenological study, grounded in a Husserlian philosophical and Minority Stress Model conceptual framework, was to explore the experiences and perceptions of counselors who provide counseling services to SM with a SMI. Data was collected from six participants using a semistructured interview and followed a thematic data analysis process, ensuring thematic saturation. The results of this study highlighted many themes regarding the unique needs of SM with a SMI, such as their multiple minority stressors, negative counseling experiences, and the impact of family, as well as counselor's perception regarding the lack of preparation in graduate school to work with SM with a SMI. Study findings may improve counselors' understanding of the needs of SM with a SMI so they may provide more effective counseling services. Also, this study highlights the importance of training counselors to work with this population and may bolster the efforts of counselor educators.

In their review, Remedios and Snyder (2015) articulated how models of stigma fall short of explaining stigmatization of women of color, because they do not consider intersectionality of multiple stigmatized identities. Using the example of the intersection of race and gender, they reviewed literature on how targets of stigma detect and respond to prejudice (making prejudice attributions, the role of identity processes such as centrality), highlighting the complexity of these processes once multiple identities (namely non-prototypical categories of race and gender) are considered. In response, we provide more in depth discussion of the challenges to inclusion and intersectionality including current and traditional psychological science approaches and the perceived politicization of intersectional research, as well as the complexity of integrating multiple identities (social class, sexual orientation and gender diversity) into stigma research, including recruitment, measurement, and analysis. We offer practical suggestions in the areas of recruitment, measurement, and analysis, to facilitate more inclusive and intersectional research, given that such work would provide a more complete understanding of the experience of stigma.

Sexual minority individuals (lesbians, gay men, and bisexuals) suffer from stigmatization, or minority stress, which often predicts negative mental health outcomes and low self-esteem. However, specific dimensions of identity (e.g., centrality and regard) may buffer against these negative outcomes in racial minorities and other stigmatized groups, including sexual minorities. Indeed, research in other stigmatized populations has found evidence for the protective properties of identity. Yet, limited research has examined dimensions of identity that buffer or protect sexual minorities. This study aimed to explore the moderating role of identity characteristics in the relation between sexual stigma and mental health outcomes. Findings in a sample of 209 gay, lesbian, and bisexual individuals suggested that public stigma, centrality, and private regard predict psychological distress, but did not support a moderation model. Private regard emerged as a predictor of self-esteem as well. Additionally, centrality and public stigma interacted in such a way that those who reported higher centrality of sexual orientation identity did not report decrements to self-esteem in the face of public stigma to the same extent as those who reported lower centrality of sexual orientation identity. All of these suggest centrality and private regard as key factors in the psychological well-being of sexual minorities and should further be explored.

Sexual minority individuals (lesbians, gay men, and bisexuals) suffer from stigmatization, or minority stress, which often predicts negative mental health outcomes and low self-esteem. However, specific dimensions of identity (e.g., centrality and regard) may buffer against these negative outcomes in racial minorities and other stigmatized groups, including sexual minorities. Indeed, research in other stigmatized populations has found evidence for the protective properties of identity. Yet, limited research has examined dimensions of identity that buffer or protect sexual minorities. This study aimed to explore the moderating role of identity characteristics in the relation between sexual stigma and mental health outcomes. Findings in a sample of 209 gay, lesbian, and bisexual individuals suggested that public stigma, centrality, and private regard predict psychological distress, but did not support a moderation model. Private regard emerged as a predictor of self-esteem as well. Additionally, centrality and public stigma interacted in such a way that those who reported higher centrality of sexual orientation identity did not report decrements to self-esteem in the face of public stigma to the same extent as those who reported lower centrality of sexual orientation identity. All of these suggest centrality and private regard as key factors in the psychological well-being of sexual minorities and should further be explored.

No description available.

Sexual minorities are the target of numerous negative stereotypes in the United States, and are sometimes perceived as deviant and devalued as compared to heterosexuals. Stereotype threat, the anxiety of confirming a negative stereotype about oneself or one's group, has been linked to perceived stress; and stress has been linked to low job satisfaction. Sexual minorities provide a unique test of stereotype threat theory because they may choose to conceal their minority status at work. Thus, this study also examines whether the visibility of the stigma is a necessary precursor to the experience of stereotype threat. Given the uniqueness of this population, a new and presumably more comprehensive model of stereotype threat (the Multi-Threat Framework) was also examined to ensure that stereotype threat was being adequately measured by examining every possible type of stereotype threat. Job satisfaction has been linked to many organizational outcomes such as poor performance, absenteeism, and turnover intentions; thus, it is important to examine predictors of low job satisfaction. Thus, the current study tested perceived stress as a mediator between stereotype threat and low job satisfaction in a sample of 150 sexual minorities who were employed full time. Internalized homophobia was predicted to moderate the relation between stereotype threat and perceived stress. Results indicated support for the moderated mediation model using only the traditional measure of stereotype threat; that is, stereotype threat predicted low job satisfaction through job stress. Moreover, at high levels of internalized homophobia, individuals reported high job stress, regardless of levels of experienced stereotype threat. However, those with low internalized homophobia reported high job stress only when stereotype threat was high. No differences were found with regards to degree of concealing, suggesting that the deleterious effects of high stereotype threat on job stress occurred regardless of whether participants were concealing. Additionally, the moderated mediation model was not supported when measured using the new Multi-Threat Framework, suggesting that the measure may not be measuring the same construct as the traditional measure. Finally, results suggest that stereotype threat added significant incremental validity in predicting job dissatisfaction over perceived discrimination. These findings, in total, suggest that stereotype threat is a valuable construct for predicting negative work outcomes for stigmatized individuals. Implications for improving the work lives of sexual minorities were discussed.

This study uses a constructivist grounded theory approach to investigate the meaning of “coming out” for LGBQ individuals. Analysis of open-ended interviews with 30 LGBQ persons revealed three main themes. First, coming out does not have a universal meaning among LGBQ persons; rather, it varies on the basis of an individual’s experiences, social environment, and personal beliefs and values. Coming out is a transformative process, and an important element in identity formation and maintenance. Second, despite being attracted only to members of the same sex, ten interviewees engaged in a queer apologetic, a kind of identity compromise whereby individuals disclose a bisexual identity that they believe satisfies their personal attractions for only members of the same sex and society’s expectation that they be attracted to members of the opposite sex. Third, both gender conformity (e.g., female=feminine) and gender non-conformity (e.g., female=masculine) present unique challenges to coming out. Because they are assumed to be straight, gender conformists must make a more concerted effort to come out. Gender non-conformists may experience greater ease coming out broadly because they are “assumed gay,” but they also experience greater opposition from family and friends who resist gender non-conformity. This study provides important insight into the meaning of coming out as well the influences of heteronormativity and gender presentation on coming out. Implication and recommendations for future research are included.

Community health workers (CHWs) make up a crucial part of the public health system by providing culturally-sensitive care in historically marginalized communities, such as those found throughout Appalachia. During the ongoing COVID-19 pandemic, CHWs have been less likely to accept the COVID-19 vaccine than other healthcare workers. It is important to understand if CHW vaccination status affects concern for their clients during the pandemic, as this may subsequently affect care delivery. Therefore, this study investigated the association between CHW vaccination status and concern for their clients given COVID-19 restrictions lifting. Secondary analysis was performed on data from an electronic survey administered in two Appalachian populations from October to December, 2021. In total, 71 CHWs were eligible for inclusion in the study. Fisher’s Exact Test was used to compare survey responses between CHWs who had received at least one dose of the COVID-19 vaccine and those who had not. 86% of CHWs had received at least one dose of the COVID-19 vaccine. Most CHWs, regardless of vaccination status, reported that client needs had changed during the pandemic. However, vaccinated CHWs were significantly more likely to have concerns for their clients with the lifting of COVID-19 restrictions than unvaccinated CHWs. A difference in concern by vaccination status may translate to a difference in care provided during the pandemic, as well. This is important to consider in creating and delivering training for CHWs so that they can provide the best possible care to communities in Appalachia.

No description available.

Wilderness therapy is an emerging treatment modality that integrates nature with evidence-based therapeutic treatments (Russell, 2001). A growing body of literature continues to support its effectiveness with adolescents and young adults (Bowen & Neill, 2013; Curtis et al., 2018; Hoag et al., 2013); however, little research has been conducted on the experiences of its LGBTQIAP+ (“queer”) participants. Such an absence is noteworthy because the percentage of queer wilderness therapy students might be as high as 18% (Wright et al., 2017) and given that queer individuals experience minority stress (Meyer, 2003), which is correlated with negative psychological outcomes (Baams et al., 2015; Mereish et al., 2019; Tebbe & Moradi, 2016). This dissertation fills the gap in the literature by using pre-existing data collected by the Outdoor Behavioral Healthcare Council (OBHC) and the National Association for Therapeutic Schools and Programs (NATSAP) to examine the mental health outcomes of young adult (ages 18-25) wilderness therapy students using the Outcomes Questionnaire 45.2 (OQ 45.2; Lambert & Burlingame, 1996). With a sample of 379 queer and non-queer wilderness therapy graduates, this study found that queer young adults’ intake OQ 45.2 scores were statistically similar to those of straight young adults. It was also found that queer young adults’ OQ 45.2 discharge scores were statistically significantly lower than their intake scores, indicating a reduction in psychological distress. This dissertation also examined preliminary post-wilderness therapy data, interpreted all results as they relate to clinical work and research, and concluded by offering next steps for treating queer young adults enrolled in wilderness therapy programs.