Dialectical behaviour therapy (DBT) for high-risk transgender and gender diverse (TGD) youth: A qualitative study of youth and mental health providers' perspectives on intervention relevance.
Dialectical behaviour therapy (DBT) for high-risk transgender and gender diverse (TGD) youth: A qualitative study of youth and mental health providers' perspectives on intervention relevance.
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DOI：
10.1111/papt.12418
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发表时间：
2022-12
影响因子：
3.4
通讯作者：
Mahaffey, Brittain
中科院分区：
文献类型：
--
作者：
Tilley, Jacqueline L.;Molina, Lucero;Luo, Xiaochen;Natarajan, Aaradhana;Casolaro, Leslye;Gonzalez, Adam;Mahaffey, Brittain
关键词：
尽管跨性别和性别多样性（TGD）青年面临重大的心理健康挑战和独特的治疗需求，但对这些青年循证治疗的可接受性的研究是有限的。为了解决这一差距，本研究探讨了辩证行为疗法（DBT）的高风险TGD青年的感知相关性。定性数据收集从六个焦点小组讨论与一个有目的的样本21 TGD青少年年龄在18 - 25岁谁赞同抑郁症，自杀，或自我伤害的历史和个人访谈与10个心理健康提供者与以前的DBT和TGD客户端的经验。采用主题内容分析法对数据进行归纳分析。结果强调了DBT在针对慢性和急性压力源方面的感知相关性，其中一些是TGD青年所独有的，例如与性别焦虑，性别相关治疗和性别认同相关的问题。确定了可能的治疗调整领域，包括适应身体意识练习和生理相关的应对技术，为经历性别焦虑的青年和加强自我护理技能。虽然人际有效性技能被认为是重要的，但提供者强调需要将安全优先于这些技能的实践。这是因为TGD青年往往比他们的顺性别同龄人经历更多的敌意和偏见的人际关系。这项研究的结果揭示了以前未探索的观点TGD青年和供应商对DBT的感知相关性，并提供DBT治疗提供者和实施研究人员与高风险TGD青年工作时要考虑的一些关键问题。
Despite the significant mental health challenges and unique treatment needs of transgender and gender diverse (TGD) youth, research on the acceptability of evidence-based treatments for these youth is limited. To address this gap, the current study explored the perceived relevance of Dialectical Behavior Therapy (DBT) for high-risk TGD youth. Qualitative data was collected from six focus group discussions with a purposive sample of 21 TGD youth aged 18 – 25 years old who endorsed a history of depression, suicidality, or self-harm and individual interviews with 10 mental health providers with prior DBT and TGD client experience. The data were analyzed inductively using thematic content analysis. The results highlighted the perceived relevance of DBT in targeting chronic and acute stressors, some of which are unique to TGD youth such as issues related to gender dysphoria, hormone-related treatment, and gender identity. Possible areas for treatment modifications including the adaptation of body awareness exercises and physiological-related coping techniques for youth experiencing gender dysphoria and the reinforcement of self-care skills were identified. While interpersonal effectiveness skills were acknowledged as important, providers highlighted a need to prioritize safety over the practice of these skills. This is because TGD youth often experience more hostile and prejudiced interpersonal experiences than their cisgender peers. The study’s findings shed light on previously unexplored perspectives of TGD youth and providers on the perceived relevance of DBT and provide DBT treatment providers and implementation researchers with some critical issues to consider when working with high-risk TGD youth.
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