Exam Preview

Acceptance and Commitment Therapy for LGBT Clients

---

1.  Which of the following is NOT an element of the ACT hexaflex? contact with the present moment values congruence defusion

2.  What are some ways in which LGBT individuals might exhibit experiential avoidance? avoiding disclosure of identity, avoiding gender expression, and avoiding healthcare avoiding disclosure of identity, avoiding gender expression, and avoiding oppression avoiding discrimination, avoiding internalized stigma, and avoiding disclosure of identity avoiding comparison, avoiding gender expression, and avoiding community spaces

3.  What is an adaptation that is important to consider when discussing values with LGBT individuals? LGBT individuals typically hold different values than non-LGBT individuals. LGBT individuals often don’t relate to the term “values”; instead, they often use the term “preferences.” Values can be a loaded term due to the ways in which terms such as “family values” and “religious values” are used to stigmatize LGBT individuals. Values can be a loaded term due to the ways in which LGBT communities use the term “values” to indicate sexual behavior.

4.  Which of the following are common presenting problems seen in LGBT clients? internalized homophobia, elevated self-esteem, increased affirmation, and non-disclosure internalized homophobia, low self-esteem, non-affirmation, and increased disclosure gender/sexuality exploration, discrimination and oppression, internalized homophobia, and lack of access to community support gender/sexuality exploration, discrimination and oppression, elevated self-esteem, and lack of access to community support

5.  Which of the following is NOT a task associated with gender and sexuality exploration? exploring identities exploring disclosure seeking information and support exploring political views

6.  How might you use ACT techniques when working with LGBT clients experiencing internalized homophobia or internalized transphobia? Help the client defuse from self-criticism and feelings of shame Help clients avoid experiences of internalized shame Help clients challenge and “fix” the thoughts and feelings that they are experiencing Help clients affix a sense of self related to their internalized homophobia/transphobia.

7.  What is a common ethical trap that clinicians can fall into when attempting to treat gender dysphoria? Clinicians can get rid of gender dysphoria using medical techniques. Clinicians can unintentionally attempt to directly fix or get rid of gender dysphoria using medical intervention. Clinicians can frame gender dysphoria in terms that are too flexible and that do not align with the medical model. Clinicians can unintentionally affirm a client’s gender in ways that are not aligned with

8.  Current research shows that ACT can have what outcomes for LGBT clients? ACT can reduce psychological flexibility, which in turn can result in symptom reduction. ACT can reduce experiences of discrimination and non-affirmation, which in turn can result in symptom reduction. ACT can increase psychological flexibility, which in turn can result in symptom reduction. None of the above.

9.  How would a clinician use ACT techniques to help a client who is deciding whether to come out to family? Encourage the client to come out to family and identify willingness to experience negative outcomes. Encourage the client to come out to family and work through defusing from negative expectations. Challenge the client’s negative expectations of their family’s reactions and defuse from those expectations. Help the client decide upon values-aligned behavior and identify willingness to experience negative outcomes.

10.  Why doesn’t ACT use self-as-context to encourage clients to view themselves as non-LGBT? ACT seeks to change cognitive content, but not to increase flexibility. ACT seeks to promote flexibility around cognitive content, not to change that content. ACT does not focus at all on cognitive content. None of the above.

11.  Why does ACT place less emphasis on symptom reduction when measuring effectiveness? In ACT, increasing values-aligned action and cognitive flexibility is the objective, regardless of whether symptoms are reduced. In ACT, therapy is deemed effective when there are improvements in the therapeutic relationship rather than when there is symptom reduction. Symptom reduction is seen as an unreliable measure of mental health outcomes. ACT does not result in symptom reduction and therefore, less emphasis is placed on it.

12.  Which of the following statements is TRUE concerning therapist bias and ethics? Therapists who practice ACT will rarely hold significant anti-LGBT bias. Therapists who hold significant anti-LGBT bias may use ACT principles to adopt more affirming attitudes. When a therapist holds significant anti-LGBT bias, they are ethically responsible to keep the patient and seek additional supervision. When a therapist holds significant anti-LGBT bias, they are ethically responsible to refer LGBT patients out.

13.  Which value conflict is NOT often found in LGBT individuals? Religious values can be in conflict with valuing accepting oneself fully. Maintaining connection with family can be in conflict with expressing oneself authentically. Pursuing romantic interests can be in conflict with sexual desires. Physical or psychological safety can be in conflict with expressing oneself authentically.

14.  A is a 30-year-old transgender woman who is exploring her gender. She realizes that she prefers to present her gender in a more masculine, tomboy-ish way, but she feels that as a trans woman, she really should be presenting more feminine. She experiences a lot of doubt, confusion, and anxiety about her gender identity as a result. How would you use ACT techniques with this case? Encourage A to present in more feminine ways through the use of experiential avoidance. Encourage A to ignore doubt, confusion, or anxiety, and instead to orient toward behaviors. Increase A’s psychological flexibility around gender expression through self as-context; establish values and work toward values-aligned behavior. Assist A in finding community members who can support her gender expression.

15.  P is a 27-year-old Christian bisexual woman who experiences ongoing shame about her sexuality. She would like to explore dating women, but feels too inexperienced and ashamed to do so. How would you use ACT techniques with this case? Help P defuse from internalized transphobia and increase her willingness to experience shame while exploring her sexuality. Help P merge with her internalized transphobia and decrease her willingness to experience shame. Help P challenge her cognitive distortions related to internalized transphobia. Teach P distress tolerance skills to navigate her distress while exploring her sexuality.