Gender Affirmative Therapy Training Suite

Scenario

It's crucial for mental health providers to understand and acknowledge the distinctive needs of individuals within diverse populations. From intake sessions to seeking help for discrimination and transition support, a significant number of transgender and nonbinary individuals share unfavorable experiences in therapy and other health services due to a lack of knowledge among providers.

To tackle these concerns, we designed this training with a diverse development team (i.e., Key Personnel, Expert Panels, Actors, Script Engineers, Focus Groups, and Community Partners), ensuring representation from individuals with diverse minorities identities, including transgender and nonbinary individuals and people of color. Our training is designed to empower providers, enhance their skills, and boost confidence in delivering gender-affirming culturally competent care. This ultimately fosters safe and trusting environments, enabling gender minorities to feel at ease and validated when sharing their experiences and receive the care they need in critical care situations.

The Gender Affirmative Therapy Training Suite includes access to four virtual client training simulations:

Intake with Jemma Walker: Jemma Walker, a new client, wants to talk about the death of their mother. Prior to the session, Jemma completed the standard intake form, but did not answer the questions identifying their gender or pronouns. Learners will complete an intake session with Jemma to understand their concerns, the reason for coming to therapy, and therapeutic goals. During the session, learners will have the ability to explore topics such as, self-reference (e.g., name and pronouns), gender-identity and gender expression, social and physical transformation, family (i.e., family of origin and chosen family), relationships, race/ethnicity, sexuality, and other intersecting identities. Jemma’s needs will change with each new play. After the session, learners will receive feedback on how well they established a safe therapeutic environment, used gender-affirmative language, and were sensitive to meeting Jemma on their terms.

Traditional Needs with James Moore: James Moore is nonbinary and has been going to therapy for about a month. They need help processing the social and professional challenges they face on a regular basis as a gender nonconforming person of color. Learners will conduct a therapy session focusing on the navigation of social and romantic issues, while also highlighting the way gender identity and expression is negotiated in those contexts (e.g., other people policing their gender). James’ needs will change with each new play. During the session, learners will practice identifying James’ concerns, therapy goals, and help them explore the pressures they feel about negotiating their gender identity in different social interactions. After the session, learners will receive feedback on how well they established a safe therapeutic environment, used gender-affirmative language, and were sensitive to meeting James on their terms.

Transition Support with Lucas Novak: Lucas Novak, a transgender man, is looking for support as he navigates the medical and legal systems to make transitions that will allow him to be his authentic self. Learners will complete a therapy session with Lucas focusing on navigating issues that may present around his gender transition. During the session, learners will practice identifying Lucas’ goals, understanding his resources (e.g., financial, support systems), and discussing a plan to help him achieve his goals. Lucas’ needs will change with each new play. After the session, learners will receive feedback on how well they established a safe therapeutic environment, identified Lucas’ goals, affirmed his autonomy to achieve his goals, used gender-affirmative language, and were sensitive to meeting Lucas on his terms.

High-Risk Needs with Eden Bray: Eden Bray, a transgender woman, is looking for support as she navigates three high-risk situations: interpersonal violence, a new HIV diagnosis, and thoughts of suicide. During each situation, learners will build rapport with Eden while identifying her unique needs and exploring resources appropriate for her as a transwoman experiencing a crisis. Eden’s needs will change with each new play. After the session, learners will receive feedback on how well they established a safe and trusting environment, individualized resources, used gender-affirmative language, and were sensitive to meeting Eden on her terms.

Each virtual client has 3 - 4 character versions based on differing gender identity and social dynamics, acceptance levels of the connection between their identity & systemic social pressures, needs and goals regarding their transition, and fears related to cis-normative resources, needs, and personal backgrounds. Jemma, James, Lucas, and Eden provide a varied training experience to prepare learners for a range of gender identities and expressions and develop culturally competent skills to provide a nuanced understanding of how to best serve the mental health needs of transgender and nonbinary individuals.

Teaching Objectives:

• Understanding a Client’s Individual Needs
• Creating a Safe and Trusting Environment
• Demonstrating Cultural Competency
• Creating Opportunities for Clients to Share Gender
• Reducing Power Dynamics (i.e., inherent in therapy and associated with gatekeeping)
• Identifying and Acknowledging Microaggressions, Discrimination & Binary-Gender Expectations
• Supporting a Client's Autonomy
• Creating Opportunities to Explore a Client’s Transition
• Validating a Client’s Identity and Experiences
• Supporting a Client’s Sense of Self

Included in Training:

• A Training Guide with information on working with trans and nonbinary clients in a respectful manner that positions them to achieve their best outcomes.
• Four Simulated Conversations with a varied character to prepare learners for a range of gender identities and expressions and develop culturally competent skills to provide a nuanced understanding of how to best serve the mental health needs of transgender and nonbinary individuals.
• Comprehensive Feedback during and after each play to help guide skill development.

This training was developed in collaboration with Towson University and with funding from The National Institute on Minority Health and Health Disparities (NIMHD) (Grant Number: #R44MD014112).

Research

Humm, L. B., Steacy, C., Elkins, J., Sailer, C., Olsen, D., Kukucka, J., Schmidt, C.K., & Galupo, M.P. (2020, August). Community partners develop practice simulations to train gender-affirmative therapy skills [Poster session]. American Psychological Association.