Cognitive-Behavioral Therapies with Lesbian, Gay, and Bisexual Clients

Christopher R. Martell, Steven A. Safren, and Stacey E. Prince

November 14, 2003
ISBN 9781572309548
Price: $44.00 $37.40
263 Pages
Size: 6" x 9"

This book provides a framework for affirmative, empirically supported cognitive-behavioral therapy (CBT) with lesbian, gay, and bisexual clients. Guidelines for competent assessment and treatment are integrated with practical descriptions of widely used CBT applications. In addition to presenting powerful treatment tools for depression, anxiety, and other problems encountered by gay and straight clients alike, the book offers clear-cut guidance on helping individuals and couples cope with the stresses of sexual minority status. Rich case illustrations bring to life the diversity of lesbian and gay communities, highlighting commonalities as well as differences among the issues that clients bring to therapy. Filling a crucial gap in the literature, this is an important resource for therapists in a range of settings, from CBT newcomers to experienced practitioners. Appendices include resources and sample client and therapist forms.

Winner—APA Division 44 Distinguished Book Award in Lesbian, Gay, and/or Bisexual Psychology

“Martell, Safren, and Prince's pairing of cognitive-behavioral therapies (CBT) with lesbian, gay, bisexual (LGB) mental health issues fortunately is a match made for all the right reasons. The authors are our modern day matchmakers and this a most welcome introduction.”

The Clinical Psychologist

“Martell et al. have done a masterful job of bringing cognitive-behavioral therapy alive for therapists who work with the lesbian, gay, and bisexual community. By centering their discussions of CBT in the lives and experiences of LGB clients, the authors powerfully demonstrate the relevance of this therapeutic paradigm to an LGB-affirmative stance. The discussion of ethics and boundary issues is an extra bonus for the reader, especially those therapists who must deal with the small-community problem in a context of a theory that does not focus on the symbolic layers of treatment. This is 'must' reading for LGB-affirmative practitioners and an excellent text for graduate-level courses.”

—Laura S. Brown, PhD, ABPP, Washington School of Professional Psychology at Argosy University-Seattle

“This volume demonstrates excellent, thorough, and current knowledge of cognitive-behavioral therapy and shows in a meaningful and practical way how this approach can be applied to therapeutic advantage with lesbian, gay, and bisexual clients. The book offers strong guidance on how to utilize the widely accepted and applicable techniques of CBT while incorporating sensitivity and responsiveness to sexual diversity issues. The combination of highlighting and valuing sexual diversity, while at the same time drawing on methods that normalize and humanize universally experienced problems, is a signal achievement. This is a most useful resource for clinicians familiar with LGB issues who want to learn more about CBT, as well as experienced cognitive-behavioral therapists seeking to better serve their sexual minority clients. It also will serve as a supplemental text for graduate students in a broad range of mental health fields.”

—Keith S. Dobson, PhD, Department of Psychology, University of Calgary, Canada

“Bravo! This fine, very welcome book represents an important and successful melding of two sometimes separate psychotherapeutic communities. The richness of the CBT model (including important, exciting, new developments therein) is integrated with the growing body of scholarly research and findings on LGB experiences. Specific frameworks utilize myriad examples to address the major issues facing LGB individuals and couples and to illustrate the applicability of CBT with these clients.”

—Kevin T. Kuehlwein, PsyD, Center for Cognitive Therapy, University of Pennsylvania

“Martell, Safren, and Prince offer an up-to-date, well articulated review of both the field of cognitive-behavioral therapy and therapeutic issues relevant to LGB people. Their thorough analysis and integration of these topics is unique and the result is essential reading for therapists working with LGB clients and for students training in CBT and/or service provision to LGB people.”

—Gordon Josephson, Doctoral Candidate, University of Ottawa

Table of Contents


1. Specific Developmental Challenges for Lesbian, Gay, and Bisexual Individuals

2. Cognitive-Behavioral Assessment

3. The Basics of Cognitive-Behavioral Therapies

4. Treating Depression

5. Anxiety Disorders

6. Couple Therapies

7. Consideration of Other Disorders and Problems

8. Emerging Behavioral and Cognitive-Behavioral Therapies

9. Ethical Considerations and Clinical Judgment

10. The Past and the Future of Cognitive-Behavioral Therapy with Lesbian, Gay, and Bisexual Clients

Appendix I. Resources

Appendix II. Frequency and Acceptability of Partner Behavior

Appendix III. IBCT Feedback Session Summary Sheet




About the Authors

Christopher R. Martell, PhD, ABPP, is the Director of the Psychological Services Center at the University of Massachusetts Amherst, where he is also a Lecturer. He maintained an independent practice for 23 years, providing cognitive-behavioral therapy to clients with mood and anxiety disorders. Dr. Martell conducts workshops and trainings on behavioral activation (BA) nationally and internationally and has consulted on research teams examining BA around the world. His books include Behavioral Activation for Depression: A Clinician's Guide (coauthored with Sona Dimidjian and Ruth Herman-Dunn). He is a recipient of honors including the Distinguished Psychologist Award from the Washington State Psychological Association.

Steven A. Safren, PhD, is Assistant Professor of Psychology at Harvard Medical School, Associate Director of the Cognitive-Behavioral Therapy Program at Massachusetts General Hospital, and a research scientist at Fenway Community Health. He has published on LGBT mental health, behavioral aspects of HIV, and mood and anxiety disorders. Dr. Safren is the Principal Investigator of an NIMH-funded study of CBT for depression and HIV medication adherence.

Stacey E. Prince, PhD, is in private practice in Seattle and is a Clinical Instructor at the University of Washington. Dr. Prince recently served as co-chair of the Washington State Psychological Association's Committee on LGBT Concerns. She has been involved in several NIMH-funded studies, and has published on gender issues in depression, CBT for depression, and integrative behavioral couple therapy.


Therapists in a range of settings, from CBT newcomers to experienced practitioners; students in clinical and counseling psychology, couple and family therapy, clinical social work, and nursing; psychiatric residents.

Course Use

Serves as a text in courses or training programs in cognitive therapy or CBT, couple therapy, psychotherapy, and clinical work with sexual minority clients.