Cognitive–behavioral therapy with gay, lesbian, and bisexual clients


  • Steven A. Safren,

    Corresponding author
    1. Massachusetts General Hospital/Harvard Medical School and Fenway Community Health, Boston
    • Correspondence and requests for reprints should be sent to: Dr. Steven A. Safren, Department of Psychiatry, WACC-815, Massachusetts General Hospital, 15 Parkman St., Boston, MA 02114; e-mail:
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  • Tracey Rogers

    1. Fenway Community Health, Boston
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Cognitive–behavioral therapy (CBT) can be adapted to a wide range of clinical difficulties and presenting problems that face lesbians, gay men, and bisexual persons. The following article presents general guidelines for and two case examples of the use of CBT. The first case is a gay male struggling with social phobia. This case is an example of how to adapt a structured, empirically supported cognitive–behavioral treatment focusing on social phobia to situations that are associated with his sexual orientation. The second is a woman struggling with multiple issues including coming out. This case provides an example of how to add specific cognitive–behavioral techniques to coming-out issues within the context of a more eclectic, longer-term therapy. © 2001 John Wiley & Sons, Inc. J Clin Psychol/In Session 57: 629–643, 2001.