The Impact of Minority Stress on Assessment and Diagnosis of GSMs

I have been doing this work for over 20 years, and in this most recent version of my career, I rarely find myself picking up the DSM and wondering what diagnosis the person in front of me should be labeled with.

When I was a younger clinician, I was taught that EVERYONE needed a diagnosis. I know now that a diagnosis (combined with a person’s hopes, dreams, and desires) can absolutely drive the treatment plan, but it is a function of funding and access more often than it is a function of care. More than anything else, I believe the diagnostic process rarely, if ever, takes into account minority stress.

My old methods were not serving my clients. I discovered that when we looked at the intersecting identities of marginalization of almost all of my clients, the concept of minority stress was the most important factor of behavioral health outcomes.

I currently work almost solely with clients who have marginalized identities. No longer under the watchful eye of funders and policymakers, I now see my responsibilities as a diagnostician through a different lens. The way I understand my responsibility, the way I choose tools to formulate a diagnosis, and the methods I use for case conceptualization have all shifted.

I bring this up as a thought exercise first, and an invitation second.

What comes to mind as you read these thoughts? Are you taking the Minority Stress Model into account as you assess your clients and formulate a diagnosis? Or are you saying to yourself, Nick, what are you talking about? 

For those interested in learning about this topic or would like the opportunity to do some process around it, I’ll be presenting “The Impact of Minority Stress on Assessment and Diagnosis of GSMs” at the upcoming Unraveling the Acronym: Understanding LGBTQIA2+ Experiences and Subcultures Virtual Conference Oct 1-2. I’ll be presenting on October 1st from 12-130pm EDT!

Some information about the workshop:

Description:

This course will help clinicians better understand how minority stress impacts assessment and diagnosis of gender and sexuality minorities. The course will define minority stress, review concepts of constrict bias in assessment tools, implicit bias of clinicians, historical bias within the field of psychology and the impact this has on assessment and diagnosis.

Learning Objectives:

• Define minority stress

• Define construct bias

• Define implicit bias

• Name three ways clinicians can approach assessment and diagnosis from a gender and sexuality minority affirming lens

Approval:

 CE approvals: APA, NBCC, NYSEDSW, NYSEDLMHC, TXBSW, NASW, AASECT