Treatment Models in Psychopathology

Rey's text chapter, H.3, states the following, "Children and adolescents with gender incongruence exhibit higher internalizing and externalizing psychopathology compared to non-referred controls, with internalizing psychopathology being more common, particularly in birth-assigned boys (Steensma et al, 2014; de Vries et al, 2016; Wallien et al, 2007; Skagerberg & Carmichael, 2013). We also know that sexual-minority youth are 3 times more likely to attempt suicide as their heterosexual peers (Giacomo, Krausz & Colmegna, 2018). One hypothesis is that this problem behavior is a result of stress due to 1) being a minority and 2) dysphoria toward their gender assigned at birth. These individuals are subjected to rates of peer bullying as high as 80% (Holt et al, 2016; Kaltiala-Heino et al, 2015; McGuire et al, 2010), and poor peer relations is one of the strongest investigated predictors for behavioral and emotional problems in gender nonconforming youth (de Vries et al, 2016). In a study of 105 gender dysphoric Dutch adolescents whose parents completed the Diagnostic Interview Schedule for Children, 32.4 % had one or more psychiatric disorders, with 21% suffering from anxiety, 12.4% from mood disorders, and 11.4% from disruptive disorders (de Vries, 2011)."



With such significant risk for psychopathology for children with gender incongruence, Rey identified that clinicians typically identify with one of three broad treatment models (therapeutic model, watchful waiting and the affirmative model; p. 17-19 in H.3). In your discussion post address the following:



Describe which model best fits in your practice identity, what are the strengths and weaknesses that you anticipate with having this framework in working with children and adolescence?

To move away from treatment focus and towards a prevention focus, what types of resources does your community have or need to develop mental health supports for sexual minority youth?