Targeting Sexual Stigma: The Hybrid Case Study of “Adam”

The purpose of this case study is to explore the effects of sexual stigma on mental health and corresponding therapy implications when working with lesbian, gay, and bisexual (LGB) clients during the coming-out process. This case study provides a literature review of sexual stigma and its consequences, describes multicultural considerations, and illustrates what are currently thought of as the best treatment practices when working with sexual minority clients. Treatment considerations are demonstrated via the hybrid case example of “Adam, ” who serves as a vivid portrayal of a psychotherapy client who struggles with research-consistent symptomatology and a crisis in identity formation. In addition to being informed by clinical examples in relevant psychological literature, Adam’s composite case is assembled from actual psychotherapy cases. Demonstrating Adam’s course of treatment provides an avenue for describing key clinical issues related to LGB mental health and the coming-out process. By adopting a qualitative, disciplined inquiry approach, I illustrate how, theoretically, treatment can be tailored to a potential client’s unique psychological struggles within the context of historical, contextual, and cultural factors. Following a pragmatic case study research format (Fishman, 1999), Adam’s case material i