Affirmative approaches and relevance of minority stress in psychological counseling with LGBT people: A review of the international literature

The acronym LGBT is used to indicate a very wide range of individuals - lesbian, gay, bisexual, transgender - who, despite intuitive differences related to diverse sexual orientations and gender identities, may be considered a homogeneous group due to the specific needs and peculiarities of development pathways, often marked by experiences of stigmatization and discrimination. In recent years, the request for psychological help from people belonging to this population has significantly increased, and this makes the definition of objectives and intervention strategies necessary. This paper aims at highlighting specific aspects, critical issues, and operational contexts related to clinical intervention with LGBT people, with particular reference to psychological counseling. After a brief historical and cultural overview on the relationship between the psychological sciences and the phenomena related to groups belonging to sexual and gender minorities, two of the most prevalent theoretical perspectives in the scientific and professional system on LGBT issues are described: the minority stress theory (a perspective used in scientific research as a key to understanding the high levels of stress usually encountered in such a population) and the affirmative paradigm (a perspective currently privileged in clinical practice with LGBT clients). Thus, the contribution is focused on the development of the LGBT dimensions within the counseling context, retracing various historical stages that led the Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling (ALGBTIC) to propose a set of guidelines which are briefly discussed, as they represent a fundamental tool for professionals involved in helping relationships. In conclusion, the current research perspectives highlighting an unsatisfactory scenario regarding the empirical evidence on the effectiveness of counseling interventions addressed to LGBT clients are discussed.

Keywords: LGBT people; Psychological and clinical interventions; Psychological counseling; Minority stress; Affirmative interventions

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• Health of Non-binary and Genderqueer People: A Systematic Review Cristiano Scandurra, Fabrizio Mezza, Nelson Mauro Maldonato, Mario Bottone, Vincenzo Bochicchio, Paolo Valerio, Roberto Vitelli, in Frontiers in Psychology 1453/2019
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• Minority stress, resilience, and health in Italian and Taiwanese LGB+ people: A cross-cultural comparison Roberto Baiocco, Cristiano Scandurra, Fausta Rosati, Jessica Pistella, Salvatore Ioverno, Vincenzo Bochicchio, Hung-Che Wang, Te-Sheng Chang, in Current Psychology /2023 pp.104
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• Trans in treatment: a mixed-method systematic review on the psychotherapeutic experiences of transgender and gender diverse people Selene Mezzalira, Nicola Carone, Vincenzo Bochicchio, Sofia Villani, Gianluca Cruciani, Maria Quintigliano, Cristiano Scandurra, in Research in Psychotherapy: Psychopathology, Process and Outcome /2025
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• Mentalizing stigma: Reflective functioning as a protective factor against depression and anxiety in transgender and gender‐nonconforming people Cristiano Scandurra, Pasquale Dolce, Roberto Vitelli, Giovanna Esposito, Rylan J. Testa, Kimberly F. Balsam, Vincenzo Bochicchio, in Journal of Clinical Psychology /2020 pp.1613
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• Minority Stress and Mental Health in Italian Bisexual People Cristiano Scandurra, Andrea Pennasilico, Concetta Esposito, Fabrizio Mezza, Roberto Vitelli, Vincenzo Bochicchio, Nelson Mauro Maldonato, Anna Lisa Amodeo, in Social Sciences /2020 pp.46
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• Breaking the binary: self-narratives of young people in Italy Salvatore Monaco, in Journal of Youth Studies /2024 pp.1
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Cristiano Scandurra, Fabrizio Mezza, Paolo Valerio, Roberto Vitelli, Approcci affermativi e rilevanza del minority stress nel counseling psicologico con persone LGBT: una revisione della letteratura internazionale in "PSICOTERAPIA E SCIENZE UMANE" 1/2019, pp 67-92, DOI: 10.3280/PU2019-001004