Recent studies have shown that suicidality among transgender youth are 3.6 times more likely to report suicidal ideation and 3.2 times more likely to attempt suicide compared with cisgender youth. To alleviate the suicide rates among transgender youth, research suggests the need for family-based interventions. This case study explores the integration of structural family therapy and the Satir growth model to increase connection and support within the family, while also creating clear boundaries that are protective and growth-enhancing. This study provides a session by session overview of how the therapist integrated the models while working with the entire family unit.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
2.
AustinA.CraigS. L. (2015). Transgender affirmative cognitive behavioral therapy: Clinical considerations and applications. Professional Psychology: Research and Practice, 46, 21–29. https://doi.org/10.1037/a0038642
3.
BaamsL.GrossmanA. H.RussellS. T. (2015). Minority stress and mechanisms of risk for depression and suicidal ideation among lesbian, gay, and bisexual youth. Developmental Psychology, 51(5), 688–696. https://doi.org/10.1037/a0038994
4.
BariolaE.LyonsA.LeonardW.PittsM.BadcockP.CouchM. (2015). Demographic and psychosocial factors associated with psychological distress and resilience among transgender individuals. American Journal of Public Health, 105(10), 2108–2116. https://doi.org/10.2105/AJPH.2015.302763
5.
BarkerH.WylieK. (2008). Are the criteria for the “real-life experience” stage of assessment for GID useful to patients and therapists?International Journal of Transgenderism, 10, 121–131. https://doi.org/10.1080/15532730802297314
6.
BocktingW. O.MinerM. H.Swinburne RomineR. E.HamiltonA.ColemanE. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. American Journal of Public Health, 103(5), 943–951. https://doi.org/10.2105/AJPH.2013.301241
7.
BrodayS. F.MasonJ. L. (1991). Internal consistency of the Brief Symptom Inventory for counseling-center clients. Psychological Reports, 68(1), Article 94. https://doi.org/10.2466/PR0.68.1.94-94
CatalpaJ. M.McGuireJ. K. (2018). Family boundary ambiguity among transgender youth. Family Relations: An Interdisciplinary Journal of Applied Family Studies, 67(1), 88–103. https://doi.org/10.1111/fare.12304
10.
ColizziM.CostaR.TodarelloO. (2014). Transsexual patients’ psychiatric comorbidity and positive effect of cross-sex hormonal treatment on mental health: Results from a longitudinal study. Pscyhoneurendocrinology, 39, 65–73. https://doi.org/10.1016/j.psyneuen.2013.09.029
11.
ConnollyM.ZervosM.BaroneC.JohnsonC.JosephC. (2016). The mental health of transgender youth: Advances in understanding. Journal of Adolescent Health, 59(5), 489–495. https://doi.org/10.1016/j.jadohealth.2016.06.012
12.
CoolhartD.ShipmanD. L. (2017). Working toward family attunement: Family therapy with transgender and gender nonconforming children and adolescents. Psychiatric Clinics of North America, 40, 113–125. https://doi.org/10.1016/j.psc.2016.10.002
13.
DunnT. W.BurlingameG. M.WalbridgeM.SmithJ.CrumM. J. (2005). Outcome assessment for children and adolescents: Psychometric validation of the Youth Outcome Questionnaire 30.1 (Y-OQ®-30.1). Clinical Psychology & Psychotherapy, 12(5), 388–401. https://doi.org/10.1002/cpp.461
14.
FreyL. M.HuntQ. A. (2017). Treatment for suicidal thoughts and behavior: A review of family-based interventions. Journal of Marital and Family Therapy, 44, 107–124. https://doi.org/10.1111/jmft.12234
15.
GehartD. R. (2016). Theory and treatment planning in counseling and psychotherapy. Cengage Learning.
16.
GrantJ. M.MattetL. A.TanisJ.HarrisonJ.HermanJ. L.KeislingM. (2011). Injustice at every turn: A report of the National Transgender Discrimination Survey. http://endtransdiscrimination.org/report.html
17.
GrossmanA. H.ParkJ. Y.RussellS. T. (2016). Transgender youth and suicidal behaviors: Applying the interpersonal psychological theory of suicide. Journal of Gay and Lesbian Mental Health, 20, 329–349. https://doi.org/10.1080/19359705.2016.1207581
18.
HealyR. W.AllenL. R. (2019). Bowen family Systems therapy with transgender minors: A case study. Clinical Social Work Journal, 1–10. https://doi.org/10.1007/s10615-019-00704-4
19.
HeckN. C.CrootL. C.RobohmJ. S. (2015). Piloting a psychotherapy group for transgender clients: Description and clinical considerations for practitioners. Professional Psychology: Research and Practice, 46(1), 30–36. https://doi.org/10.1037/a0033134
20.
JohnsM. M.LowryR.AndrzejewskiJ.BarriosL. C.DemissieZ.McManusT.RasberryC. N.RobinL.UnderwoodJ. M. (2019). Transgender identity and experiences of violence victimization, substance use, suicide risk, and sexual risk behaviors among high school students – 19 states and large urban school districts, 2017. Morbidity and Mortality Weekly Report, 68, 67–71. https://doi.org/10.15585/mmwr.mm6803a3
21.
Katz-WiseS. L.RosarioM.TsappisM. (2017). LGBT youth and family acceptance. Pediatric Clinical North America, 63, 1011–1025. https://doi.org/10.1016/j.pcl.2016.07.005
22.
KosciwJ. G.GreytakE. A.PalmerN.BoesenM. (2014). The 2013 national school climate survey: The experiences of lesbian, gay, bisexual, and transgender youth in our nation’s schools. GLSEN. https://files.eric.ed.gov/fulltext/ED570433.pdf
23.
MinuchinS.FishmanH. (1981). Family therapy techniques. Harvard University Press.
24.
MinuchinS.ReiterM. D.BordaC. (2014). The craft of family therapy: Challenging certainties. Routledge; Taylor & Francis Group.
25.
NewcombM. E.LaSalaM. C.BourisA.MustanskiB.PradoG.SchragerS. M.HuebnerD. M. (2019). The influence of families on LGBTQ youth health: A call to action for innovation in research and intervention development. LGBT Health, 6, 139–145. https://doi.org/10.1089/lgbt.2018.0157
26.
PachankisJ. E.BernsteinL. B. (2012). An etiological model of anxiety in young gay men: From early stress to public self-consciousness. Psychology of Men & Masculinity, 13(2), 107–122. https://doi.org/10.1037/a0024594
27.
ParkerM. L.MolteniJ. (2017). Structural family therapy and autism spectrum disorder: Bridging the disciplinary divide. American Journal of Family Therapy, 45(3), 135–148. https://doi.org/10.1080/01926187.2017.1303653
28.
ReisnerS. L.GreytakA.ParsonsJ. P.YbarraM. L. (2015). Gender minority stress in adolescence: Disparities in adolescent bullying and substance use by gender identity. Journal of Sex Research, 52, 243–256. https://doi.org/10.1080/00224499.2014.886321
29.
ReisnerS. L.VettersR.LeclercM.ZaslowS.WolfrumS.ShumerD.MimiagaM. J. (2015). Mental health of transgender youth in care at an adolescent urban community health center: A matched retrospective cohort study. The Journal of Adolescent Health, 56, 274–279. https://doi.org/10.1016/j.jadohealth.2014.10.264
30.
RudeS.BatesD. (2005). The use of cognitive and experiential techniques to treat depression. Clinical Case Studies, 4(4), 363–379. https://doi.org/10.1177/1534650103259749
SatirV. (1988). The new peoplemaking. Science and Behavior Books.
33.
SatirV.BaldwinM. (1983). Satir step by step: A guide to creating change in families. Science and Behavior Books.
34.
SatirV.BanmenJ.GerberJ.GomoriM. (1991). The Satir model: Family therapy and beyond. Science and Behavior Books.
35.
ShiresD. A.StroumsaD.JaffeeK. D.WoodfordM. R. (2018). Primary care providers’ willingness to continue gender-affirming hormone therapy for transgender patients. Family Practice, 35, 576–581. https://doi.org/10.1093/fampra/cmx119
36.
ShumerD. E.SpackN. P. (2013). Current management of gender identity disorder in childhood and adolescence: Guidelines, barriers, and areas of controversy. Current Opinion in Endocrinology, Diabetes, and Obesity, 20, 69–73. https://doi.org/10.1097/med.0b013e32835c711e
