College Mental Health

Dr. Hannah Roberts · March 14, 2024 ·

Creating a Safe Space for LGBTQ+ People in Therapy

“It takes no compromise to give people their rights…

it takes no money to respect the individual.

It takes no political deal to give people freedom.

It takes no survey to remove repression.”

~Harvey Milk

by Gavin Hannegan, Cal Poly, San Luis Obispo undergraduate intern, supervised by Dr. Hannah Roberts

Therapy can be an incredibly rewarding experience, so it is important to create a comfortable environment for your clients. For LGBTQ+ folk, it is even more important. The therapist-client relationship can offer a safe space for LGBTQ+ individuals to be able to freely express themselves without judgment. But this community may feel overwhelmed trying to find a therapist that affirms them. You might explicitly state that you welcome people of all backgrounds, which is a great start, but how can you follow this statement up with action?

Here, we will be offering a few tips to help you better affirm your LGBTQ+ clients. As you read, keep in mind that the process of building that trust with your client may take time. Some clients may be more receptive to you than others. But with enough time, the relationship you build with your LGBTQ+ clients can become a valuable resource for that community.

Be Open to Learn

A common misconception is that to be an LGBTQ-affirming therapist, you have to also identify as a member of the LGBTQ community, but practicing empathy with your clients can help bridge any gaps. One theme that emerged in interviews with SLO County residents who attended therapy is that positive experiences with therapists occurred when the therapist were willing to learn more about LGBTQ identities, regardless of if the therapist identified as LGBTQ or not (Bettergarcia et al., 2021). You might ask your clients some questions about their identities to better understand your perspective. Here are some examples:

“Tell me more about this.”
“I’m not sure I fully understand where you’re coming from. Could you help me understand?”
“What makes you feel most affirmed?”

Allow your clients to educate you too. They should feel comfortable enough to correct you and explain how that made them feel. However, it is not their job to teach you everything about how to effectively work with the LGBTQ+ population; you may need to do some homework and develop your knowledge outside of the session.

Actively Validate Their Identities

An active effort with your LGBTQ+ clients is key. In their research, Anzani et al. (2019) distinguish between passive forms of affirmation towards trans people (i.e., not using microaggressions) and active forms of affirmation (i.e., encouraging gender exploration). While both forms can be helpful, Anzani et al. (2019) recommend that therapists strive to be actively affirming in order to help their clients navigate the cisnormativity that exists within society. Active validation looks like:

Connecting your clients to local groups and resources
Using your client’s correct name and pronouns before, during, and after transitioning
Treating your client’s identities as normal and authentic

In other words, an affirming therapist should do more than the bare minimum. The work that you do with the LGBTQ+ population can create positive change both in and out of a session. Take some time to reflect on how you approach LGBTQ+ issues with your clients. Do you simply acknowledge homophobia or transphobia or do you work with your clients to develop tactics to combat these prejudices?

Treat Your Clients as Individuals, Rather Than as Representatives of A Group

The ways in which one client experiences their identities might not be the same ways that other queer folk experience their identities. If you generalize these experiences by saying something like, “All gay people experience…,” then that could harm your connection with your clients. Remember that the label of LGBTQ+ encompasses many different identities. In one survey, mental health clinicians reported that even though they might be affirming of lesbian, gay, and bisexual clients equally, they actually perceive themselves to be more competent when treating lesbian and gay clients compared to bisexual clients (Ebersole et al., 2018). Each of these distinct identities can bring unique experiences–on top of the unique experiences that each individual already has! If you feel unfamiliar with some of the identities within the LGBTQ+ label, it may be best to do some research on your own time. You can also ask your clients for clarification, but do this sparingly. You might also need to adopt a multicultural approach and to consider the interplay of multiple identities. Keefe et al. (2023) found that racial and ethnic minorities who also identified as LGBQ responded best to mental health programs that emphasized the minority stress model, compared to those that did not implement this model. In other words, racial and ethnic minorities may be subject to discrimination based on race and discrimination based on LGBTQ+ status, so you should account for each of these influences when they apply.

One last note: a client’s reasons for attending therapy might not even be related to their gender or sexual identity. While you should not outright ignore their identities, it may not be necessary to always attribute certain topics to their gender identity or sexual orientation. These identities are just a few aspects of who someone is. Remember that this is your journey, and you deserve to feel respected and affirmed in the ways that feel most comfortable to you.

Feel like you want your clients to have more information? Here’s a blog post that features the same tips, but directed specifically towards potential clients seeking LGBTQ-affirming therapists.

Have more questions or feel like you need supportive therapy? Schedule a session with one of our therapists today! You can schedule online here!

We hope you enjoyed this blog post! Have more topics you’d like us to blog about? Contact us and we’ll be sure to include your topic in a future post!

References

Anzani, A., Morris, E. R., & Galupo, P. (2019). From absence of microaggressions to seeing authentic gender: Transgender clients’ experiences with microaffirmations in therapy. Journal of LGBT Issues in Counseling, 13(4), 258-275. https://doi.org/10.1080/15538605.2019.1662359

Bettergarcia, J., Wedell, E., Shrewsbury, A. M., & Thomson, B. R. (2021). “There’s a stopgap in the conversation”: LGBTQ+ mental health care and community connection in a semi-rural county. Journal of Gay & Lesbian Mental Health, 26(1), 48-75. https://doi.org/10.1080/19359705.2021.1900973

Ebersole, R. C., Dillon, F. R., & Eklund, A. C. (2018). Mental health clinicians’ perceived competence for affirmative practice with bisexual clients in comparison to lesbian and gay clients. Journal of Bisexuality, 18(2), 127-144. https://doi.org/10.1080/15299716.2018.1428711

Keefe, J. R., Rodriguez-Seijas, C., Jackson, S. D., Bränström R., Harkness, A., Safren, S. A., Hatzenbuehler, M. L., & Pachankis, J. E. (2023). Moderators of LGBQ-affirmative cognitive behavioral therapy: ESTEEM is especially effective among Black and Latino sexual minority men. Journal of Consulting and Clinical Psychology, 91(3), 150-164. https://doi.org/10.1037/ccp0000799

Sarah Park · September 14, 2017 ·

I remember missing my bedroom from home during my first quarter of my freshmen year of college. I went from being the only person in my room to living with 3 other women. It was tense and not all of our personalities fit well. We started off polite enough but soon we devolved into yelling matches. None of us were bad people, we were just in a strange new situation without a lot of understanding of how to address the conflict we kept running into. Here is a list of 5 things I wish I knew when I was experiencing living with roommates for the first time.

1. Communication

I really should say TIMELY communication. Don’t let things build. What often happens is people let things slide until they can’t stand it anymore then when they finally say something it comes out with an edge of frustration or anger. This leaves the other person feeling surprised or defensive.

Let’s look at an example of how to communicate clearly. The situation is that you notice that your roommate used your computer without asking and you are not ok with this. Maybe you would have let them use your computer if they had asked but it feels like a violation for them to just use it.

Step 1: State the facts. In a calm tone say; “I saw you used my computer while I was out.”

Step 2: Express how you are feeling. “When you use my things without asking it makes me feel uncomfortable.”

Step 3: Tell them what you would like in the future. “Next time I would like you to ask before you use any of my stuff. If I’m not here it’s ok to text me.”

Step 4: Indicate what the outcome will be if they do what you ask of them in the future. “I would like to continue to build a trusting relationship with you and this will help!”

2. Be clear and stay on track.

Even if you follow all the steps above it is still possible that your roommate will respond defensively. A common tactic is to change the fight into something else. For example, “well I had to wash your dishes this morning because you left your cereal bowl in the sink. You should wash your dishes more often so I don’t have to do it.”

I know it is sooooo tempting to be derailed by these types of statements but the best course of action is to stay on topic.

Be a broken record: “We can talk about that later. Right now we are talking about you using my computer without permission. In the future I would like you to ask before using any of my things.”

3. Actually listening.

So far we’ve talked about ways you can communicate clearly to a roommate, but what about when someone is trying to tell you something? It’s important to try and listen to what they are asking of you. Of course there are boundaries to this, you should not stand for abusive and aggressive forms of communication. However, if a roommate is approaching you with a concern in a way that is not abusive it is up to you to really take in a hear what they are saying. It does not mean you agree, it means you respect the other person enough to hear them and let them know you are hearing them. You can use similar steps from number 1 to be a better listener.

Let’s switch perspectives and pretend you are the roommate who used the computer without permission.

Step 1: Repeat what you understood. “What I’m hearing you say is that you are not comfortable with me using your stuff without asking. I didn’t think it was a big deal and I’m hearing that it wasn’t ok with you.”

Step 2: Indicate how their communication makes you feel. “I didn’t mean to make you feel uncomfortable. I’m really sorry for that.”

Step 3: State what you will do in the future. “I’ll totally ask before I use any of your stuff in the future.”

4. Using your resources.

Your Residence Assistants (RAs) and Coordinators of Student Development (CSDs) are trained to help with roommate communication and conflict. Students often go to them as a last resort, I’d encourage you to engage your RA before you at the point of wanting to move out. Both RAs and CSDs can help with mediation and can support you to use better communication skills.

During my college roommate conflict reaching out to our RA was really what helped. Having another person support us to navigate communication was key. We were all so sure our side was right it was nearly impossible for us to discuss our differences without breaking into a fight. The RA provided us the support we needed to stay calm and communicate.

5. Knowing when to walk away.

Sometimes there is just a poor match between roommates and all the communication in the world won’t fix that. Understand what your limits are and talk to your RAs or CSDs about your desire to move. Also understand that moving may not solve everything. There might be other issues with the next roommates and moving isn’t always easy with full dormitories. Weigh your options and honor your needs.

In my situation one of my 3 roommates ended up moving out. It was really what was best for the 4 of us. We were all much happier and we were able to remain friendly with one another. Not everyone is meant to live with each other.

Living with other people is often not simple or immediately easy. However, the close relationships that can result from clear communication and understanding can be priceless. Those women I lived with my freshmen year are still friends of mine and it’s been quite some time since we shared that room together.

If you would like additional support navigating school, roommates and being away from home Thrive San Luis Obispo is here to help. We specialize in helping Cal Poly students adjust and thrive. Contact us today to schedule a consultation and see if coaching or therapy is right for you!

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Dr. Hannah Roberts · September 7, 2017 ·

Dear New College Student:

Congrats! You have made it through that magical, frustrating experience that is high school and are headed off to college! Here is a simple strategy to survive college:

Take It Slow

Didn’t see that one coming? I know. I’m sure everyone in your life is telling you that “these will be the best years of your life.” And you’re getting a lot of advice about making friends, joining every club, going Greek, getting a job, and even how to drink as a university student. All those to-dos can leave college freshmen and transfers nearly paralyzed with overwhelm. So let’s try something different: take your time. Slow down and get tour bearings before you dive in.

Relationships

Yes, relationships are an important part of how to survive college. Know that the first people you meet in college do not need to be your forever friends or your future spouse. Many friendships are built around shared experiences, and while there are many wonderful experiences during Orientation/Week of Welcome, there are often many more bonding moments throughout life. Your roommate does not need to be your sister from another mother – be aware that roommates often have their own honeymoon phase where they first are amazed by all of the wonderful similarities they have, but then quickly spiral into tense arguments when differences show up.

Sex

And, speaking of relationships, sex can wait too. Just because you haven’t yet doesn’t mean you never will. And if you’re not really interested, it’s probably a sign not to push through or to let the other person convince you. Believe me, it’s not worth saying “yes” because you can’t think of why to say “no.” Survive college with fewer hookup regrets.

Parties

When it comes to parties, don’t do anything that doesn’t feel right. You do not need to prove your worth based on how many shots you’ve taken. Not everyone drinks in college and just because you don’t drink tonight doesn’t mean you never will. Survive college without incurring underage drinking or possession of alcohol charges, as well as avoiding hospital visits for alcohol overdose.

Greek Rush

Don’t rush into Rush. Focus on getting grounded and having a positive routine before you think about Greek Life. Fraternity and sorority recruitment take up an incredible amount of time and quite an emotional toll as well. It’s easy to lose track of all that’s happening in your life when you’re headed from one event to another. Maybe that’s why they call it rush? Many universities delay rush for that reason. If you have a choice to think about rushing in winter or spring, or even your sophomore year, choose that! You will end up knowing so much more about the chapters that you choose and you will feel great about them choosing you on bid day.

Schedule It!

One other simple strategy to take it slow and survive college? Put all of the following into a schedule (you can use your calendar on your phone) and protect that schedule no matter what!

Time For You: Find quiet spaces where you can connect with yourself. Don’t forget who you are in this time of transition.
Study Time: Break your assignments and studying down into small, manageable slots most days. Don’t save long, epic cramming sessions for right before finals.
Office Hours: Your professors are there to help, but it’s your responsibility to show up and prove you want to learn. Office hours are a great way to demonstrate your commitment to success, as well as to get to know your faculty.
Nutrition: Eat slowly and mindfully. This also helps with those of you that get tummy troubles when you have stress or anxiety. Looking for more tips on how to eat mindfully – check out this blog post by Dr. Albers, a mindful eating specialist.
Move Your Body: Exercise is a fantastic way to break up an academic day and keep your mind and body healthy and balanced.
Sleep: Try to keep sleep as consistent as possible for optimal brain functioning. Go to bed at the same time most nights and try to aim for seven to nine hours of sleep!

Feeling anxious? Not sure how to make this first year work for you? Got caught in all the excitement and now you’ve fallen behind? We are here for you! Contact us today to schedule a consultation and see if coaching or therapy is right for you!

Dr. Hannah Roberts · September 1, 2017 ·

Letting Go

For the last 18 years or so, a main part of your identity has been about being a parent. You’ve been known as “Emily’s mom.” Your days have been structured around your child’s schedule: what time school begins, what lunch needs they have, what time you have to get to practice, and what groceries need to be picked up. Your house has been constantly filled with the ambient sounds of childhood: first the crying, cooing and babbling; then the sounds of playtime; and more recently, the musical tastes of teens (but let’s admit it: you liked some of their music). And now, everything is eerily quiet. Your days feel strangely empty. Shouldn’t you be doing something? Shouldn’t you be worried about something?

These first few months after your student leaves for college can be disconcerting. And when stressors do arise – you feel helpless and unsure how to help. You can’t just swoop in like you did before. There is the physical distance standing in your way, as well as the legal (yes, the dreaded FERPA restrictions), and psychological distance. That distance can feel like a giant abyss between you and your child.

Your instinct is to leap over that chasm and keep doing what you’ve been doing. At this point, you’ve been worrying and hovering over every scraped knee and every tear shed – it is a comfortable and familiar role for you! And now, today is the day to try something different. And it will be ok.

Giving Some Space

You want nothing more than for you child to be a fully functioning adult. Truly, you want that even more than you want to feel needed. And the only way your child is going to mature into an adult is to learn by doing. And to learn what not to do by doing, as well.

They will make mistakes (so many mistakes). They will change their mind (so many times). They will be disappointed. They will feel rejected. It’s going to hurt to watch these things play out or to see them make choices that may be different from those you would choose for them, but this is the only way for them to learn and grow.

Your role is to now serve as a consultant or advisor… from a distance. When they ask you for help, don’t deny it, but instead reflect questions back to them, asking them what solutions they can think of, including what they think would work best and what they think they can do. Your child’s [perceived] lack of success is not your failure. If you need to vent about these struggles, find an alternative listening ear and keep a neutral, reflective approach when you talk with your student.

Making Communication Clear

If you haven’t already had a conversation with your child about communication, now is the time. Talk about what their preference is and talk about what’s realistic for you. Find a middle ground if possible and talk about emergencies as well. At minimum, it’s probably best to have a dedicated once-weekly check-in time. I’m guessing early in the morning isn’t great for them, and late at night is not so good for you. We’ve often found Sunday afternoons are most convenient: there’s not as much happening on campus and you will be a welcome study break for them.

You might also discuss texting – how much is too much (for them) and how much is too little (for you). Most students welcome fun update texts (with pics of the family dog) that do not require a response. If you do need a response to a text, state that clearly in your message and include a specific time frame.

Set a reasonable expectation for home and campus visits. It is often helpful if your student can stay mostly on campus their first term. If they are missing you (or you are missing them), it might be easier for you to visit them. That way, they don’t sacrifice study time for travel and they can show you their space and introduce you to friends and roommates.

Finding Your Own Path

Be sure to acknowledge all of the many emotions you may be experiencing, both the positive and negative ones. Most of us get really uncomfortable with negative emotions… we don’t like feelings like grief, sadness, and fear. Yet, these are going to be very normal parts of your transition. Acknowledge all emotions, but do not make it your child’s responsibility to soothe those emotions, or expect your student to have the same emotions. What can be helpful is to identify the core value behind those emotions and reframe them in a positive way. You are sad because you miss someone you love. It’s ok to acknowledge the sadness, but keep the emphasis on the love. And if you find that these emotions are getting in the way of your own thriving, then make sure you find your own support with a parent group (Cal Poly’s Parent Facebook Page is great), your spouse, a great therapist, or coach (more about us here).

Use this newfound space and time to do something positive for yourself. What’s that thing you’ve been wanting to do? Set an example for you child by learning a new skill, picking up a hobby, or fostering a new friendship. You student may have secret fears that all your happiness, hopes, and dreams rest on their shoulder – this can contribute to an unspoken sense of pressure and anxiety. If your child sees that you are doing fine with this change, it lets them know that they can be ok with the change as well.

One last thought: Say “I love you” often. You can’t really say it too much. Even if they don’t always say it back. Words are so much more important when there’s physical distance and your love makes all the difference in your child’s confidence and success.

Dr. Hannah Roberts · August 24, 2017 ·

Dear College Student:

Congrats! You are now a college student! All grown up and moving out and so very ready to start the next chapter of your life! One piece of advice: be yourself.

Here’s the scene: It’s your first day on campus for Orientation or Week of Welcome: everyone arrives on campus checking out whatever everyone else is doing. People are wondering what is normal and what is ok and how to feel accepted. Most people make decisions based on what they think their peers will do and what they see their peers doing. But that ends up being really unhealthy and completely unproductive – you end up having friends you have nothing in common with. You’ll feel like an impostor (a very real issue for college students and you’ll feel suffocated by your own experience.

Instead, take this time to really get to know yourself. Listen to your body and your values and your needs. Make decisions that work for you!

For instance:

As much as possible, schedule your classes at times when you are most awake and productive. You can’t always avoid a 7AM class, but if you’re an afternoon person, try to schedule classes in your sweet spot. Same goes for study times.
Take time for yourself. You don’t need to socialize 24/7 (I’m looking at you, introverts!). You probably now share a room with at least one other person, eat in a noisy environment, and now attend how many hours of classes? It can be hard to hear yourself over all that noise, so take some time for yourself. For most people, that can mean finding a quiet spot outside, going on a hike, or taking advantage of your campus’ meditation room, massage chair, or napping pod.
Wear what’s comfortable for you. College is one of the few times in your life where you have absolutely no dress code. Express yourself through your clothing and be comfortable – you will find yourself better able to focus.
Try something you’ve always wanted to. College is all about learning about yourself and there should be plenty of opportunities in your campus clubs or college town to try out new activities or hobbies. Take a pottery class, join the ski club, or try out for a play. If you don’t like it, no one will judge you and you can move on to a new adventure. Who knows? You might just find your life passion and/or your new best friend.
Say no to relationships and hookups that don’t feel good. Life’s too short. Figure out what you want from intimate relationships and friendships and hold out for that. (Note: sometimes it takes a few bad experiences to find out very clearly what you don’t want. Don’t beat yourself up about it, but don’t keep repeating the same regrets).

College is a time to truly get to know yourself. You are the one person that you will spend the rest of your life with, so why not start off becoming the best version of yourself today?!

Having a hard time figuring out who you are and what you want? Not feeling great about navigating the college experience? Already paralyzed by stress and anxiety? We are here to help! Schedule your video coaching session today to make this year your best year yet!