The CBT Dive

E20 Interview: Adapting CBT interventions for sexual and gender minorities

• Rahim Thawer, MSW • Episode 20

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In this interview, Dr. Trevor Hart discusses the need for CBT interventions that target sexual and gender minorities (SGM) and explains how they differ from standard psychotherapy. He addresses some of the critiques that are often shared about the CBT approach and shares his perspectives on the utility of goal-oriented models. Finally, he tells listeners what resources they can avail themselves of to learn more about SGM-affirming CBT.

GUEST BIO: Dr. Trevor Hart is the Director of the HIV Prevention Lab at the Toronto Metropolitan University, Department of Psychology. He is also a Research Chair in Gay and Bisexual Men’s Health with the Ontario HIV Treatment Network.Trevor Hart works to develop and test sex-positive, anti-oppressive HIV prevention interventions and psychotherapies for gay, bisexual and other men who have sex with men. His work is both community-based and clinical and relies on a health promotion framework. 
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ABOUT THE CBT DIVE PODCAST
The CBT Dive is a video podcast that brings therapy skills to the real world. Each episode welcomes a new guest who wants to explore a challenging situation using the most common cognitive behavioural therapy tool: the thought record.

ABOUT HOST
Rahim Thawer is a queer, racialized social worker and psychotherapist based in Toronto. He's created The CBT Dive podcast to support folks who want to learn how to use a thought record and to demystify what therapy can look like.

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UNKNOWN:

Thank you.

SPEAKER_00:

Welcome to the CBT Dive, a vodcast that goes into the lives of real people with real struggles. Each episode welcomes a new guest who wants to explore a challenging situation using the most common cognitive behavioral therapy tool, the Thought Record. Your host, Raheem Thawar, is a social worker and psychotherapist based in Toronto and well-known for his work in LGBTQ communities. He's created the CBT Dive to diminish mystify what therapy can look like, and share intervention skills for wellness. We hope that each episode helps you along on your own journey for insight and self-compassion.

SPEAKER_01:

Hello, Dr. Trevor Hart. How are you today?

SPEAKER_02:

I'm doing well. How are you, Rahim?

SPEAKER_01:

I am living the dream. It's so good to see you. Somebody from Toronto.

SPEAKER_02:

Yeah, and I'm excited about your travels across the world.

SPEAKER_01:

Yeah, and I brought the CBT dive with me to Johannesburg. Before we get into it, you know that I have a lot of questions for you. I'm just going to share with our listeners a bit about you. Dr. Hart received his doctorate in clinical psychology from Temple University. After graduate school, he completed a postdoctoral fellowship at Emory University School of Medicine, through which he received training at the US Center for Disease Control and Prevention. He has received several awards for his advancements to research and clinical work, including induction as a fellow of the Canadian Psychological Association and as a fellow of the Association of Behavioral and Cognitive Therapies. Dr. Trevor Hart is the director of the HIV Prevention Lab. He holds a research chair in gay and bisexual men's health from the Ontario HIV AIDS Treatment Network. Dr. Hart is currently conducting multiple studies, including a test of new gay and queer friendly therapies for social anxiety for HIV negative gay and bisexual men, and a study examining how biomedical HIV prevention, such as the use of pre-exposure prophylaxis or PrEP is changing attitudes and sexual health for gay and bisexual queer men across three cities in Canada. He also has a private practice focusing on CBT and other evidence-based therapies related to sexual minority people in Ontario. Dr. Trevor Hart, did I capture all of that okay? Looks good to me. So, I'd love to just tell the viewers, you know, I met Dr. Hart when I was first working, like pre-MSW, like when I was working at the Alliance for South Asian AIDS Prevention, and that was in 2009. So we're talking over a decade ago. And Trevor has been kind enough and supportive enough of my career trajectory to invite me to be on all kinds of advisory committees, And we've spoken together at conferences and he's always been very respectful and kind of supported me along in my career. So I'm excited to have him here. So Trevor, I'd love for you to tell me a bit about CBT. What do you like about it or love about it? And in the therapy you do, what kinds of CBT tools do you tend to gravitate towards?

SPEAKER_02:

Well, one of the things, I wasn't originally trained in my undergrad to do CBT. I was trained in a program that really didn't talk much about it. And so I was a bit surprised about all this CBT stuff. And I had received some negative messages about it too. Oh, it's not real therapy. It's a symptom management. It's not going to help you with anything important. It's just, you know, a surface level thing. And then I found out that when working, doing CBT, I had patients that were getting better. I had patients that were grateful. We were having, making real life changes. I remember being at a practicum where I was helping somebody with one supervisor and then switch supervisors. And then the supervisor was like, why aren't you doing this, that, and the other? Your patient's not really getting better. And I was like, yeah, they're not. And I'm like feeling really upset about it because I like want to really help them. They're really suffering from a lot of anxiety and depression. They were like, you know, have you considered using a CBT approach? And so what I did is I integrated that CBT into the approach that I was already using. And then I had that patient, got a lot better and then they were doing a lot better. And one of their comments to me toward the end was, I've really appreciated all the work that you've done to help me to change my life. But if you don't mind me saying, why don't we start this earlier? Because I felt like we were just kind of like just talking, just talking about stuff, but not making any real changes in my life before. And I was like, so that was one of my first experiences where I was like, maybe the CBT stuff is actually pretty good. And maybe that kind of strong man that's painted, you know, about like, oh, it's surface level is kind of not really accurate. Right. You know, I really think that there is an increasing awareness about the benefits of CBT and that it's realistic. It's realistic and it's effective and it can help people So many things. Yeah.

SPEAKER_01:

You started seeing people get better. And at the end of sessions or at the end of your time with clients, they were thanking you. I've had a similar experience and I find it's part of it is, you know, people really feel like something concrete is getting done and something tangible. And, you know, If you're talking, that can be helpful, but people don't leave with something concrete to reflect on, right? And so something like a thought record I find is really great. I've heard people, they'll take their thought record and then put it on their fridge or they'll reflect on it from time to time. Are there specific CBT tools that you like or use? And do you do them in a written format or do you kind of, do talk therapy in a way that's informed by CBT thinking?

SPEAKER_02:

Yeah, I tend to do work that involves both talking and writing it out. I find that it's hard to remember when people say, oh, I did think about it. I'm like, tell me about what you thought. It's usually kind of very ad hoc and it can be very surface level where it's like, I thought to myself, I don't know, imagine I was giving a presentation on a video podcast to, you know, an important member of our community and you want to do a good job. Imagine I was doing a thought record. Oh, and I thought, well, you know, I guess I'm going to flub this up. I'm not going to sound competent. And then I do it in my head. I might end up with something like, you can do it. Like just something that like you might hear from your friends, right? But if you do a full thought record, I think you can go a little bit deeper than cheerleading. And I think cheerleading is good, by the way, but I think we can do even more than that as therapists. But I want to answer your question about tools, too. Do you want me to hold on for a sec?

SPEAKER_01:

No, I just wanted to say, when you said you can go deeper beyond the cheerleading, I think I just want to point out to people that the process of coming up with the negative automatic thoughts and then distilling them a bit has so much depth to it. And so it really counters that idea that it's surface level because when you're digging what's underneath the automatic thought, it does go deep. But please go ahead. Tell me about your favorite tools. What do you like? What do you hate?

SPEAKER_02:

I don't think I hate too much, but I tend to use the tools that are used in CBT. CBT has got a lot of tools. There's psychoeducation, which is understanding your psychology, your psychological strengths and your challenges. I think that's a good first step is just to gain some insight as to what do we know? And CBT therapists are not afraid to say, hey, what do we know from the research literature? Like what things have we learned as far as what caused a certain problem or what makes it maintain, but then also making it come to life by talking about, hey, to what extent is that true for you? What's going on in your life or how much does that jive with your experience? That's one tool. Another tool is cognitive restructuring, which is helping to change the way that we think so that our thinking is more rational, helpful, or aligned with our values. And I'd say that's a key component of the thinking part of CBT, changing the way we think so that we can think in a way that makes us feel better. There's also behavioral experiments or exposures, facing difficult and anxiety-provoking situations so we can do what we want to do in life. There's relaxation exercises that we can use when we're feeling stressed or just having new ways to reduce our muscle tension and our anxiety. And then there's mindfulness exercises like learning to live in the moment and to understand our thoughts and feelings as believing experiences like anything else that we can experience and not be overwhelmed by our own thoughts. So I'd say all of those things would be things that I think are great tools and we've got great evidence for them.

SPEAKER_01:

Great. I'm so glad you talked about both psychoeducation and mindfulness, because people sometimes will start therapy, in my experience, and they'll say, I've received this diagnostic label, right? And I might say, do you know what that means? Or what does that mean to you? And sometimes I'll say, it wasn't really explained to me. I've just had it forever. So a bit of psychoeducation about like, when is this diagnosis usually given? What does it tend to mean? What are the common symptoms? How does it look in different people? What can it, how does it manifest in your life? What might it prevent you from doing? Or why might something be difficult? Goes a really long way. I'm glad you mentioned mindfulness because it's not always talked about as being part of the package of CBT. But for a lot of folks, you know, we can only access our rational mind or alternative ways of thinking once we're grounded. And so pairing that, you know, sometimes students I supervise will say, when do I use this mindfulness business? And I'm like, well, it could even be a good way to... It could be something useful to do before you do a thought record or before you get deep into the thoughts, right? Help ground somebody and help reduce their level of anxiety. I personally find behavioral experiments very challenging to do with my clients. Dr. Hart, do you have trouble with those or any of the tools? Or do you find, is there a tool that you find clients have a lot of trouble with?

SPEAKER_02:

I think it's pretty random to me what folks will have more trouble with or less. I think some folks have trouble getting their mind around cognitive restructuring, either because it's a little tough for them to kind of figure out their own thoughts. They're not aware of their thoughts or they find it a little bit, for some folks, it can be a little intellectually challenging where it's like, what is it after what? And then I have to do what? Like there's a bunch of steps. And for other folks, they're so intellectual that they get wrapped up in their own thoughts. And I have to take them back down to earth and be like, let's talk about which thoughts are helpful as opposed to having a discussion about what thought is more logical and what thought is less logical and what does logic mean? And you can go there if you're not aware that your goal is really to help the person and not to have a really interesting conversation. For behavioral stuff, people are avoidant. People don't come to see you for CBT usually because they're feeling... confident in their ability to do whatever they want to do, right? So they do this thing called avoidance, where they avoid doing the things that they want to do. They wanted to ask somebody out for sex or for a date or to hang out, but they avoided it. They wanted to tell their boss that they had some good ideas that could change the way that they do things at work, but they avoided it. They wanted to speak up at a meeting, but they avoided it. And so all these behavioral experiments, those are all things about going to do the things you want to do, testing out your thoughts. So if you have a thought, no one cares about what I have to say at work, and then that thought leads you to not acting, you can use a behavioral experiment to say, hey, how about I intentionally say raise my hand at that Zoom meeting or in-person meeting and I articulate my point. And will people just say nothing or will people say that's a good point? There's opportunities for people to learn about how they can engage with the things that they want to do. They can feel strong and empowered.

SPEAKER_01:

Okay. I love that example. You're making me want to try behavioral experiments again. Yeah. I really like that you point out that, you know, it's not supposed to be easy. People are coming to work on things that they're avoiding or having a hard time with. I find that like that gives me, helps me access my own empathy and working with clients. Because I think it can sometimes, when you're lacking motivation or you're afraid of judgment, sometimes, I think it's stressful for the client to put themselves in a difficult position, and sometimes it's stressful for the therapist. And as I'm thinking about it, I'm thinking, oh, I wonder if it's my anxiety that gets in the way. What if my client tries something in a behavioral experiment and it doesn't go their way? And so it's like I'm catching their anxiety. It's contagious. So I have to work on that. Trevor, what is it about CBT that makes it so popular? It seems to be a common go-to for a lot of people and organizations. You know, I've had students I supervise that say, teach me CBT. And I'll say, okay, I'm happy to. What interests you about it? And they'll say, every job description I've looked at says I need to know how to do this. So maybe you can shed some light on why it's so widespread and so popular, particularly in the nonprofit sector.

SPEAKER_02:

Well, let me tell you, that was not the case when you and I first met, whether it's your first memory of me or vice versa, that was not the case. I think things have changed in the last 10 years and it's a part of an ongoing change. And the push is really towards just a pragmatic focus, like just like we want people to get better. We know that there's a variety of therapies available and CBT is not the only therapy that you could use, but we also know that CBT has a strong evidence base for it saying, you know what, it's, it's going to help. It's going to help you with your clients or patients, by the way, use those terms interchangeably, the humans that we're trying to help. Yes. So, uh, that it works, basically. So at first, I think there was some, even some resistance to CBT, like, oh boy, it's surface level because of psychodynamic people thought that they were doing very deep work or the more humanistic people didn't like that it was directive because it meant that you were disempowering the person and So there was a lot of resistance, actually, and there still is quite a bit of resistance in the field against CBT. But I have to say, I think what people like at community-based organizations is that they like their people getting better quickly and that they care less about what theory and how much the therapist likes the theory and is sold by the theory. What they care about is not theory. What they care about is, can we show the government? that we've helped 300 people get better in the past year that and we can show like actually show that it was not just they said they really liked it and they learned a lot but they said

SPEAKER_03:

yeah

SPEAKER_02:

i'm feeling better and now i'm able to function i'm able to i'm able to uh get off of ODSP if they want to do so, touch and go as to whether that's even a good idea in, you know, in Ontario, you know, because of our disability framework is very challenging to work with. I'm able to get to work. I'm able to enjoy my love life and my sex life. And so I think that that's, I think it's really just the, that many of the organizations that we work with, they don't care about our theories. What they want to know is what gets people better. And by the way, I want to tell you, I'm not in the CBT camp. I'm not in a camp. I'm not a part of, I don't follow. I'm not a Beckian or an Elysian. We don't have that in the way that I was trained. What we have is evidence-based. And I will tell you that if we find that something else works better than CBT, And we can show that it works better than CBT. I'm going to be pissed, but you know what? I'll be pissed. I'll be pissed because I'm old. And that means I have to learn new stuff. That is why. Not because I think CBT is the way to go. I just think right now it's got the strongest evidence base. And I want to help my clients the best I can.

SPEAKER_01:

Yeah. No, that makes a lot of sense. And I think you've known that, you know, I've been of two minds about CBT. I think it wasn't too many years ago that I was quite critical of it. Do you remember that?

SPEAKER_02:

I do. And I remember us having a conversation. I was like, what about CBT? And you were just like, meh. And I was like, okay. I'm like, I don't know what to say because I mean, so much of it when we're trying to fellow therapists, it's about your readiness to accept messages and your readiness. And I was like, I don't know what's my place to tell a fellow therapist what to do. Yeah. But I've

SPEAKER_01:

come some way. I was

SPEAKER_02:

surprised you came to me with the CBT dive. I was like, okay.

SPEAKER_01:

Yes.

SPEAKER_02:

I was not expecting it. I

SPEAKER_01:

think we should pause there for a moment and just delve into that if we can. Okay. I asked you to come on the show for that very reason, I think, because I've been at a conference where you've talked about CBT and I've been like, I don't think this is a great idea. I don't think this is great for clients. I've had strong opinions like that. And I continue to be of two minds about CBT, you know, when I'm like, I'm not sure it works for everybody. But, you know, there's a few things that I've realized. One is that CBT can be adapted. to work for different people. And two, it's easy to criticize something when you are struggling with using it yourself. And so that's an admission that I didn't fully know how I could use these tools. And when I started to supervise students, I found by the time I started to supervise students, I had taken two intense trainings in CBT and they came in with a lot of critiques about it. And they would say, it's not client-centered, it's not this, it's not that, it's not anti-oppressive. And I would say, well, I don't know that that's true. I think any therapeutic modality can be done badly, right? You could say, You could say, you know, psychodynamic free association is client centered because the client gets to do a lot of the talking. You could say CBT is client centered because a client picks the goal. You could say both of those are bad for somebody through some other rationale. So I said to my students, and I've come to learn this very much. You can critique something once you've learned how to do it and you've attempted it, right? You really need to try it with clients and see how it can fit into your practice. And I started the CBT dive because I thought I really want students of therapy, people who are training in CBT, other professionals, And folks who've gone through some therapy to just come to the podcast and see how we work through things in a very linear way. I think that's one of my favorite things is how you can really isolate a problem and work through it in a linear way. So it feels like I've come to a point in my career where I'm appreciating a lot of the work you've done for so many years, Trevor. So I just want to say thank you for that.

SPEAKER_02:

I'm honored, Rahim. You're such a leader in the field that it's, you know, I knew you when you were kind of at the earlier stages of your career. Yeah. And then you're just, I see you as, you know, at the top of your game and just a real contributor to our community. Someone whose voice is so valued and so appreciated. And so, Rahim, I'm glad I could contribute in some way. I mean, I think we're all learning from each other in the community, both the therapy community and also kind of the sexual and gender minority community. I think when we listen, we can also listen to critiques, but also hear where the critiques are coming from. Then we can improve our work, which is part of what I'm trying to do is improve what CBT does.

SPEAKER_01:

And having said that, so, We both do a lot of work with LGBTQ communities or sexual and gender minorities. And from what I understand, a lot of your research and some of the practices you've developed or drawn on are about using CBT with LGBTQ communities. Can you tell me a bit about what that work has entailed and why is there even a need to adapt interventions to make them, you know, queer and trans-specific or queer and trans-aware or queer and trans-competent. You could see that I'm not even sure what the language is, but there's a kind of adaptation that people talk about. Tell us a bit about it.

SPEAKER_02:

I mean, CBT, while it's really effective, it hasn't really been tested in the context of the things that many of us would experience who are members of sexual and gender minority communities, the LGBTQ2I community. and all the other identities that I haven't listed. So it doesn't, CBT as done by cisgender straight people probably isn't going to take a look at societal homophobia, transphobia, heteronormativity, cisnormativity. And these are all things that we live in as sexual and gender minority people. Like this is our context, whether we wanted it to be or not. And so what ends up happening is we experience a lot of extra stresses compared to people that might be a cisgender heterosexual person. People have, everyone has stresses in their lives. Everybody has potentially financial stresses or family stresses or financial work stresses or other relationship stresses or social problems. But when you're a queer or trans or other sexual or gender minority person, you also have to deal with being treated in really derogatory ways as kids and as adults, fear of being rejected for who you are, literally like, should I tell this person? Should I not tell this person? Do they know? Are they going to treat me poorly because I exist? Or will they not treat me poorly because I exist? Do I try to hide whether I exist? Dealing with heteronormative and cisnormative comments from our family, like your own family of origin that might have been a place of support might actually also be a place of great oppression and concerns about where it's safe to be out. So there's like a, I think there's a profound need for intervention that can be evidence-based but explicitly anti-oppressive.

SPEAKER_01:

Yeah. So what does an affirmative CBT practice look like? And how does it differ from standard psychotherapy? How does somebody know they're being like LGBT affirming in their practice?

SPEAKER_02:

It's easier said than done, but it is also easily done. It just needs some thought. The affirmative interventions, they're going to talk about the things that people normally talk about. So let's say if you've got somebody who's coming to work with you because they're having panic attacks, you might still help that person with their panic attacks. If they're depressed, you're still gonna help that person with depression, but you'd also can talk about stresses that we experience in the community. And sometimes those are called those minority stressors. So the stressors of being a part of a minoritized group, and we've talked about specifically kind of heteronormative and cisnormative kind of stressors, but this could be true for all forms of oppression, whether it's racist stressors or sexist stressors or classist stressors or anti-immigration stressors or anti-religion-based stressors. So things that basically make you feel other than for doing nothing wrong whatsoever just existing as a person that had your identities. And so these affirmative interventions, they'll talk about oppressive forces and for STM people by helping STM people, sexual and gender minority people, find ways to live their lives. Like for example, our sexual confidence CBT program that we're testing out at Ryerson goes beyond typical CBT for addressing social anxiety disorders. So usually social anxiety disorder, CBT, you would talk about how you think about yourselves, face anxiety-provoking situations, like asking somebody out for a date or to hang out or going to a party, speaking up at a meeting. And all of this is great. This is great. But standard CBT therapists won't think about asking about, hey, you know what, here's another stressful situation. How about what do you do when you hear homophobic comments on the street? What about a social anxiety situation called, I would like to hold hands with my partner who does not appear to be of the other gender? right? So, you know, like a heterosexual relationship, what do I do when I'm holding hands with my gender diverse or trans or same sex partner? And they won't talk about gay sex. They won't talk about trans sex. They don't talk about, oh my goodness, we have sex too, because it's like very uncomfortable to talk about sex. Like that's inappropriate. And that's, but sex is an interpersonal situation where people kind of need to be assertive if they want to be able to give consent. So in the standard CBT, they wouldn't talk about any of this stuff, but in our sexual confidence CBT program, we talk a lot about it. So it's still CBT, but it talks about the stresses that we experience in the community.

SPEAKER_01:

Well, This is the first I'm hearing of this sexual confidence CBT, and it sounds really fascinating. So perhaps you could share a link so listeners, I'll put it in the show notes and listeners can check it out. It sounds really interesting. So what I'm getting from you about queer and trans affirming or SGM affirming CBT is that one, it really takes into account like systemic issues people face, like kinds of discrimination and validates that. So we're not trying to change a thought around, you know, I experience homophobia and you're trying to convert that into a positive. That's not what we're doing. We're affirming people's difficult experiences in the world. And the other part of that is as the as the affirming CBT therapist, you're going to places, topics, issues in somebody's life that have to do with the subculture they live in. So things to do with sex and sexuality, the interpersonal experience of being with somebody else, dealing with things like maybe internalized stigma or homophobia, that kind of thing. That sounds really fascinating. I'm also thinking, You know, what do you say to people who might say that CBT is too short term or perhaps too surface level to deal with things like oppression, which is essentially what you're talking about, right? When you talk about discrimination people face, how do you respond to that?

SPEAKER_02:

Well, I mean, the first way is by saying, well, but we are doing anti-oppressive CBT, so I think it could happen. Not only do I think it could happen, we're doing it, and anecdotally, we're seeing some really good outcomes, and we're really happy about the improvements that some of our participants have been having. You know, CBT can be really short-term. But it is not always. I mean, there are very effective programs that you could treat insomnia in only two to four sessions. That's really cool. And although those short-term therapies are amazing, CBT can also be used to help people to process and move through past traumatic experiences. That doesn't sound surface level to deal with social isolation, to deal with feeling unlovable. feeling unworthy as a person, feeling incompetent, feeling like that you're less of a person because you're a sexual or gender minority person, or because of your experiences as a racialized or indigenous person. I don't consider any of that stuff to be surface level. I consider that stuff to be, in my opinion, very deep. And CBT doesn't need to be short-term in order to be CBT. I've seen some folks for as short as two sessions, but I've seen some other folks for longer than two years, depending on their needs. You know, my goal, what's different in CBT versus some other therapies, not all therapies, but some other therapies is that the CBT therapist always has a goal to help that person to become independent and And to feel like a whole person without meeting the therapist, that the goal is to get, they, that's a learning model in a way where you might learn some new skills, but eventually you don't need to, because you know, as much as the therapist does and you're using those skills, you're not just a knowledgeable in your head, but you're using those skills to strengthen yourself and to empower yourself on the inside. And so it, it, CBT does lean on the side of shorter term therapies, but what shorter term means for person A is going to be really different than person B.

SPEAKER_01:

Yeah, I really appreciate that. And you know, when you first were talking about, you were listing off some core beliefs, right? Like I'm unworthy, I'm unlovable. I think CBT has done a really good job of distilling a lot of common core beliefs. And I think when people look at those at a first glance, I think that's what makes it seem like it might be simplistic or surface level. But actually, I think this is where the psychoeducation comes in, particularly around trauma, right? Like when we look at having difficult experiences in the world, those shift the ways we see ourselves and the world. They shift how we see the past, present, and future, right? And it's in that context that we talk about core beliefs. So it absolutely can be trauma-informed or trauma-focused. Thank you for helping me clarify that. That is something I've also wanted people to hear and to acknowledge. Trevor, what are the last questions I have for you? Where can people learn to be more affirming of sexual and gender minorities in their approach to CBT? Is there something they can read? Are there trainings, I don't know, you provide? Where can people learn more about this?

SPEAKER_02:

Well, the fields could be a lot bigger than it is, but for the people who are listening, if you're listening, we've got something for you. So first of all, there is a book called The Handbook of Evidence-Based Mental Health Practice with Sexual and Gender Minorities by John Pachankis and Stephen Safran, who are the editors. And it kind of reviews the literature, but also gives some examples of like, okay, here's how you do this thing. Here's how you do that thing. And so these folks are folks, the editors are folks that are all about affirming and affirmative practice in CBT with a focus in on sexual and gender minority people. I'd also say that like in the age of Google Scholar, you can actually, a lot of people don't know about it. They're like, what? You mean I can look at all of the articles? You can look at a lot of scientific articles for free just by going to Google Scholar and maybe there are other free resources as well that are of other companies. But that's, I happen to use it frequently and sometimes a lot of the stuff is free. And there are journals like cognitive and behavioral practice where it's journals that have articles in it, but they're written for us as clinicians, as therapists, as counselors. So it's like, okay, here's the problem. Let me walk you through it. Let me tell you how we address this problem. Here's how you can do it too. So there are journals like that as well. And we do do some stuff at our gay counseling training hub. So we have something called, again, gay counseling training hub. I can send you the link for that as well. And what we do is we listen to the needs of the community and people tell us like, I want a training on X, you know, or a community organization wants to get a training on affirmative CBT, or they want to get training on, can you just give us some basics of working with LGBTQ2I people?

SPEAKER_01:

Yeah.

SPEAKER_02:

Great. Or you want to learn how to do motivational interviewing, which is another kind of evidence-based counseling. And you want to know how to do that to help your clients to to make important changes in their lives, like kind of changes, let's say, in their health behaviors or other aspects of their life. We offer all of that and it's specifically focused on gay, bi, queer men. But if you are seeking a training that's kind of more broad for sexual and gender minority folks, We're still into it. So we're not exclusivists. We're just funded to do this work by our funder with Gay by Queer Men. But yeah, we'd be glad to provide that training. And that's a big part of where the field needs to go is to training folks and helping folks who want to help others.

SPEAKER_01:

Great. Dr. Trevor Hart, thank you so much for being a guest on this show. I'm really glad to have had you, and I look forward to running into you at a conference again and talking shop, and maybe we will co-present someday on CBT in sexual and gender minority communities. Thanks for being here.

SPEAKER_02:

Thanks, Rahim. It's always a pleasure to chat with you.

SPEAKER_00:

Thanks for tuning in to the CBT Dive. Don't miss an episode. Subscribe to our YouTube channel at thecbtdive.ca. You can also listen on the go wherever you get your podcasts. To follow Rahim on social media, check out ladyativan.com. See you soon.

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Rahim Thawer, MSW

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