Broadening Understanding in Working Therapeutically With Sexual Minority Young People

Young, Paris and Daiches, Anna and Islam, Nargis (2024) Broadening Understanding in Working Therapeutically With Sexual Minority Young People. PhD thesis, Lancaster University.

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Abstract

Whilst identifying as sexual minorities does not automatically associate one with ill- health, sexual minority individuals, living within heteronormative social structures, continue to experience disproportionately poorer health outcomes compared to their heterosexual counterparts. Young people are particularly vulnerable due to various developmental and social factors. Given healthcare professionals’ role in mitigating health inequality, this thesis explores their personal experiences to broaden current understanding and capture nuances in providing health care to sexual minority young people. Section one presents a systematic literature review of six qualitative studies on the experience of healthcare professionals working with sexual minority youth. Four constructs, representing ‘the complexity of tasks’, were generated using thematic synthesis. They capture understanding young people’s needs, professionals’ personal conflicts, uncertainties, fear of ‘getting it wrong’, relationship complexities, and, most importantly, their desire to support sexual minority youth. The review advocates for prioritising therapeutic relationships over sexuality-specific knowledge and emphasises the need to support healthcare professionals. Section two is an empirical research paper that investigates the experience of psychological therapists working with sexual minority adolescents. Seven participants were interviewed, and their transcripts were analysed with thematic analysis, informed by critical realism. Two dispositional and seven inferential themes were generated, which highlighted the centrality of therapeutic skills in working with sexual minority adolescents, including managing therapists’ own assumptions, agendas, and pulls. The paper also captures socio- political influences within the increasingly politically polarised psychological profession and advocates for profession-wide change to enable open, constructive dialogues. Section three offers a critical appraisal of the author’s reflections on the research process, including its impacts on his personal and professional identity development as a researcher, a social agent, and a psychologist. Particular focus is placed on his reflections regarding the negotiation between personal agency and existing social power.