Inspira Advantage interviewed Dr. Rachel Friedman to understand how clinical psychologists help diverse populations. Dr. Rachel Friedman is a clinical psychologist at NYCBT.
What are some of the most common mental health challenges you see among the LGBTQ+ community in New York, and how does CBT uniquely address them?
I believe that the mental health challenges seen in New York are akin to the challenges that the LGBTQ+IA community experiences across the country. LGBTQ+IA community members are uniquely exposed to a level of discrimination, medical invalidation, rejection from family and peers, and fear for safety in public spaces that heteronormative identifying people do not experience. These challenges can make it all the more likely that an individual develops anxiety, depression, PTSD, internalized negative beliefs about themselves, social isolation and feelings of loneliness, and can increase the risk of suicide or self-harm.
CBT as a treatment approach is specifically designed to help all of these mental health concerns. By examining negative thought patterns, we can directly evaluate the way our thoughts influence our emotions and our behaviors. While certain thought patterns may have stemmed from negative, discriminatory experiences, CBT can help challenge these thoughts. This is especially true if the thoughts have generalized over time and contributed to a decreased sense of self-esteem. Through collaborative conversations, alternative perspectives can be reached and the client will gradually see a decrease in anxiety and depression. What’s even better is these unpleasant feelings are often replaced by greater openness for experiencing pleasant emotions.
For aspiring healthcare professionals, what would you say they should understand about the role of CBT in improving patient outcomes and building trust with clients?
CBT therapists at the core of our training learn to challenge thought patterns. However, in working with the LGBTQ+IA community, it’s also so critically important to balance changing thoughts with validating the emotional experiences of LGBTQ+IA folks. Many queer persons have lost or have strained relationships with loved ones; creating a safe, validating, trusting and affirming relationship with your client is vital. If a client has experienced relationship rifts, treatment often incorporates teaching clients assertiveness skills and working to challenge worry thoughts and fears about their ability to advocate for themselves, or ask for apologies from those that have caused hurt and pain. Many times, helping a client to repair a relationship, or, establish healthy boundaries and distancing themselves (and increasing connection to a chosen family!) is the element of treatment that can have the greatest impact on patient outcomes.
Can you share a success story or impactful case where CBT made a significant difference, and what lessons future providers can take from it?
Generally speaking, I have seen CBT provide the skills necessary for individuals to create and live the life that they seek. Many of the clients we see in our LGBTQ+ Mental Health program have struggled with self acceptance. A major barrier to self-acceptance can be internalized homophobia. In labeling this, processing the shame associated with these beliefs, and increasing the use of self-validating statements, we have been able to decrease the painful self-hatred that my clients have felt so deeply for many years. Through this work, there is also an increase in value actioned behaviors that allowed for freedom of self expression, and greater connection to their sense of self. Future providers, I impart this wisdom: never lose faith in the power of CBT! The beliefs these folks have can be so deeply ingrained and instilled, and may take time to shape–but the hard work is always worth it and so very rewarding for all.
For more information about NYCBT's LGBTQ+ Mental Health resources, click here: https://www.newyorkcbt.com/lgbtq-mental-health-2/
Inspira Advantage is proud to interview experts like Dr. Rachel Friedman to help future doctors understand the challenges and rewards of a medical career.
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