Providing Relationship Interventions to Same-Sex Couples: Clinical Considerations, Program Adaptations, and Continuing Education

Romantic relationships buffer minority stress in transgender and non-binary adults: Effects on depressive symptoms and suicidality

BACKGROUND

Transgender and non-binary (TNB) individuals are at greater risk of mental health concerns relative to their cisgender peers due to experiences of minority stress. Thus, it is critically important to identify factors that may be protective and buffer the effects of minority stress. This study examined whether romantic relationship involvement and quality buffered effects of TNB minority stress on depressive symptoms and suicidal ideation.

METHODS

A large international sample (n = 1156) of TNB adults (n = 654 partnered; n = 502 single) reported on minority stress experiences, relationship status and quality, and mental health outcomes (i.e., depressive symptoms and suicidal ideation).

RESULTS

The effects of victimization and rejection on depressive symptoms and suicidal ideation were attenuated among partnered individuals. However, once relationship quality was considered, the buffering effects of relationship involvement applied only to those in more satisfying relationships; the stress-buffering effects were not observed among those in distressed relationships. Of particular importance, general interpersonal satisfaction did not act as a minority stress buffer, suggesting there may be unique stress-buffering effects of being in a satisfying romantic relationship on depressive symptoms and suicidal ideation.

LIMITATIONS

The cross-sectional nature of the current study precludes definitive conclusions regarding causation.

CONCLUSIONS

These findings suggest that romantic involvement may serve a stress-buffering role for TNB adults, but only when these relationships are satisfying. Our results have important theoretical and clinical implications, and further research is needed to investigate the utility of relationship interventions to buffer the effects of TNB minority stress on depressive symptoms and suicidality.

Emerging Adult LGB+ Romantic Relationships: Narratives about Met and Unmet Relationship Needs

Although emerging adulthood is recognized as a pivotal time for relationship development, most studies concern heterosexual youth or older sexual minority partners. Using narratives from 40 college student emerging adults, we sought to understand the particularities and generalities of lesbian, gay, bisexual and other sexual minority (LGB+) relationship experiences. Positive experiences particular to being in a LGB+ relationship concerned partner support for coming and being out; support from family members for the relationship was rarely mentioned. Negative experiences were twice as likely to be mentioned as positive ones. They concerned how partners being at different levels of outness and problems with family support stressed the relationship. Generalities pertaining to positive relationship factors included meeting needs for support and using perspective taking to deal with conflict. Negative factors included unmet needs for companionship and intimacy and breakup anxiety about whether the relationship had a future. Our findings suggest the importance of developing strength-based LGB+ affirmative education for emerging adults to promote core relationship processes and strengthen skills to cope with stressors specific to sexual minority romantic partnerships.

Recruiting and retaining sexual and gender minority couples in intervention research: Lessons learned from trials of tailored relationship education programs

Relationship interventions, including healthy relationship education, couple therapy, and dyadic approaches to treating mental and physical health issues, hold promise for promoting relationship and individual health among sexual and gender minority (SGM) populations. Because SGM couples live within a context of societal stigma against their minority identities and relationships, they are likely to be best served by targeted, culturally sensitive relationship interventions that are affirming, free of hetero- and cis-normativity, and address the unique stigma-based challenges that they face. Therefore, a key goal for the field today is to conduct research evaluating and refining newly developed relationship interventions designed specifically for SGM couples. In this paper, we offer recommendations for effectively recruiting and retaining large, diverse samples of SGM couples for clinical trials of tailored relationship interventions, grounded in guidelines for psychological practice and conducting research with SGM populations. Throughout, we offer examples and lessons learned from our experiences conducting clinical trials of tailored SGM relationship education programs. We encourage the use of recruitment and retention strategies that involve members of the target SGM community from the outset, are informed by knowledge about SGM individuals and relationships, use currently preferred language for individual identities and relationships, attend to issues of confidentiality regarding sexual/gender identity or relationship involvement, and adhere to the norms of the particular community and recruitment venue.

Longitudinal associations of relationship support and strain and internalized homophobia with mental health among middle-aged and older gay and bisexual men

Objectives: Mental health concerns (e.g. depression, anxiety) that negatively impact gay, bisexual, and other men who have sex with men (GBMSM) persist over the life course and into old age, but less is known about potential contributors to GBMSM's mental health. Close relationships can be a source of risk or resilience from stress, exerting direct relationships on mental health, and may mediate well-established associations between minority stress and mental health. This study examined whether primary partner relationship support and strain were uniquely associated with, and mediated the association between internalized homophobia, and mental health among older GBMSM.Methods: GBMSM (N = 517, M age = 60) from the Multicenter AIDS Cohort Study, who were in primary relationships with men, provided self-report data at four timepoints. We used multilevel modeling to examine longitudinal associations among relationship support and strain and internalized homophobia with depression and anxiety.Results: Relationship strain, but not support, was positively associated with mental health concerns longitudinally. There was a significant, positive indirect effect of internalized homophobia on depression and anxiety through strain, but no support. Internalized homophobia was positively associated with relationship strain, which was positively associated with mental health symptoms longitudinally.Conclusions: Relationship strain was associated with depression and anxiety longitudinally among middle-aged and older GBMSM and mediated associations of internalized homophobia with mental health. The role of partner support warrants further investigation. Mental health interventions are critically needed for older GBMSM and, for partnered GBMSM, should include strategies for reducing relationship strain to foster well-being.

Internalized homonegativity moderates the association between attachment avoidance and emotional intimacy among same-sex male couples

Introduction

The present study aimed to examine dyadic associations between attachment insecurity and emotional intimacy in same-sex male couples, and to investigate whether and how each partner’s internalized homonegativity (IH) moderated these associations.

Methods

The sample included 138 same-sex male couples. Both dyad members completed self-report measures of attachment insecurity, emotional intimacy, and IH. The actor-partner interdependence model with moderation analysis was applied.

Results

Indicated that higher levels of actor’s and partner’s attachment anxiety and attachment avoidance were associated with lower actor’s emotional intimacy. IH moderated the partner effects of attachment avoidance on emotional intimacy. The partner’s higher attachment avoidance was associated with one’s own lower emotional intimacy at low (but not high) levels of one’s own IH and at high (but not low) levels of the partner’s IH.

Discussion

Findings suggest that the partner’s attachment avoidance may differently affect one’s own emotional intimacy depending on the IH levels of both dyad members. Helping partnered sexual minority men decrease attachment insecurity while recognizing their own and their partners’ IH may promote relationship quality.

Sexual Orientation and Infidelity-Related Behaviors on Social Media Sites

Little research has been focused on offline or online infidelity in GL dating relationships, especially in a post-communist socio-cultural context. Infidelity-related (IR) behaviors on social media sites might be as hurtful to relationships as offline infidelity, both in gay, lesbian (GL) and heterosexual romantic monogamous relationships. In this cross-sectional study, we aimed to examine the associations between dyadic satisfaction, attitudes toward infidelity, and problematic internet usage, with IR behaviors on social media sites among GL and heterosexual unmarried individuals in Romanian sexual minority communities. Results showed that GL respondents did not significantly differ from heterosexual participants regarding IR behaviors. Furthermore, we found the main effect of attitudes toward infidelity and problematic internet use on IR behaviors. Sexual orientation highlights the main effect of IR behaviors when analyzed with dyadic satisfaction. The current study may be a precursor to further research investigating correlations in online IR behavior among lesbian and gay individuals engaging in consensual nonmonogamy. Implications of the findings are discussed in the social context of a post-communist country where GL individuals may face discrimination and stigma because of their sexual orientation.

Attachment and Dyadic Forgiveness in Individuals in Same-Sex Couple Relationships

(1) Background: There is abundant evidence linking attachment insecurity to lower levels of interpersonal forgiveness. However, this association has been almost exclusively explored in people in a different-sex couple relationship, and there is little evidence referring to gay, lesbian, and bisexual (LGB) people in a same-sex relationship. The present study examines the association between romantic attachment and dyadic forgiveness in individuals involved in a same-sex couple relationship. (2) Methods: A total of 248 participants (52.8% female) aged 18-67 years (mean age: 31.02 ± 9.39) completed the Experiences in Close Relationships questionnaire and the Transgression-Related Interpersonal Motivation Inventory. (3) Results: Structural equation modeling showed that attachment avoidance was more strongly associated with dyadic forgiveness than attachment anxiety. Higher levels of attachment anxiety and avoidance were both linked to higher levels of avoidance motivation in response to partner transgressions, and higher attachment avoidance was linked to lower benevolence motivation. Multigroup analyses indicated a gender-specific association between attachment avoidance and revenge motivations, which was positive and significant among men only. (4) Conclusions: In the present study, we have identified that attachment avoidance plays a more prominent role in the tendency to forgive in same-sex couples. Implications at both theoretical and clinical practice levels are discussed.

Cognitive-behavioral couple therapy for same-sex female couples: A pilot study

Despite comparable levels of relationship satisfaction and intimacy, same-sex couples break up faster and more often than different-sex couples, highlighting a need for quality couple therapy. Research suggests that culturally tailored services are desired by same-sex couples and may be more effective and better received. Although efficacious couple therapies exist to treat relationship distress, they have been overwhelmingly studied with different-sex couples. Sexual minority (SM) affirming couple therapies have not been systematically developed or evaluated. The current study involved developing and pilot testing a couple therapy tailored for distressed same-sex female couples. This treatment integrates the SM stress model with the empirically supported cognitive-behavioral couple therapy framework and is the first culturally tailored couple therapy for same-sex couples to be empirically evaluated. Therapists delivered the treatment in an open-trial format to a pilot sample of 11 same-sex female couples experiencing relationship distress and SM stress. Treatment was delivered with high adherence to the treatment manual. Participants reported high treatment satisfaction. As hypothesized, participants experienced significant decreases in relationship distress and improvements in couple coping with SM stress from pre- to post-therapy. Limitations precluded clear conclusions regarding anticipated improvements in individual mental health. Participants experienced comparable or stronger improvements in relationship functioning compared to couples in a similar benchmark study. Given this is a small pilot study, results are interpreted with caution. Implications for culturally tailoring evidence-based couple therapy for marginalized groups are discussed.

Heteronormative Relationship Education for Same-Gender Couples

In recent years, same-gender group-based relationship education has emerged as a viable intervention to prevent relationship distress among same-gender couples. However, many of these programs are conducted in metropolitan areas and lack the ability to reach rural populations. The current study sought to investigate whether two wide-reaching web-based heteronormative relationship education programs could positively impact same-gender relationships. In a sample of 49 same-gender couples, heteronormative relationship education had small (Cohen's d = 0.16-0.39) but reliably positive effects on key areas of relationship functioning and perceived stress relative to a waitlist control group. Additionally, when same-gender couples were matched with different-gender individuals with similar baseline characteristics, no reliable differences between the two groups emerged even though the program effects were sometimes half as large for same-gender couples. Finally, same-gender participants were as satisfied with the program as the matched different-gender individuals. Though the results of the present study indicate that heteronormative relationship education can be helpful for same-gender couples, additional tailoring should be undertaken to ensure that same-gender couples experience as much benefit as possible. Estimates from the current study could be used in future studies to detect what might be small-sized differences.

Exploring Children's Creative Self-Efficacy Affected by After-School Program and Parent-Child Relationships

This study aimed to verify the relationship among children’s creative self-efficacy, parenting style, parent–child relationship, and after-school program. Judgmental sampling was used for subject selection from Taiwan. There are 550 valid participants composed of elementary school to junior high school students; their data were put into the statistical process. The multiple regression analysis was applied in this study. The survey tool was developed based on literature review and related articles. Research result supported the idea that the after-school program was the most significant variable that affected the student’s creative self-efficacy. The “punitive discipline” and “autonomy support” of parenting style can affect positive parent–child relationships as well as students’ creative self-efficacy. Evidence supported the notion that “negative parent–child relationships” will not motivate students’ creative self-efficacy. Besides, the after-school program plays an important role in the students’ creative self-efficacy independently.

Gay, Lesbian, and Heterosexual Couples About to Begin Couples Therapy: An Online Relationship Assessment of 40,681 Couples

We currently have little idea of precisely who goes for couples therapy. This is a report of the results of a validated online assessment of relationship and individual functioning based on 39,251 heterosexual, 1,022 lesbian, and 438 gay couples about to begin couples therapy. Using validated and reliable questionnaires of relationship and individual functioning, this report presents and compares, for each sexual-orientation, the percentage of couples, pre-therapy, who are coping with a variety of relationship problems. To test for the replicability of results, the sample was divided randomly into two subsamples and statistical tests were performed on each sample. Couples initiating therapy suffer from greater distress and many more co-morbidities than has been presumed in previous literature, and same-sex couples present a particular set of both strengths and challenges compared to heterosexual couples. Gay-male and lesbian couples were very different on trust and monogamy, as were heterosexual and lesbian couples. Based on this epidemiologically sized sample, the challenge to our field may be to create interventions with much larger effect sizes than we currently have.