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Clinical Round Tables

LGBTQIA+

Navigating Identity: Integrating Tailored DBT and Evidence-Based Group Therapy for Gender Expansive Individuals

Clinical Round Table 4 - Navigating Identity: Integrating Tailored DBT and Evidence-based Group Therapy for Gender Expansive Individuals

Thursday, June 25, 2026
11:30 AM - 1:00 PM PDT
Location: Golden Gate C1, B2 Level
Earn 1.5 Credit
Keywords: LGBTQ+, Group Therapy,
Level of Familiarity: Basic to Moderate
Recommended Readings: Tilley, J. L., Molina, L., Luo, X., Natarajan, A., Casolaro, L., Gonzalez, A., & Mahaffey, B. (2022). Dialectical behaviour therapy (DBT) for high‐risk transgender and gender diverse (TGD) youth: A qualitative study of youth and mental health providers' perspectives on intervention relevance. Psychology and Psychotherapy: Theory, Research and Practice, 95(4), 1056-1070.,   Chinsen, A., Wilson, J., Tollit, M. A., Pang, K. C., Pace, C. C., & Cronin, T. J. (2024). “There’s hope and there’s a future for all of us”: co-design of a group cognitive behavioral therapy (CBT) intervention for trans young people (TAG TEAM). International Journal of Transgender Health, 1-17.,   Aunon, F. M., Ingram, P., Wolkowicz, N., Martino, S., Kacos, H., Spana, E., ... & Decker, S. E. (2025). To Adopt or Adapt: A Scoping Review of Dialectical Behaviour Therapy With Patients With Minoritised Identity Constructs. Counselling and Psychotherapy Research, 25(1), e70000.,   ,  
This clinical roundtable will examine adaptations to evidence-based group therapies (EBGTs) across three diverse treatment settings serving gender-expansive youth and adults. Gender-expansive individuals experience disproportionately high levels of invalidation, marginalization, and discrimination related to their gender identity. A growing body of research demonstrates elevated rates of emotion dysregulation, mood and anxiety disorders, suicidal behavior, and non-suicidal self-injury (NSSI) in gender-diverse populations, with rates of NSSI nearly twice those observed in cisgender peers. These disparities underscore the critical need for tailored, affirming, and effective evidence-based interventions.

While existing EBGTs offer robust frameworks for addressing emotion dysregulation and associated psychopathology, meaningful adaptation is often necessary to address the lived experiences of gender-expansive group members and to optimize engagement, retention, and clinical outcomes. Adaptations discussed will include the use of gender-relevant examples in skill teaching; expanded attention to invalidating environments; integration of discussions of gender-affirming care, activities, and resources; development of advocacy skills; and intentional cultivation of supportive, affirming group communities.

This roundtable brings together clinicians implementing adapted versions of Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and Cognitive Behavioral Therapy (CBT) group interventions across diverse clinical contexts. Panelists will discuss practical considerations related to setting, diagnosis, developmental stage, and caregiver involvement, drawing on both the clinical literature and lived experience in group design and facilitation. The session will highlight key advantages, challenges, and ethical considerations in adapting EBGTs for gender-expansive individuals, and will offer attendees concrete guidance for inclusive and effective group-based care.

Learning Objectives:

  • Describe mental health disparities affecting gender-expansive individuals and implications for group-based treatment.
  • Identify key principles for adapting DBT, ACT, and CBT groups for gender-expansive populations.
  • Apply practical group adaptations that enhance engagement, retention, and clinical outcomes.
  • Evaluate challenges and ethical considerations in delivering adapted EBGTs across diverse settings.
  • Integrate strategies to create affirming group climates that support validation, advocacy, and community.