Attachment-Based Family Therapy for LGBTQ Youth in a Community Setting: A Community-Engaged, Qualitative Pilot Study of Youth and Parent Experiences

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth who experience family rejection are at increased risk for depression and suicide. Attachment-Based Family Therapy (ABFT) demonstrates promising results for reducing this risk with LGBTQ youth. This community-participatory, mixed-method study piloted the use of ABFT with LGBTQ youth. Fourteen families completed treatment with adolescent youth, pre- and post-individual and family interviews, and a measure of youth mental health. Post-therapy, 80% of youth showed a significant reduction in psychological distress. The qualitative thematic analysis constructed four themes describing how families present to therapy with emotional distress, caregiver support needed during ABFT, how caregivers acquired new listening and communication skills, and LGBTQ youth experiences of finding freedom to explore and talk about sexual and gender identities. Implications from the study suggest the need to challenge heteronormative emotional structures of families for increasing emotional support of fathers with their LGBTQ children.