Gary Diamond, Ph.D., received an AFSP Standard Research grant to modify Attachment-Based Family Therapy (ABFT) for lesbian, gay and bisexual (LGB) adolescents and then pilot test the eight-week treatment with 10 youth experiencing significant suicidal ideation. ABFT had already been demonstrated to reduce suicidal ideation and depression in teens. Since issues related to minority sexual orientation contribute to suicidal ideation and attempts among LGB teens and their families, the goal of this study was to adapt the treatment for this group. The study findings were recently published in Psychotherapy. This specialized treatment is particularly important given the increased rate of suicidal ideation and suicide attempts among LGB youth (Haas et al., 2011).
Suicidal ideation and attempts emerge in the context of depression and other mental disorders accompanied by environmental stressors including social and family conflict. Lack of family support and acceptance can increase risk for suicidal ideation and attempts. ABFT aims to improve family acceptance and increase adolescents’ independence and competence. The first phase of the grant involved assembling a treatment development team of six senior clinicians who were experienced in working with suicidal adolescents including LGB youth. The panel reviewed the treatment manual and watched several videotaped sessions with LGB youth. They modified ABFT to increase the time focused on helping parents reconcile feelings and beliefs about their child’s sexual orientation and helping children to increase their acceptance of their parents. They also began working with the youth to increase competence and independence earlier in the course of treatment. A final modification involved helping parents to eliminate subtle yet potent comments and behaviors that express non-acceptance.
The second part of the grant involved implementing the modified therapy with 10 LGB adolescents and their families after discharge from the hospital for serious suicidal ideation or a suicide attempt. The fact that eight of 10 families completed eight or more weeks of treatment demonstrated the feasibility and acceptance of the treatment. All eight reported significantly reduced suicidal ideation and some reported less depression. The findings also suggested that attachment anxiety and attachment avoidance between teens and their mothers was also reduced. Currently, Dr. Diamond and his colleagues are testing ABFT for LGB in a larger sample before training others.
Gary Diamond, Ph.D., is a Senior Lecturer in Clinical Psychology in the Department of Psychology at Ben Gurion University, Beer-Sheva, Israel. He conducted the study at Children’s Hospital of Philadelphia, Philadelphia, Pa.
Published articles from this study:
- Diamond, G. M., Diamond, G. S., Levy, S., Closs, C., Ladipo, T., & Siqueland, L. (2012). Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: a treatment development study and open trial with preliminary findings. [Controlled Clinical Trial Research Support, Non-U.S. Gov't]. Psychotherapy: Theory, Research, Practice, Training, 49(1), 62-71.
- Diamond, G. M., Shilo, G., Jurgensen, E., D'Augelli, A., Samarova, V., & White, K. (2011). How Depressed and Suicidal Sexual Minority Adolescents Understand the Causes of Their Distress. Journal of Gay & Lesbian Mental Health, 15(2), 130-151. doi: 10.1080/19359705.2010.532668