Security amidst stigma: Exploring HIV and sexual minority stressors through an attachment-based psychotherapy group.

Despite strides in HIV prevention and lesbian, gay, bisexual, and transgender care, comprehensive care centers are of critical importance for lesbian, gay, bisexual, and transgender communities and people with HIV/AIDS who continue to contend with intersecting stigmas and chronic minority stressors. Building on the integrated attachment and sexual minority stress model, we discuss these themes by highlighting a group vignette from an urban psychiatric clinic that has provided affirmative psychotherapy to marginalized communities affected by HIV/AIDS for over 2 decades. The authors have rotated at the clinic as cofacilitators of a weekly, process-oriented group for sexual minority men who are HIV positive or are affected by HIV. In this article, we provide a theoretical foundation for HIV-affirming group psychotherapy and clinical integration of minority stress and attachment-based interventions. Group psychotherapy provides a rare opportunity to bond an often-isolated community by evoking factors of universality, cohesiveness, and catharsis. It simultaneously enables us to confront individual existential concerns with serostatus disclosure, grief, and feelings of victimization, as well as challenge internalized stigma and rejection sensitivity. We apply these issues to a verbatim clinical exchange, analyzing attachment-related themes and issues pertaining to minority stress and stigma, as well as discuss group mechanisms for attachment interventions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Perceived microaggressions in health care: A measurement study.

The current study examined the psychometric properties of the Microaggressions in Health Care Scale (MHCS), including factor structure, measurement invariance, and internal consistency reliability. We used a cross-sectional research design to study perceived racial microaggressions, discrimination, and mental health in 296 African American and Latino respondents. Participants completed measures that assess healthcare microaggressions and daily discrimination as well as the Depression, Anxiety and Stress Scale (DASS-21). Results revealed that the MHCS has promising psychometric properties. The confirmatory factory analysis (CFA) revealed that the MHCS is a unidimensional scale. Multi-group CFAs provided evidence of measurement invariance across racial / ethnic groups and gender. The internal consistency reliability of the scale was .88 for the overall sample. Microaggressions correlated with daily discrimination scores (r = .67), as well as mental health symptoms (r's = .40 -.52). The MHCS is a brief, valid, and reliable measure that can be used to assess and monitor racial and cultural forces that shape patient-provider interactions. This study concludes with a discussion of the ongoing need for research on microaggressions in healthcare as well as implications for future research.