DBT and CBT Effectiveness for Gay and Lesbian Clients

One 2017 study examined the effectiveness of Dialectal Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) in a partial hospitalization program in a sample of 441 patients. Approximately 19% of the sample identified as "lesbian, gay, bisexual, queer” or another “sexual minority.” Was the treatment as effective for these patients as it was for the heterosexual patients?

Unsurprisingly, it was. There was no significant difference in treatment outcomes between the two groups. DBT and CBT are both focused on basic emotional and cognitive processes, and it would be difficult to imagine why sexual orientation would be a factor. However, participants who identified as “bisexual” did score worse on treatment outcomes. Specifically, they reported more incidents of self harm and suicidal thoughts.

Why the disparity? What separates clients who identify as bisexual from those who identify as gay, lesbian, or straight? A further investigation of such clients and their difficulties in treatment would prove interesting.