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The LGBT Casebook

Edited by Petros Levounis, M.D., M.A., Jack Drescher, M.D., and Mary Barber, M.D.

  • ISBN 978-1-58562-959-6
  • Item #62959
2014 Society of Sex Therapy and Research Health Professional Book Award Winner!

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Even in today's more enlightened society, it takes courage for many lesbian, gay, bisexual, and transgender (LGBT) individuals to come out of the closet and embrace their sexual orientation and identity. Coming out, or facing internal and societal conflicts related to sexuality, involves a great deal of anxiety that can permeate other aspects of an LGBT individual's life—particularly when seeking psychiatric treatment. The goal of The LGBT Casebook is to help clinicians, trainees, and other mental health professionals address the mental health needs of LGBT people in the context of problems these individuals face in their everyday lives, including homophobia and discrimination.

The LGBT Casebook begins with five chapters devoted to basic concerns that affect LGBT populations, including coming out, heterosexist attitudes, the don't ask, don't tell mentality, legal issues, gay parenting, and sexual identity in patient-therapist relationships. In the rest of the book, clinician-authors present case studies of 20 patients with different DSM diagnoses, illuminating the impact of LGBT identity and illustrating a way of working with each presented patient. Features and benefits of The LGBT Casebook include:

  • Insights into the unique problems LGBT people face in their everyday lives when compared with heterosexual individuals.
  • Problems that are common to all LGBT individuals, such as the anxiety of being in the closet (hiding one's identity) or coming out (embracing one's identity).
  • Practitioners with little experience in working with the LGBT population can gain a better understanding of psychiatric diagnoses within the context of an LGBT individual's everyday life.
  • The book can be read cover-to-cover to gain insights into the full diversity of the LGBT population, or by specific chapters of interest to help with the diagnosis of a patient currently in treatment.
  • A glossary at the back of the book defines both clinical and colloquial terms and phrases that clinicians and patients use to define themselves and their peers.

While The LGBT Casebook is the ideal general overview and roadmap for the clinician new to treating LGBT patients, it also provides new pearls of wisdom and insights for psychiatrists, residents, medical students, nurses, and clinical social workers who are already familiar with working with the LGBT community. By introducing a diverse range of people, diagnoses, and presenting problems, it will serve as a valuable reference book for all mental health professionals when assessing and treating the mental health concerns of lesbian, gay, bisexual, and transgender patients.


  • Contributors
  • Foreword
  • Preface
  • PART I: Basic Principles
  • Chapter 1. What's in Your Closet?
  • Chapter 2. Coming Out to Self and Others
  • Chapter 3. From Outlaws to In-Laws
  • Chapter 4. LGBT Parenting
  • Chapter 5. Sexual Identity in Patient-Therapist Relationships
  • PART II: Case Studies
  • Chapter 6. Attention-Deficit/Hyperactivity Disorder
  • Chapter 7. Substance Dependence
  • Chapter 8. Schizophrenia
  • Chapter 9. Major Depressive Disorder
  • Chapter 10. Dysthymic Disorder
  • Chapter 11. Bipolar Disorder
  • Chapter 12. Panic Disorder
  • Chapter 13. Obsessive-Compulsive Disorder
  • Chapter 14. Posttraumatic Stress Disorder
  • Chapter 15. Generalized Anxiety Disorder
  • Chapter 16. Adjustment Disorder
  • Chapter 17. Borderline Personality Disorder
  • Chapter 18. Parent-Child Relational Problem
  • Chapter 19. Partner Relational Problem
  • Chapter 20. Bereavement
  • Chapter 21. Occupational Problem
  • Chapter 22. Identity Problem
  • Chapter 23. Religious or Spiritual Problem
  • Chapter 24. Acculturation Problem
  • Chapter 25. Phase of Life Problem
  • Glossary
  • Index


    Andrew J. Anson, M.D.
    Kenneth Ashley, M.D.
    Mary E. Barber, M.D.
    Philip A. Bialer, M.D.
    John K. Burton, M.D.
    Stephan Carlson, M.D.
    Kenneth M. Cohen, Ph.D.
    Jack Drescher, M.D.
    Laura Erickson-Schroth, M.D., M.A.
    Nanette Gartrell, M.D.
    Ronald E. Hellman, M.D.
    Karine J. Igartua, M.D., C.M., F.R.C.P.C.(C)
    Dickson Jean, M.D.
    Helene Kendler, L.C.S.W.
    Robert M. Kertzner, M.D.
    Steven Joseph Lee, M.D.
    UbaldoLeli, M.D.
    PetrosLevounis, M.D., M.A.
    Vittorio Lingiardi, M.D.
    Lorraine Lothwell, M.D.
    Anthony Lujack, M.D., J.D., M.S.
    Scot G. McAfee, M.D.
    Christopher A. McIntosh, M.D.
    Nicola Nardelli, Psy.D.
    Aaron Patterson, M.D., M.B.A., M.A.
    Jennifer C. Pizer, Esq.
    Daniel Safin, M.D.
    Ritch C. Savin-Williams, Ph.D.
    David K. Schwing, L.C.S.W.
    Shane S. Spicer, M.D.
    Serena YuanVolpp, M.D., M.P.H.
    KhakasaWapenyi, M.D.
    Eric Yarbrough, M.D.

About the Authors

Petros Levounis, M.D., M.A., is Director of the Addiction Institute of New York; Associate Chair for Clinical Services in the Department of Psychiatry and Behavioral Health, and Chief of the Division of Addiction Psychiatry at St. Luke's and Roosevelt Hospitals; and Associate Clinical Professor of Psychiatry at Columbia University College of Physicians and Surgeons in New York, NY.

Jack Drescher, M.D., is Clinical Associate Professor of Psychiatry and Behavioral Science at New York Medical College, and Training and Supervising Analyst at the William A. White Institute in New York, NY.

Mary E. Barber, M.D., is Clinical Director of Rockland Psychiatric Center and Assistant Clinical Professor of Psychiatry at Columbia University College of Physicians and Surgeons in New York, NY.

The title of The LGBT Casebook does not do full credit to this rich source of information and clinical support for all health care professionals, at every stage of learning and practice. Given the prevalence of GLBT individuals in society, and the stresses to which their sexual orientations subject them, most of us will see GLBT patients, and few of us, whatever our own orientations, are prepared to offer them the expertise they deserve. It's all in this Casebook, in well-organized and eminently readable form. Kudos to editors Levounis, Drescher, and Barber. Their book should be on the bookshelf of each of us.—Nada L. Stotland, M.D., M.P.H., Professor of Psychiatry, Rush Medical College, President, American Psychiatric Association, 2008-2009

A book that should be read by everyone! The LGBT Casebook brings homosexuality out of the psychiatric closet and into the 21st century. Based on solid evidence from the scientific literature, this book breaks common myths and stereotypes, helping the reader truly understand gays, lesbians, bisexuals, and transgendered women and men. It reaches deep into the mind of LGBT people to explore the psychological distress caused by homophobia and stigma; describes the legal standing of LGBT family relationships; and shows the practicing mental health clinician how to manage the most common psychiatric conditions affecting individuals in today's LGBT communities.—Analice Gigliotti, M.D., Past President, Brazilian Association on Studies of Alcohol and Other Drugs (ABEAD)

[For] difficulty in treating special populations, this book is a must. The case studies lend themselves to everyday problems, concerns, and solutions.—Steven S. Kipnis, M.D., FACP, FASAM, Medical Director, New York State Office of Alcoholism and Substance Abuse Services, Steven S. Kipnis, M.D., FACP, FASAM, Medical Director, New York State Office of Alcoholism and Substance Abuse Services

This brilliantly edited volume is an essential reference and must read for all therapists who treat LGBT patients and their families. The unique issues LGBT patients bring to therapy are interwoven with the common clinical problems in every day practice as the case studies illustrate beautifully. A groundbreaking contribution to the field.—Steven S. Sharfstein M.D., President and CEO, Sheppard Pratt Health System, Baltimore, Maryland, Steven S. Sharfstein M.D., President and CEO, Sheppard Pratt Health System, Baltimore, Maryland

This timely and sensible book seems to me to be a model of what a casebook should be. It is clear without being simple. It is relatively brief. It embodies good listening to patients. It is scientifically up-to-date and well written and edited. It provides reasonably detailed and thoughtful examples across a solid group of major psychiatric diagnoses – as well as across a few psychiatric and social categories other than diagnoses – and examples of integrated, educated, and helpful biopsychosocial consideration and treatment of people. I recommend this book to all psychiatrists, young and old, and to our mental health colleagues and students, particularly, but not limited to, those who are actively or might potentially work with LGBT (lesbian, gay, bisexual, and transgender) patients or clients.—Lawrence Hartmann, M.D., The American Journal of Psychiatry, 11/1/2012

With this casebook, psychiatry finally finds itself walking toward – to meet and understand – the LGBT experience. The editors do a wonderful job of covering this rapidly changing cultural topography, ranging from more recent changes, such as the repeal of don't ask don't tell, to the ongoing national debate concerning marriage equality, with its resulting legal uncertainties. Drs. Levounis, Drescher, and Barber cover the significant ground yet to be gained and address how this affects our clients and their families. As such, this book is a needed addition to help therapists deal with LGBT-related issues.—Genevieve Yancey, M.D., The American Journal of Psychiatry, 11/1/2012

The variety and detail of the cases provide a living palette of LGBT experiences, one that offers a practical guide for the clinician rather than merely offering a theoretical framework for interaction with LGBT patients This volume should have broad appeal for all health care professionals given that it is difficult to imagine a clinician who will not at some point have LGBT patients or patients whose lives are touched by LGBT individuals. It should be required reading for trainees such as psychiatric residents.—James Krajeski, M.D., M.P.A., Journal of Psychiatric Practice March 2013

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