Let’s Talk about CBT - Research Matters is a brand-new podcast from the BABCP, hosted by Steph Curnow, Managing Editor for the BABCP Journals Behavioural and Cognitive Psychotherapy and The Cognitive Behaviour Therapist. In this episode, Steph talks to Dr Jake Camp a clinical psychologist and DBT therapist about their paper “Gender- and sexuality-minoritised adolescents in DBT: a reflexive thematic analysis of minority-specific treatment targets and experience” published in the Cognitive Behaviour Therapist. This study aimed to understand the experiences of GSM young people in DBT and what difficulties and dilemmas associated with their gender and sexuality diversity were thought by them to be important to target in DBT. Jake talks about what this study found and highlights some really helpful recommendations for clinicians working with young LGBTQ+ people. You can find Jake's ful paper here: https://bit.ly/45GhM1C If you liked this episode and want to hear more, please do subscribe wherever you get your podcasts. You can follow us at @BABCPpodcasts on X or email us at podcasts@babcp.com. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF Transcript: Steph: Hello and welcome to Let’s Talk about CBT- Research Matters, the podcast that explores some of the latest research published in the BABCP journals with me Steph Curnow. Each episode, I'll be talking to a recently published author about their research, what was the motivation behind it and how they hope it will impact the world of CBT? In this episode, I talked to Dr Jake Camp. Jake is a clinical psychologist and lead author of the paper “Gender and sexuality minoritised, adolescents in DBT, a reflexive thematic analysis of minority specific treatment targets and experience” which was published in the Cognitive Behaviour Therapist. Steph: Hi, Jake, welcome to the podcast. Jake: Hello, nice to be here. Steph: Thank you so much for joining us. So just to start off the podcast, are you okay to tell me a bit about yourself and the service that you work for? Jake: Yes, absolutely. So, so my name is Jake Camp. the pronouns I use are he/they. I'm a clinical psychologist, and DBT therapist. So my main area of work is at a national, DBT service for adolescents that's based at the renowned Maudsley Hospital. I also work academically, mostly with the department of psychology and the LGBTQ+ mental health research group. So that is at King's College, London. and I mostly work with young people who have experienced a ton of trauma, sadly, and have had a lot of difficulties that have led to, finding it very hard to sort of survive and thrive in the world. Often, young people end up being quite highly suicidal, sadly and my area of research that I'm particularly keen with, and of course what we're hopefully talking a bit about today, is mainly around how therapies work for minoritised groups and particularly LGBTQ+ groups as my sort of main area of research. So, it's great to have a chat about that. Steph: So yeah, that leads us really nicely into talking about the paper because we are talking about one of the minority groups that you have been researching. So do you want to tell us a bit about who they are and what the paper is that we're talking about today? Jake: Yeah. So, the paper that we are focusing on today is, one where I really wanted to spend some time privileging and I suppose, increasing the sort of voices of LGBTQ plus young people in DBT. For those who are not familiar with that acronym, although hopefully most people are, of course, that is usually people who identify with a minoritised or minority sexual identity, so that's like lesbian, gay, queer, etc and or a sort of minoritised or diverse gender identity, so that might be trans, non-binary, or so forth. So the paper really was to try and, you know, sort of give a platform to LGBTQ+ young people about their experiences of Dialectical Behaviour Therapy or DBT, because what we know from the literature is that, generally LGBTQ plus people experience quite a lot of barriers to accessing services. There's also some evidence of poorer experiences of services and even some of the poorer outcomes, particularly in the sort of adult literature. So we know that there's a bit of a problem with how we meet the needs of LGBTQ plus group generally across our services, and we know that LGBTQ plus groups usually are significantly more likely to experience mental health difficulties and particularly engage in self-harm and suicidal behaviours, sadly, which we think is associated with, societal oppression, what we call minority stress. So those are stressors unique to their sort of minority characteristics or identity. So, we think it's super important, you know, to sort of do more work in this area. And of course, sadly, there's not actually that much, particularly in DBT about this, but, I would say there's also not much robust work, across that sort of fields as well. So, so this is the paper. Steph: And I think one thing that really struck me when I was reading the paper, I've read a couple of iterations of it from when it was submitted to the published version, it's really about how much the lived experience of the young people you were researching in this was very important to, to the topic and to you. And so what motivated you really to look at this research area in particular and, and focus on this. Jake: Yeah. Yeah, good question. I think, it really stems, obviously, from early on, and I touch on this a little in the paper, I identify as LGBTQ+ so generally just describe myself as a queer/nonbinary psychologist and I think, you know, growing up in a societal context where we had the sort of echoes of what I now know was sort of Thatcherism, Section 28, which precluded, the sort of conversations around what was termed homosexuality in schools, which ultimately meant that, you know, things like bullying with content around this, things like talking about modelling good experience of this, showing you that you could be a queer young person and be okay and thrive, were just completely absent from my childhood, mixed in with, I think, you know, we certainly were coming out of the AIDS epidemic when I was growing up and a number of other social, cultural things, I think just meant that, you know, growing up as a queer kid really wasn't comfortable and from a very early age, starting to feel different from people and starting to feel that societal oppression was very heavy. Mixed in with, a number of other sort of areas of difficulty and trauma in my sort of familial environment. I think I was I've always been very keen to try and use my privilege to help people, help my kin almost, help people, help those queer kids, you know, to sort of grow up and thrive, because I really didn't feel like I had that. And so that sort of informed how I've ended up going down the route of LGBTQ mental health as my sort of main area of research. And, I think, of course, part of that is they're my tools, they're my tools for activism in some ways, is that, the area that I can use and the privilege I have is that I can focus my research energy into this and hopefully try and make the system better. So, they're the sort of overarching aims. The reason I ended up in this sort of project area specifically is firstly, because, I work in DBT and very passionate and keen about supporting people who have quite complex trauma that other sort of traditional services don't always quite meet their needs, you know, so the sort of the running theme for it, and I think DBT does that really nicely and when I started working in the National DBT Clinic, I was very surprised to quickly see that in this group of very highly suicidal young people, that about 60 to 70 percent of them were LGBTQ+ which of course is an outrageous over representation, compared to what should be if there was no health inequality there. And that sparked my interest because I thought, I need to work out what's going on here. And I need to try and make sure we're meeting their needs and make sure that other services are meeting their needs too, because I think what that potentially speaks to is that their needs are not being met sufficiently earlier in the treatment pathway before they end up needing DBT. And of course, DBT, you know, is really made for people where they're highly suicidal, high severity of difficulty usually been going on a long time. So this paper sort of squarely came out of that. I thought, where do I start? Well, I want to start, you know, with the young people and their voices, and I want to know what's working for them, what isn't working for them, and actually what is important about their experience as a minoritised individual that we need to be thinking about in therapies, in particular, of course, DBT. So that was the sort of inspiration for it, and it's part of a wider program of work, of course, to try and complement some of those questions that I had. But here it was squarely about, what do the young people think? what would they advise us to do, which I think is super important. Steph: Yeah, absolutely. And that really comes across in the paper, I think. Like I say, it's really nice when you can read papers that you know have been written with real thought and real compassion as well, that definitely comes across in the paper. Before we getting into talk about the paper itself, would you mind explaining a little bit about DBT for maybe listeners who don't know what it is, or maybe don't know that much about it? Jake: Yeah, of course, yeah. So DBT stands for Dialectical Behaviour Therapy. so, we usually describe it as a sort of third wave CBT approach. for those who are not familiar with that terminology, third wave, I usually think of as meaning standard sort of second wave CBT, which is the
