The Case of "Adam": Reflections and Future Directions


  • Sarah Hope Mandel



sexual stigma, internalized homophobia, identity formation, LGB clients, LGB-affirmative therapy, multicultural theories, cognitive-behavioral therapy, client-centered therapy, hybrid case study, case study, clinical case study


Three commentaries on "Targeting Sexual Stigma: The Hybrid Case Study of  'Adam' " (Mandel, 2014) present additional insights into providing psychotherapy for sexual minority clients who struggle with internalized homophobia, minority stress, and identity formation concerns.  In his thoughtful response, Christopher Martell (2014) writes about heteronormativity, behavioral activation, multidimensional treatment, and the issue of “readiness” to address sexual orientation and identity in treatment.  Rachel Proujansky and John Pachankis (2014) describe their exciting principle- and evidence-based LGB-affirmative psychotherapy, and explain the importance of addressing sexual behavior when working with sexual minority clients.  Additionally, Daniel Chazin and Sam Klugman (2014) highlight key issues related to the coming-out process and systemic-level interventions.  In the following response, I summarize the psychologists’ comments and provide feedback to further the dialogue regarding how to best serve the needs of sexual minority clients. 

Author Biography

Sarah Hope Mandel

San Fishman, Ph.D. Editor-in-Chief, Pragmatic Case Studies in Psychotherapy Professor of Clinical and Organizational Psychology Graduate School of Applied and Professional Psychology Rutgers University Mailing address: 57 Jaffray Court Irvington, NY 10533 914-693-8549 fax: 603-917-2567 email:




How to Cite

Mandel, S. H. (2014). The Case of "Adam": Reflections and Future Directions. Pragmatic Case Studies in Psychotherapy, 10(2), 147–155.