Date of Award

2026

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

First Advisor

Jill Rathus, Ph.D.

Second Advisor

Kathleen Camacho, Psy.D.

Third Advisor

Gustavo Cutz, Psy.D.

Abstract

Professional guidelines emphasize the importance of adapting evidence-based treatments to the cultural and contextual needs of minoritized populations. Although substantial research has examined lesbian, gay, bisexual, transgender, and queer (LGBTQ+) mental health, comparatively little is known about the psychotherapy experiences of Chinese sexual and gender minority individuals or how dialectical behavior therapy (DBT) may be delivered responsively with this population. DBT is an evidence-based treatment for emotion dysregulation, self-harm, and suicidal behavior that explicitly addresses the effects of invalidating environments. Because Chinese cultural contexts and LGBTQ-related minority stress may both shape emotional expression, help-seeking, and treatment experiences, this qualitative study examined how Chinese LGBTQ+ adults understood psychotherapy and evaluated the potential fit of DBT. Eighteen participants with current or previous mental health service experience completed semi-structured interviews after viewing brief psychoeducational materials about DBT. Grounded theory analysis generated five theoretical constructs concerning help-seeking, therapeutic expectations, initial impressions of DBT, perceived applicability and adaptation of DBT, and the influence of culture on psychotherapy. Findings suggested that DBT was viewed as potentially relevant but that its fit depended on clinical need, therapist competence, affirming delivery, pacing, autonomy, cultural contextualization, and available resources. The findings offer guidance for culturally responsive DBT with Chinese LGBTQ+ clients.

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