A group model for gay and lesbian clients with chronic mental illness.

This article examines the creation of a gay affirmative group model that focuses on the unique social, developmental, and psychoeducational needs of lesbian and gay clients who attend psychiatric day treatment. The author discusses how these clients' psychosocial potential can be maximized in a group that addresses issues related to their sexual orientation, including their double stigmatization as both mental patients and homosexuals. The following modifications of traditional group interventions are illustrated: (1) the tolerance of primitive interpersonal styles; (2) the encouragement of differentiation; and (3) the need for a structured, nonconfrontational approach. These principles, which lead to enhanced group safety and cohesion, are contrasted with those of a more traditional "coming-out" group. Overcoming resistance and homophobia among staff and other clients is outlined, as is establishing the group as an integral component of a gay-sensitive treatment structure in a mental health agency.