Delivering research-supported intervention is increasingly important, given the growing emphasis on evidence-based practice in mental health treatment. When working with clients who hold marginalized identities, however, therapists may have questions about how to best tailor interventions, as treatments may not yet have demonstrated efficacy with under-represented populations. This paper describes potential strategies for using dialectical behaviour therapy (DBT) skills to help LGBTQ+ clients, guided by a theoretical model for understanding sexual stigma. Joining these two paradigms, suggestions are made for applications of skills that can help LGBTQ+ clients who are in DBT effectively interact with invalidating environments characterized by structural stigma. DBT-based strategies aimed at buffering clients from environmental invalidation and enhancing their skills in self-validation can help provide them with pathways towards affirming their own sexual orientation and gender identity. Examples from clinical cases are used to enhance understanding of skills application in practice.

As legal authorities consider the constitutionality of the laws surrounding prostitution in Canada, we have the opportunity to rethink some of the fundamental assumptions that have been made about sex work and the socio-legal responses to it. In this article we draw on the concept of structural stigma to analyze the stigmatic assumptions inherent in the Canadian laws and briefly describe their effect—the civic exclusion of sex workers. We then consider the ways in which these same assumptions of risk and immorality are reproduced in end-demand (partial criminalization), legalized (regulatory) models, and decriminalization. While the decriminalization of sex work is the response that relies on the least stigmatic assumptions, even the celebrated New Zealand model is not absent of moralization and “othering” discourse. Further reflection is required to conceptualize a policy approach that transcends stigmatic assumptions so as to respect the human and civil rights of sex workers.