Parental In‐Session Behaviors and <scp>LGBTQ</scp> + Young Adults' Perceived Parental Rejection and Acceptance in Attachment‐Based Family Therapy

This study examined whether decreases in parents' negative in-session behaviors predicted reductions in LGBTQ+ young adults' perceived parental rejection and increases in their perceived parental acceptance over the course of attachment-based family therapy for sexual and gender minority (ABFT-SGM) young adults and their nonaccepting parents. A total of 126 videotaped sessions from 22 families who participated in an open clinical trial of ABFT-SGM were coded to assess changes in parents' positive and negative in-session behaviors. Young adults' perceived parental rejection and acceptance were measured at baseline, 8 weeks, 16 weeks, 24 weeks, and 36 weeks. In line with findings from the open clinical trial, on average, perceived parental rejection decreased and perceived parental acceptance increased over the course of therapy. For both mothers and fathers, decreases in negative in-session behaviors moderated increases in young adults' perceived parental acceptance but not reductions in perceived parental rejection. Findings underscore the importance of reducing negative parental in-session behaviors, such as criticism and invalidation, during conjoint sessions with their LGBTQ+ young adult.