In countries worldwide, LGBT individuals are subject to persecution and discrimination, including grave human rights violations based on their sexual orientation or gender identity. Asylum provides a mechanism for LGBT individuals fleeing such persecution to legally remain in the United States. However, asylum is not guaranteed, and the asylum-seeking process may be particularly challenging for individuals with complex trauma histories. Although many LGBT asylum seekers are referred to individual psychotherapy by their legal counsel to prepare for the asylum process and to mitigate risks for retraumatization, many decline due to fear, shame, and cultural barriers, among other factors. Thus, we offer a model of group therapy forLGBT asylum seekers, rooted in multicultural and empowerment frameworks, which aims to address the unique concerns and challenges faced by LGBT asylum seekers. These include recovery from the effects of complex trauma, managing the stress of immigration and acculturation, minimizing the risk for retraumatization which may occur during the asylum-seeking process, and overcoming cultural obstacles to individual psychotherapy. We review and integrate empirical and theoretical literature on the mental health of immigrants and asylum seekers, LGBT mental health, and group therapy for trauma, LGBT individuals, and asylum seekers to offer theoretical support for the value of group therapy for LGBT asylum seekers. Research is needed to evaluate the effectiveness of these group interventions. We offer recommendations for research along with suggestions for addressing the practical challenges encountered in working with LGBT asylum seekers.

Grounded in a view of the therapeutic alliance as a process of intersubjective negotiation between patient and therapist, this study examines therapist reflective functioning (RF) as a predictor of process and outcome of psychotherapy in 43 cases of brief relational therapy. Psychotherapy process was measured with the Working Alliance Inventory, Session Evaluation Questionnaire, and a measure of rupture resolution. Outcome was measured with the Symptom Checklist Revised-90 (SCL-90) and the Inventory of Interpersonal Problems-32 (IIP-32) at intake, termination, and 6-month follow-up. Analyses revealed that higher therapist RF predicted greater therapist-reported Working Alliance Inventory, greater patientreported depth, and greater reported degree of resolving ruptures from both patients' and therapists' perspectives. Therapist RF was correlated with increased self-reported symptoms on SCL-90 and IIP-32 from intake to termination. Therapist RF was correlated with a decrease in symptoms on SCL-90 and interpersonal problems on IIP-32 from termination to 6-month follow-up. The results are consistent with the hypothesis that therapists' capacity for mentalization is associated with greater depth of in-session exploration and greater success in resolving in-session ruptures allowing for the potential facilitation of greater patient change.

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