Four Steps Toward Intersectionality in Psychotherapy Using the ADDRESSING Framework

An intersectional approach to psychotherapy offers opportunities for strengthening the therapeutic alliance and improving professional practice via attention to cultural complexities affecting clients, therapists, and the mental health system. The ADDRESSING (Age and generation, Developmental or other Disability, Religion and spirituality, Ethnicity and racial identity, Socioeconomic status, Sexual orientation, Indigenous heritage, National origin, Gender) framework facilitates intersectional work by calling attention to the interaction of oppression/privilege systems (e.g., racism, heterosexism, ableism, classism) and to the within-group diversity of people of color (e.g., by sexual orientation, dis/ability, class, etc.). Using the ADDRESSING framework, the present article suggests the following four steps toward integrating intersectionality into therapeutic practice: (1) the therapist’s ongoing self-assessment and development of a multicultural, intersectional orientation; (2) attention to structural inequities embedded in the mental health system; (3) consideration of the impact of systemic oppression on individuals who hold intersectional identities; and (4) recognition of the resilience, strengths, and support that often emerge with intersecting identities. Several studies are summarized regarding the use of the ADDRESSING framework in therapeutic settings, along with case examples, information regarding resilience in relation to intersectionality, a discussion of the limitations of the framework, and suggestions for further research and work.