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Psychological therapists can play a key role in supporting identity development and advocating for systemic change. This study explored therapists' lived experiences of working with sexual minority adolescents, attending to both reported experiences and deeper social mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A qualitative study using a critical realist approach to thematic analysis that integrated inductive coding with abductive and retroductive theorising.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seven UK\u2010based psychological therapists participated in semi\u2010structured interviews conducted between January and March 2024. Analysis examined both dispositional and inferential themes, exploring both surface experiences and deeper social mechanisms shaping participants' experiences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three dispositional themes were generated: (1) therapists' experiences of socio\u2010environmental forces shaping adolescent sexuality; (2) the striving to offer attuned, responsive therapy; and (3) the influence of socio\u2010political tensions on navigating identity\u2010related work. The analysis suggests that the therapeutic process functions as a\n                      <jats:italic>relational shield<\/jats:italic>\n                      against conflicting structural forces. By centring this relational process to navigate developmental fluidity, effective practice relied on\n                      <jats:italic>agential striving<\/jats:italic>\n                      to protect the adolescent's narrative from external agendas. This involved fundamental clinical skills: creating a non\u2010judgemental space, using compassionate curiosity, and maintaining awareness of relational pulls and assumptions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Socio\u2010political structures are often enacted within the therapy room, presenting both challenges and opportunities for therapeutic work. The findings suggest that therapy functions as a mediating space, shielding adolescents' developing identities from polarisation and stigma. This highlights the ethical necessity of maintaining a protected process in a politicised climate.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papt.70051","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:28:34Z","timestamp":1773005314000},"page":"684-704","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Supporting sexual minority adolescents: A critical realist thematic analysis of psychological therapists' experiences"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5819-6165","authenticated-orcid":false,"given":"Paris","family":"Young","sequence":"first","affiliation":[{"name":"Lancaster University  Lancaster UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8485-442X","authenticated-orcid":false,"given":"Nargis","family":"Islam","sequence":"additional","affiliation":[{"name":"Lancaster University  Lancaster UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8394-9905","authenticated-orcid":false,"given":"James","family":"Lea","sequence":"additional","affiliation":[{"name":"University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2450-6271","authenticated-orcid":false,"given":"Anna","family":"Daiches","sequence":"additional","affiliation":[{"name":"Lancaster University  Lancaster UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Critical realism for health and illness research","author":"Alderson P.","year":"2021"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20104642(19)30339\u20106"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/00918369.2025.2493150"},{"key":"e_1_2_12_5_1","unstructured":"APA. 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