Table 4.

Most Important Lessons Taken Away from the Training

Topic	Theme	Participant comments
LGBT identities	General identity comprehension and understanding of LGBT stigmatization	“Homosexuality is a natural expression of sexuality in humans.”
		“To better understand the LGBT people. Being gay/lesbian is not a choice, [it] is about attraction.”
		“I've learned about LGBT lifestyle, types of LGBT individuals.”
		“In this training I learned that LGBT identity is not a choice [it] is an orientation.”
		“Information about the gay community here in Romania.”
		“The effects of social opinion on individual's self-perception, the process and manifestations of internalized homophobia.”
	Attitude shifts	“I knew that this category of people—LGBT—is different from us, the straight ones … but we have to understand those differences … we must learn a great deal from them: after all, we are people with needs and all of us suffer sometimes in our life, all of us have desires, dreams or failure, broken dreams. Why is it so hard to understand?! Why do we have to compare and have prejudices??? Yes … we are different… but also the same in our humanity.”
		“Those with LGBT identity are not ‘sick’ or abnormal and may or must be healed. I learned about homophobic stigma that may be ‘criminal’ and any man regardless of his sexual orientation, should not go through this.”
		“The concept of internalized homophobia was of great importance to me.”
		“There were two enlightening [pieces of] information for me in regards with the social stigma and internalized homophobia.”
		“Understanding is the best way for a good life!!!”
		“To be tolerant and to help LGBT individuals.”
		“I learned that LGBT persons have the same needs and feelings as hetero people.”
		“Knowing and learning is the best way to improve yourself and understand how important is to look at life from the right perspective.”
		“In my opinion the most important thing that I learned during this training is that the LGBT people have a strong community and with the increase of the specialists [who can support them] it can be much stronger.”
		“[Being] LGBT is not an illness or a choice—psychologists have no information and training in LGBT [issues].”
LGBT health	Minority stress impact on health	“Better understanding the multilevel issues regarding LGBT status.”
		“Statistics about homophobia [in the context of health disparities due to minority stress].”
		“The concept of internalized homophobia comes into mind.”
		“To understand LGBT problems.”
		“I've learned about how an LGBT person feels.”
		“More details about the effects of shame on one's self-confidence, the difficulty of being different and its effects on the whole life and society, the negative discrimination risks and implications.”
	Stigma's impact on health	“Consider the negative impact of stigma”
		“I learned about …. HIV”
		“The clear data about how LGBT [individuals are] affected in terms of mental illness.”
		“The consequences of minority stress.”
		“Stigma is the most important trigger of distress.”
		“More about LGBT individuals' experiences (with more stress and few support sources) [which negatively impact their health].”
		“[Health] risks of unprotected sex, info about HIV.”
		“The risk and the treatment of HIV.”
		“[I learned] about LGBT mental health; about genetic causes.”
Clinical approaches	Addressing LGBT mental health affirmatively	“[I learned] methods of affirmative therapy.”
		“Practice guidelines for LGB clients.”
		“How to work with LGBT clients in an affirmative framework.”
		“Approach an LGBT client in a respectful and affirmative way—the challenges that a psychotherapist/counselor caring for LGBT clients may encounter—how to express my feelings when working with LGBT clients—ethical challenges when caring with LGBT clients—therapy with a LGBT person is no different from therapy with straight clients (in many ways)—the most important issue to be understood in the relationship with LGBT clients is the stigma attached to their status, which is sometimes their main issue.”
		“How to better help a client if he or she is LGBT in counseling.”
		“[I learned the] ‘know how's’ about how I could actually help them.”
		“The most important things that I learned … was that I realized that I have the best profession in the world. I respect all my clients no matter if they are straight, transgender, LGB, adolescents, … women or men.”
		“What implies being an affirmative therapist—the challenges of providing therapy for LGBT clients.”
		“[I learned] about affirmative therapy for LGBT [individuals]. Now, I understand the big picture and–[at] the same time —the details that compose it. This session helped me to get all the information I need about LGBT persons. Now, I have the knowledge of what to do in a psychological intervention to a LGB person.”
	Case example references	“Sexual compulsivity, about internal homophobia and I also learned a lot from the cases presented.”
		“Be honest, supportive.”
		“The challenges that a psychotherapist/counselor caring for LGBT clients may encounter.”
		“I will remember [from] now [on] that helpful question: “Do you date men, women or both?”
		“Things that need to [be] address[ed] in therapy, like the stress of stigma, finding the anchors, building supportive relationship[s] and validate the strengths [that LGBT persons] have… We need to do something that will make our society feel more comfortable with LGBT people.”
		“Most important for my profession, I learned the best approach for those with LGBT identity.”
		“I loved how [the trainers] presented information about LGBT people, how, who and when we can help them and be supportive.”
		“Internalized homophobia should be addressed.”
		“Most valuable [was the trainers'] direct experience … Quite impressive work … and great example of effective practice. … It gave me a reliable image of the issues that LGBT community confronts daily and better tools and understanding of how to build an effective and warm relationship with an LGBT person.”

Brackets indicate additions by the authors to increase clarity; parentheses appear as they were inserted by the participants themselves as they provided written comments.