The development of the Minority Stress Module

What is it about?

People who belong to equity-denied groups, including sexual, gender, and ethnoracial minorities, often experience unique, chronic stressors related to their identities, such as discrimination and internalized stigma. These experiences, collectively known as minority stress, can increase the risk of developing mental health problems. Although minority stress plays an important role in shaping mental health, it is rarely discussed during routine diagnostic assessments. Many clinicians feel unsure about how to ask about identity-based experiences or may worry about causing discomfort, which leads to important information being overlooked. To address this gap, researchers and clinicians created the Minority Stress Module (MSM) as part of the Diagnostic Assessment Research Tool (DART). The MSM was developed by a team with expertise in minority stress, diagnostic interviewing, and clinical work with equity-denied communities. Its development was guided by well-established minority stress theory, clinical insights gathered from working with marginalized clients, and direct consultation with individuals who have lived experience of minority stress. The result is a brief, 13-question semi-structured interview that helps clinicians ask about experiences, symptoms, and resilience factors related to minority stress in a respectful and effective way. The MSM is designed to strengthen the therapeutic relationship, provide a more accurate understanding of clients’ concerns, and support better diagnostic and treatment decisions. By openly discussing minority stress, clinicians can develop a clearer picture of how identity-based experiences affect mental health. Incorporating the MSM into diagnostic assessments offers a practical, standardized approach that promotes more inclusive, contextualized, and client-centered mental health care.

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Photo by Van Tay Media on Unsplash

Photo by Van Tay Media on Unsplash

Why is it important?

Minority stress impacts the mental health of equity-deserving groups but is often not assessed for in practice due to several challenges, including a dearth of inclusive assessment tools, a lack of provider knowledge, and high rates of misdiagnosis and overdiagnosis. The Minority Stress Module, a semi-structured interview tool that will be integrated into the Diagnostic Assessment Research Tool (DART), was created to assess for experiences, impacts, and resilience factors associated with minority stress. Integration of this tool within clinical settings may contribute to more equitable diagnostic assessment by improving case conceptualization, diagnostic decision-making, and treatment recommendations for equity-deserving groups.