Although we are continually working to improve our exercises, they are not ideal for all clients and therapists will need to use their clinical judgment to decide on when they are appropriate. Even if the clients fit the exercise/research inclusion criteria (see our Grow webpage for details on specific studies), these are issues to consider:

• Clients who are actively in crisis or are at risk for harming themselves or others will need more care than these exercises can provide. If your client is in a potentially life-threatening situation or another person may be in danger, don’t recommend this site. Instead, you might engage in crisis counseling, advise them to use hotline resources (some are listed on the “Learn” webpage” under online resources, ask to go to their local hospital emergency room, or call 911. Processing heterosexism will not be what they need during that time.

• Clients who do not have access to email, a computer or tablet, or who are not comfortable typing for extended periods on a cell phone will find it difficult to participate in these exercises.

• Clients who are not comfortable reading in English may find it challenging to participate as well. (We are working on translations and hope to have these in the future!)

In our empirical studies, these exercises have been reported as helpful by the vast majority of participants. If you are unsure if the exercises would be right for your clients though after reading these contraindications, you might wish to consult with a supervisor and/or talk with your clients and see if they think the exercises would be helpful to them.