Structures Shape Care moves beyond identity-based checklists to examine how systems, norms, and power shape what happens inside the therapy room. This intermediate workshop helps clinicians recognize how structural bias influences assessment, diagnosis, consent conversations, documentation, and the therapeutic relationship—often before clients ever disclose. Through applied examples and case material, participants learn how to interrupt harm, strengthen alliance, and provide ethically sound, affirming care for sexual, gender, and relationally diverse clients.
In person option - 4268 Canton Road, Marietta GA 30066 (seats limited)
Virtual option - Zoom Webinar
For information on equity pricing, see below
Approved by the Georgia Psychological Association. For more information, see below
Recording
A recording will be available after 60 days. To obtain synchronous CE certificates, participants must attend the live event, however asynchronous certificates will be available for recorded viewing.
This course is intended for psychologists, counselors, social workers, marriage and family therapists, and other mental health and related professionals.
It is expected that participants will have basic knowledge of the topic. Less than 25% of the presentation will review knowledge provided in an introductory workshop in this topic area. The remaining time will focus on advanced topics such as new research, specialty topics not typically covered in graduate education, or specific clinical applications.
Consent as Foundation - Understanding Sexual, Gender & Relationship Diversity
This course serves as a foundation for all the courses in this series on SGRD.
This intermediate workshop advances clinicians beyond foundational SGRD (sexual, gender, and relational diversity) knowledge and into applied clinical competence, with a focus on strengthening therapeutic relationships, increasing access to care, and examining how structural biases shape mental health practice. Drawing on contemporary research, minority stress frameworks, and professional ethical guidelines, the program explores how heterocentric, monocentric, cisnormative, and amatonormative assumptions are embedded within clinical systems and influence both therapeutic process and client experience.
Building on prior SGRD 101/201 material, the workshop examines how privilege, bias, and discrimination operate not only at the individual level but also through institutional norms such as intake procedures, diagnostic frameworks, documentation practices, and unspoken clinical assumptions. Participants analyze how these structures contribute to minority stress for clients in consensual non-monogamy, kink/consensual power exchange, asexual-spectrum, queer, and other sexually marginalized populations, and how such stress may emerge within therapy through guarded disclosure, misattribution of distress, alliance rupture, or premature pathologization.
The program integrates research on clinician bias and misassumptions (e.g., pathologizing CNM, misinterpreting consensual power dynamics, conflating identity or relationship structure with dysfunction) into discussion of common clinical pitfalls, microaggressions, and ethical tensions. Particular attention is given to assessment, rapport building, consent-centered inquiry, and safety evaluation within contexts where structural constraints may limit ideal care.
A significant portion of the workshop focuses on affirmative and ethically responsive clinical behaviors, including differentiating population-level diversity from pathology, using sex-positive and consent-focused language, and engaging in collaborative, curiosity-based assessment. Case examples address complex consent scenarios, coercion versus negotiated dynamics, working with partners or metamours, navigating differences in desire, and responding to shifts in relationship structure.
Participants also examine strategies for creating affirming therapeutic spaces—both physical and virtual—and for reducing structural barriers through thoughtful documentation, demographic forms, and representation. The workshop concludes with guided therapist self-reflection on how personal discomfort, internalized norms (e.g., “kink-phobia,” “poly-phobia”), and professional socialization enter the therapeutic relationship and influence clinical decision-making. Overall, this program enhances applied clinical competence, ethical responsiveness, and structural awareness in service of more equitable mental health care for clients whose sexual and relational lives fall outside dominant cultural norms.
Dr. Rachel Anne Kieran (Psy.D.) is a psychologist, writer, and educator, and the founder of StorieBrook Therapy & Consulting, LLC, an affirming therapy practice rooted in justice, community, and cultural humility. Her clinical work focuses on sexual, gender, and relational diversity (including kink and consensual non-monogamy), neurodiversity, fat and disability justice, and clients from non-majority spiritual and pagan paths.
Dr. Kieran’s practice model emphasizes accessible, bespoke collaboration with clients, including sliding-scale options and a community space designed to be welcoming, trauma-aware, and identity-affirming. Through StorieTree Professional Education, she creates continuing education programs for mental health and allied professionals that center ethics, intersectionality, and dismantling systemic barriers to care.
Her current writing projects include a book on finding and crafting mental healthcare for diverse spiritualities, and related work on “rainbow sheep” identities—those who never fully fit either mainstream or countercultural norms. Across her roles as therapist, educator, and author, Dr. Kieran is committed to the belief that affirming care is a right, not a privilege.
After completing this workshop, participants will be able to:
Differentiate individual bias from structural discrimination as they relate to sexual, gender, and relational diversity in mental health care.
Recognize common signs of structural harm in client presentations, including patterns of mistrust, over-disclosure, minimization, hypervigilance, or reluctance to seek care.
Identify at least three ways systems of privilege (e.g., mononormativity, heteronormativity, cisnormativity) shape access, credibility, and clinical interpretation in healthcare (including mental health).
Explain how “neutral” clinical practices and policies can reproduce inequity even in the absence of overt prejudice.·
Analyze how power operates invisibly in diagnosis, assessment, and treatment planning for sexually and relationally marginalized clients.
Apply a structural lens to common clinical scenarios in order to distinguish systemic harm from individual pathology or clinician error.
Examine how their professional training and institutional context have shaped their assumptions about normality, risk, and legitimacy in relationships and sexuality.
Recognize defensiveness and individualization as common responses to structural critique, and develop strategies for staying engaged with systems-level analysis.
Welcome & Framing – 15 minutes
From Identity Knowledge to Structural Awareness - 20 minutes
Individual bias vs. structural discrimination
Structural competency in mental health care
Structural Biases Related to GSRD - 55 minutes
Structural bias as an active clinical force
Mononormativity as a case example
Privilege, bias, and discrimination in clinical systems
Assumption, bias, and silence as barriers to care
Structural Bias in Assessment, Diagnosis & Documentation – 25 minutes
Diagnosis as a structural act
Intake forms and documentation as gatekeepers
Structural Discrimination in the Therapeutic Relationship – 30 minutes
Alliance, safety, and disclosure under power
Minority stress during therapy
Microaggressions as systemic, not accidental
Ethics, Power & Clinical Responsibility – 20 minutes
Therapist authority and ethical decision-making
Cultural humility as an ethical stance
Integration, Application & What Comes Next – 15 minutes
Identifying and interrupting structural harm
Bridging to future workshops in the series
This is a live program. Full attendance is required to receive a certificate of completion. Certificates of completion will be issued following verified attendance.
This program has been approved for CE by the Georgia Psychological Association.
Acceptance of continuing education credit is determined by individual licensing boards.
The Georgia State Board of Examiners of Psychologists accepts GPA-approved CEs for license renewal under Area III for renewal of their licensees. For information on the board requirements in other states, please consult your state licensing rules.
The Georgia Board of Professional Counselors, Social Workers, and Marriage & Family Therapists accepts GPA-approved CEs for license renewal as related hours for renewal of their licensees (Rule 135-9-.01(2)(f)(1)). For information on the board requirements in other states, please consult your state licensing rules.
StorieTree Professional Education has submitted an application for APA Sponsor Approval and is currently in the review process. All StorieTree programs are developed in alignment with the APA Ethical Principles of Psychologists and Code of Conduct and the APA Standards for Continuing Education Sponsors.
Standard Price - $90
For more information on equity pricing for accessibility, please read the StorieTree Pricing & Equity Policy
For more information on StorieTree's ongoing accessibility efforts, please visit our Accessibility page.