Juan Camarena works with Mark—a third-generation, working-class, Latino male. Mark sought therapy because of his sexual attraction to men, which he feels is taboo in his culture. His sexual activities caused him enough distress to think he may be a sex addict and thus to seek out a therapist who could help. In this session, Mark begins to realize that the frequency of sexual interactions is not the issue so much as his sexual interactions with men. His feelings of guilt and shame are based on his standards of what is sanctioned sexual behavior for men in his community. Camarena practices from a gay-affirmative, multicultural approach. In his work with Mark, Camarena recognizes, honors, and validates Mark’s Latino heritage as well as his perceived masculinity. Camarena asks about Mark’s family history, immigration stories, and connection to his grandfather’s home country to help communicate to Mark that his ethnic identity is important and a valuable asset. Camarena uses bibliotherapy and homework outside the session to continue Mark’s identity-formation process, which is in line with both multicultural and gay-affirmative therapy. Utilizing motivational interviewing techniques such as exploring ambivalence and rolling with resistance is especially helpful in Camarena’s work with Mark. The goal of treatment is to lower Mark’s distress that brought him to therapy by helping Mark create an identity that is meaningful to him. Juan Camarena is a licensed marriage and family therapist, licensed professional clinical counselor, and certified sex therapist. He has a master’s degree in counseling from San Diego State University and a master’s degree in human sexuality from Widener University, in Philadelphia, where he is also a doctoral candidate. His clinical work and research are focused on the intersection of sexual behaviors and sexual identities with cultural and ethnic identities.