This case study describes Cognitive Processing Therapy (CPT) with a 30-year-old gay man with symptoms of acute stress disorder (ASD) following a recent homophobic assault. Treatment addressed assault-related posttraumatic stress disorder symptoms and depressive symptoms. Also addressed were low self-esteem, helplessness, and high degrees of internalized homophobia. Client symptomatology was tracked using the PTSD Symptom Scale and the Beck Depression Inventory over the course of 12 sessions and for a 3-month posttermination session. Symptoms were significantly reduced by the end of the 12-week therapy and were maintained at 3-month follow-up. This case highlights the utility of this therapy in targeting both ASD symptoms and internalized homophobia relating to experiencing a hate crime-related assault. The authors elaborate on theoretical and applied issues in adapting a structured cognitive-behavioral intervention to the treatment of ASD symptoms associated with experiencing a hate crime.According to national statistics, violent crime in the United States decreased over the past 10 years, yet rates of hate crimes have increased 3.5% (Federal Bureau of Investigations, 2001). Hate crimes based on sexual orientation (16.3%) comprise the third highest category after hate crimes based on race (53.6%) and religion (18.2%). Fifty-six percent of sexual orientationbased hate crimes reported to police were violent offenses (U.S. Department of Justice, 2001). Yet no studies have been conducted on whether standard treatments for posttraumatic stress disorder (PTSD) are efficacious for victims of these types of violent offenses.Hate crimes have been defined as crimes of bias ranging from verbal assault to homicide intended to harm an individual or group because of perceived minority group membership (Herek, 1989). Current federal hatecrime law defines hate crimes as crimes motivated, in whole or in part, by the offender's bias (Swigonski, Mama, & Ward, 2001). This bias may be demonstrated in a variety of ways, including the presence of bias-related comments, written statements, or gestures made by the offender indicating bias (Federal Bureau of Investigations, 1999). A common feature among definitions of hate crimes is victim perception of the event as bias-related (Herek, Gillis, & Cogan, 1999;Swigonski et al., 2001).Studies from within the gay/lesbian/bisexual/trans-gender (GLBT) community suggest that experiences with hate crimes are relatively common . Recent studies have reported 11% to 16% of gay men and lesbians experienced sexual or physicalassaults because of their sexual orientation (Herek et al., 1999;Rose & Mechanic, 2002). One fourth of gay men and one fifth of lesbian women experienced criminal victimization at least once during adulthood due to their sexual orientation (Herek et al., Address correspondence to Debra Kaysen, University of Washington Medical School, Department of Psychiatry and Behavioral Sciences, Box 356560, Seattle, WA 98195-0650; e-mail: dkaysen@u.washington.edu.. 1999). GLBT yo...