LGBTQ-affirmative Mental Health Treatments
LGBTQ individuals disproportionately experience depression, anxiety, and substance use problems compared to heterosexual, cisgender individuals. For gay and bisexual men, these mental health disparities co-occur with risk for HIV/STI infection. One source of these disparities is often assumed to be LGBTQ people’s greater social stress, such as threat-oriented social perceptions and behavioral avoidance. While these tendencies are often adaptive in early development, when held onto throughout life, they can ultimately erode healthy relationships and behaviors.
We are creating LGBTQ-affirming psychotherapy programs that undo these maladaptive tendencies to improve LGBTQ individuals’ mental, behavioral, and sexual health. For instance, our ESTEEM intervention reworks gay and bisexual men’s cognitive, behavioral, and emotional experiences to be self-affirming. Originally tested in a small waitlist-controlled trial, this treatment is now being tested in a large multi-site trial in NYC and Miami, funded by the National Institute of Mental Health (NIMH). Results will not only establish whether this treatment works over the long-term but also how and why it works, allowing healthcare professionals to incorporate research evidence into their practices.
We created another treatment, EQuIP (Empowering Queer Identities in Psychotherapy), with input from expert mental health providers with expertise treating sexual minority women’s mental health. This treatment, funded by NIMH, the Lesbian Health Fund, and the Yale Fund for Gay and Lesbian Studies, specifically aims to help sexual minority women cope with identity-related stress in order to reduce their depression and alcohol abuse.
Our other LGBTQ-affirmative treatment studies are testing similar interventions in diverse global regions (e.g., Eastern Europe, China), in group format (e.g., at the Fair Haven Community Health Center in New Haven), using technologies (e.g., smartphones), and with particularly vulnerable populations (e.g., rural LGBTQ youth, LGBTQ migrants).
- Burton, C. L., Wang, K., & Pachankis, J. E. (in press). Psychotherapy for the spectrum of sexual minority stress: Application and technique of the ESTEEM treatment model. Cognitive and Behavioral Practice.
- White Hughto, J. M., Clark, K. A., Altice, F. L., Reisner, S. L., Kershaw, T. S., & Pachankis, J. E. (2017). Improving correctional healthcare providers' ability to care for transgender patients: Development and evaluation of a theory-driven cultural and clinical competence intervention.Social Science & Medicine, 195, 159-169.
- Clark, K. A., White Hughto, J. M., Pachankis, J. E. (2017). "What's the right thing to do?" Correctional healthcare providers' knowledge, attitudes and experiences caring for transgender inmates. Social Science & Medicine, 193, 80-89.
- Leluţiu-Weinberger, C., & Pachankis, J. E. (2017). Acceptability and preliminary efficacy of a lesbian, gay, bisexual, and transgender-affirmative mental health practice training in a highly stigmatizing national context. LGBT Health, 4(5), 360-370.
- Millar, B. M., Wang, K., & Pachankis, J. E. (2016). The moderating role of internalized homonegativity on the efficacy of LGB-affirmative psychotherapy: Results from a randomized controlled trial with young adult gay and bisexual men. Journal of Consulting and Clinical Psychology, 84(7), 565-570.
- Chaudoir, S. R., Wang, K., & Pachankis, J. E. (2017). What reduces sexual minority stress? A review of the intervention "toolkit". Journal of Social Issues, 73(3), 586-617.
- Pachankis, J. E., Hatzenbuehler, M. L., Rendina, H. J., Safren, S. A., & Parsons, J. T. (2015). LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: A randomized controlled trial of a transdiagnostic minority stress approach. Journal of Consulting and Clinical Psychology, 83(5), 875-889.
- Pachankis, J. E. (2015). A transdiagnostic minority stress treatment approach for gay and bisexual men's syndemic health conditions. Archives of Sexual Behavior, 44(7), 1843-1860.
- Pachankis, J. E., & Goldfried, M. R. (2007). On the next generation of process research. Clinical Psychology Review, 27(6), 760-768.