ESTEEM study

LGBTQ-affirmative Mental Health Treatments (ESTEEM) 

LGBTQ individuals disproportionately experience more depression, anxiety, and substance use problems compared to their cisgender, heterosexual counterparts. The source of these disparities is often located in exposure to minority stress (the stress associated with sexual orientation-related social disadvantage). Our lab is working on creating various LGBTQ-affirming psychotherapy programs that address the underlying pathways through which minority stress operates to impact the health of LGBTQ individuals. 

Our ESTEEM study is working to test an affirming therapy that addresses the way sexual minority stress effects the health of gay, bisexual, and queer men. Minority stress drives young gay and bisexual men’s HIV transmission risk, which is increasing in this demographic group. To this end, we have developed a cognitive behavioral intervention that aims to reduce co-occurring mental health problems, substance use, and HIV risk behaviors among young gay and bisexual men by targeting cognitive and affective minority stress processes. Having demonstrated preliminary efficacy in a small pilot study, the intervention is currently being evaluated in a NIH-funded randomized controlled trial in NYC and Miami.


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, 875-889.

Millar, B., Wang, K., & Pachankis, J.E. (2016).  The moderating role of implicit 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, 565-570.

Parsons, J. T., Rendina, H. J., Moody, R., Gurung S., Starks, T. J., &  Pachankis, J. E.  (in press). Preliminary efficacy of an emotion regulation intervention to improve mental health and reduce HIV transmission risk behaviors for HIV-positive gay and bisexual men with sexual compulsivity.  AIDS and Behavior.

Pachankis, J. E. (2014).  Uncovering clinical principles and techniques to address minority stress, mental health, and related health risks among gay and bisexual men. Clinical Psychology: Science and Practice, 21,313-330.

Proujansky, R. A., & Pachankis, J. E. (2014).  Toward formulating evidence-based principles of LGB-affirmative psychotherapy. Pragmatic Case Studies in Psychotherapy, 10, 117-131.

Pachankis, J.E., & Goldfried, M.R. (2010).  Expressive writing for gay-related stress:  Psychosocial benefits and mechanisms underlying improvement.  Journal of Consulting and Clinical Psychology, 78, 98-110.

Pachankis, J.E. (2009).  The use of cognitive behavior therapy to promote authenticity. Pragmatic Case Studies in Psychotherapy, 5, 28-38.

Pachankis, J.E., & Goldfried, M.R. (2004).  Clinical issues in working with lesbian, gay, and bisexual clients. Psychotherapy, 41, 227-246.


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