LGBTQ-Affirmative Mental Health Treatments & Implementation

LGBTQ individuals disproportionately experience depression, anxiety, and substance use problems compared to heterosexual, cisgender individuals. One source of these disparities is often assumed to be LGBTQ people’s greater social stress, which leads to chronic experiences of hypervigilance and behavioral avoidance. While these tendencies are often initially adaptive, when held onto throughout life, they can ultimately erode healthy relationships and behaviors.

We have created and evaluated LGBTQ-affirming psychotherapy programs that undo these maladaptive tendencies and improve LGBTQ individuals’ mental, behavioral, and sexual health. Most notably, our team has developed and tested the efficacy of LGBTQ-affirmative cognitive behavioral therapy (CBT) . This treatment was developed in close consultation with community members and clinical experts and has shown associations with reduced depression, anxiety, substance use across several NIH-funded clinical trials. LGBTQ-affirmative CBT has been developed and tested with gay and bisexual men, queer women, and transgender and non-binary individuals in diverse contexts (e.g., community clinics) and countries (e.g., the US, Romania, China). The treatment has been successfully delivered in-person, remotely, in groups, and via online platforms. The LGBTQ-affirmative CBT therapist guide and client workbook are available from Oxford University Press in accessible formats that can be used by all LGBTQ people.

Our current intervention research is now (1) testing LGBTQ-affirmative CBT in a large NIH-funded randomized controlled trial with sexual minority women and (2) studying effective ways to implement LGBTQ-affirmative CBT in LGBTQ community centers, including through training mental health providers and peer counselors in low-resource settings in the US and internationally.

• Pachankis, J. E., Soulliard, Z. A., Morris, F., & Seager van Dyk, I. (2023). A model for adapting evidence-based interventions to be LGBQ-affirmative: Putting minority stress principles and case conceptualization into clinical research and practice. Cognitive and Behavioral Practice, 30(1), 1–17. https://doi.org/10.1016/j.cbpra.2021.11.005
  
• Pachankis, J. E., Soulliard, Z. A., Morris, F., & Seager van Dyk, I. (2022). A model for adapting evidence-based interventions to be LGBQ-affirmative: Putting minority stress Principles and Case Conceptualization into Clinical Research and Practice. Cognitive and Behavioral Practice. https://doi.org/10.1016/j.cbpra.2021.11.005