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LGBTQ-Affirmative Mental Health Treatments & Implementation

Illustrated by Victoria Lee

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 and evaluating LGBTQ-affirming psychotherapy programs that undo these maladaptive tendencies and 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. This intervention has been tested in a small waitlist-controlled trial, as well as a large multi-site trial (in NYC and Miami) which was funded by the National Institute of Mental Health (NIMH).

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., Romania, 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). Recently, we have also embarked on a study in partnership with CenterLink to validate our training procedures for these LGBTQ-affirmative treatments.









Additional Publications

  • 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.