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.
- Training in LGBTQ-affirmative cognitive behavioral therapy: A randomized controlled trial across LGBTQ community centers.Pachankis JE, Soulliard ZA, Seager van Dyk I, Layland EK, Clark KA, Levine DS, Jackson SD. J Consult Clin Psychol. 2022 Jul. PMID: 35901370.
- LGBQ-affirmative cognitive-behavioral therapy for young gay and bisexual men's mental and sexual health: A three-arm randomized controlled trial.Pachankis JE, Harkness A, Maciejewski KR, Behari K, Clark KA, McConocha E, Winston R, Adeyinka O, Reynolds J, Bränström R, Esserman DA, Hatzenbuehler ML, Safren SA. J Consult Clin Psychol. 2022 Jun; 2022 Apr 28. PMID: 35482652.
- Current Capacity and Future Implementation of Mental Health Services in U.S. LGBTQ Community Centers.Pachankis JE, Clark KA, Jackson SD, Pereira K, Levine D. Psychiatr Serv. 2021 Jun; 2021 Apr 22. PMID: 33882684.
- A pilot cultural adaptation of LGB-affirmative CBT for young Chinese sexual minority men's mental and sexual health.Pan S, Sun S, Li X, Chen J, Xiong Y, He Y, Pachankis JE. Psychotherapy (Chic). 2021 Mar; 2020 Jun 15. PMID: 32538644.
- Has depression surpassed HIV as a burden to gay and bisexual men's health in the United States? A comparative modeling study.Bromberg DJ, Paltiel AD, Busch SH, Pachankis JE. Soc Psychiatry Psychiatr Epidemiol. 2021 Feb; 2020 Aug 12. PMID: 32785755.
- Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study.Bränström R, Pachankis JE. Am J Psychiatry. 2020 Aug 1; 2019 Oct 4. PMID: 31581798.
- A transdiagnostic minority stress intervention for gender diverse sexual minority women's depression, anxiety, and unhealthy alcohol use: A randomized controlled trial.Pachankis JE, McConocha EM, Clark KA, Wang K, Behari K, Fetzner BK, Brisbin CD, Scheer JR, Lehavot K. J Consult Clin Psychol. 2020 Jul; 2020 May 21. PMID: 32437174.
- Brief online interventions for LGBTQ young adult mental and behavioral health: A randomized controlled trial in a high-stigma, low-resource context.Pachankis JE, Williams SL, Behari K, Job S, McConocha EM, Chaudoir SR. J Consult Clin Psychol. 2020 May. PMID: 32271053.
- Psychotherapy for the Spectrum of Sexual Minority Stress: Application and Technique of the ESTEEM Treatment Model.Burton CL, Wang K, Pachankis JE. Cogn Behav Pract. 2019 May; 2017 Jun 1. PMID: 31592215.
- Improving correctional healthcare providers' ability to care for transgender patients: Development and evaluation of a theory-driven cultural and clinical competence intervention.White Hughto JM, Clark KA, Altice FL, Reisner SL, Kershaw TS, Pachankis JE. Soc Sci Med. 2017 Dec; 2017 Oct 30. PMID: 29096945.
- "What's the right thing to do?" Correctional healthcare providers' knowledge, attitudes and experiences caring for transgender inmates.Clark KA, White Hughto JM, Pachankis JE. Soc Sci Med. 2017 Nov; 2017 Oct 5. PMID: 29028559.
- What reduces sexual minority stress? A review of the intervention "toolkit".Chaudoir SR, Wang K, Pachankis JE. J Soc Issues. 2017 Sep; 2017 Sep 21. PMID: 29170566.
- 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.Millar BM, Wang K, Pachankis JE. J Consult Clin Psychol. 2016 Jul; 2016 Apr 21. PMID: 27100124.
- LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: A randomized controlled trial of a transdiagnostic minority stress approach.Pachankis JE, Hatzenbuehler ML, Rendina HJ, Safren SA, Parsons JT. J Consult Clin Psychol. 2015 Oct; 2015 Jul 6. PMID: 26147563.
- A transdiagnostic minority stress treatment approach for gay and bisexual men's syndemic health conditions.Pachankis JE. Arch Sex Behav. 2015 Oct; 2015 Jun 30. PMID: 26123065.
- 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