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YSPH Team Creates LGBTQ+-affirmative Cognitive-behavioral Therapy

Yale Public Health Magazine, Yale Public Health: Fall 2023

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LGBTQ+-affirmative cognitive-behavioral therapy (CBT) represents the first evidence-based mental health treatment created by and for LGBTQ+ individuals to address the unique stressors that LGBTQ+ people face across life.

LGBTQ+-affirmative CBT has been tested across several clinical trials and shows efficacy for reducing LGBTQ+ people's co-occurring depression, anxiety, and substance use problems.

“The treatment has been tested with gay and bisexual men in New York City, New York, and Miami, Florida; queer women in New York City; Black and Latino gay and bisexual men in New Haven, Connecticut; gay and bisexual men in China; transgender and non-binary individuals in Eastern Europe, and in several other settings by colleagues around the world,” said John Pachankis, Susan Dwight Bliss Professor of Public Health in the Department of Social and Behavioral Sciences and director of Yale’s LGBTQ Mental Health Initiative.

When we found that LGBTQ-affirmative CBT could help improve LGBTQ people’s mental health, we wanted to make sure that LGBTQ people could access this treatment in their local communities.

John Pachankis

“Given its promise for addressing LGBTQ people's disproportionate risk of poor mental health, the Yale LGBTQ Mental Health Initiative is now studying ways to implement LGBTQ-affirmative CBT across the U.S.,” Pachankis said.

His team at Yale created LGBTQ+-affirmative cognitive behavioral therapy by listening to the needs of the LGBTQ+ community and their providers nationwide. Ten years in the making, the value of the treatment was established across randomized trials. This year, Pachankis received a nearly $4 million grant from the National Institutes of Mental Health to test the best ways of implementing LGBTQ+-affirmative cognitive therapy at 90 LGBTQ+ community centers around the country.

Mental health providers can learn to deliver evidence-based LGBTQ+-affirmative cognitive behavioral therapy through low-cost online training, which would help deliver more evidence-based mental health care to LGBTQ+ people and support its implementation across practice settings, according to a recent study by the Yale LGBTQ+ Mental Health Initiative.

“When we found that LGBTQ-affirmative CBT could help improve LGBTQ people’s mental health, we wanted to make sure that LGBTQ people could access this treatment in their local communities,” Pachankis said.

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