Symposia
LGBQT+
Ilana Seager van Dyk, Ph.D.
Senior Lecturer
Massey University
Wellington, Wellington, New Zealand
Zachary A. Soulliard, Ph.D.
Postdoctoral Associate
Yale School of Public Health
New York City, New York
Eric K. Layland, Ph.D.
Postdoctoral Fellow
Yale School of Public Health
New York, NY
John E. Pachankis, Ph.D.
Susan Dwight Bliss Professor of Public Health (Social and Behavioral Sciences)
Yale School of Public Health
New Haven, Connecticut
Background: LGBTQ youth experience disproportionately high rates of mental health challenges relative to their heterosexual and cisgender peers. This phenomenon has been explained via minority stress theory, which states that unique LGBTQ stressors (e.g., discrimination) combine with general life stress to increase an individual’s risk of mental illness. However, to date, the only intervention tested in a randomized controlled trial that attempts to directly reduce maladaptive responses to minority stress—LGBTQ-affirmative CBT—has only included young adults. The goal of this study was to adapt and pilot this treatment with a clinical sample of LGBTQ youth, and to assess its feasibility and acceptability.
Methods: Nine LGBTQ youth (aged 12-16; 78% gender diverse, 100% sexual minority) were recruited online. Per the K-SADS, 100% of youth met DSM-5 criteria for an anxiety disorder; 44% also met for a depressive disorder. Youth attended 10 weekly 90-minute online group therapy sessions facilitated by a licensed clinical psychologist. Session content came from the adult version of the treatment adapted to be more developmentally appropriate by pulling from adolescent CBT protocols, as well as by adding content to meet the unique needs of LGBTQ youth (e.g., LGBTQ role models). Youth and their parents completed pre- and post-treatment and weekly post-session measures assessing treatment feasibility (session attendance, barriers to attendance) and acceptability (Client Satisfaction Questionnaire-8), as well as mental health symptoms (Revised Children’s Anxiety and Depression Scale).
Results: Youth attended an average of 7 sessions (range: 2-10), and reported limited barriers to attendance (e.g., technical difficulties). Two youth did not complete the full intervention (one due to need for a higher level of care, one due to anxiety in the group setting). On the CSQ-8, youth (M=27.13, SD=5.22) and parents (M=28.25, SD=3.77) expressed high satisfaction with the services received. Finally, mental health symptoms decreased from pre- to post-treatment, with RCADS total T-scores reducing by an average of 13.2 points per youth report, and 4.61 points per parent report.
Conclusions: Initial results suggest that LGBTQ-affirmative group CBT is both feasible and acceptable with youth aged 12-16 meeting criteria for an anxiety and/or depressive disorder. Future research can compare this intervention to existing treatments to assess its efficacy in improving LGBTQ youth’s mental health and reducing their maladaptive responses to minority stress.