Implementing LGBTQ-affirmative cognitive-behavioral therapy: implementation strategies across five clinical trials

Abstract Background LGBTQ-affirmative cognitive-behavioral therapy (CBT) is an evidence-based treatment for reducing transdiagnostic mental and behavioral health concerns among LGBTQ individuals. Preserving the effects of this intervention as it is translated into practice can maximize public health...

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Main Authors: Audrey Harkness, Zachary A. Soulliard, Eric K. Layland, Kriti Behari, Brooke G. Rogers, Bharat Bharat, Steven A. Safren, John E. Pachankis
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Implementation Science Communications
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Online Access:https://doi.org/10.1186/s43058-024-00657-x
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author Audrey Harkness
Zachary A. Soulliard
Eric K. Layland
Kriti Behari
Brooke G. Rogers
Bharat Bharat
Steven A. Safren
John E. Pachankis
author_facet Audrey Harkness
Zachary A. Soulliard
Eric K. Layland
Kriti Behari
Brooke G. Rogers
Bharat Bharat
Steven A. Safren
John E. Pachankis
author_sort Audrey Harkness
collection DOAJ
description Abstract Background LGBTQ-affirmative cognitive-behavioral therapy (CBT) is an evidence-based treatment for reducing transdiagnostic mental and behavioral health concerns among LGBTQ individuals. Preserving the effects of this intervention as it is translated into practice can maximize public health benefits. This study systematically identifies and evaluates implementation strategies for LGBTQ-affirmative CBT. Methods First, we identified and operationalized implementation strategies used across five trials of LGBTQ-affirmative CBT using the Pragmatic Implementation Reporting Tool. Second, we evaluated the relative importance of these strategies via a quantitative assessment (N = 31 unique trial implementers). Survey responses were analyzed descriptively within each trial. Across all trials, we organized strategies as (1) high priority, (2) moderate priority, and (3) optional (if resources are available) for implementing LGBTQ-affirmative CBT. Results Within each trial, we identified 20 or more implementation strategies that were used, many of which overlapped across trials. We identified nine high priority strategies (e.g., working with clients to engage them in LGBTQ-affirmative CBT), nine moderate priority strategies (e.g., conducting ongoing training in LGBTQ-affirmative CBT), and nine optional/resource dependent strategies (e.g., showing visual indicators of LGBTQ affirmation within the physical spaces where LGBTQ-affirmative CBT is delivered). Conclusions LGBTQ-affirmative CBT is a complex intervention requiring a package of implementation strategies. Our findings provide guidance for implementers in settings with different levels of resources regarding the highest priority strategies that may be needed to preserve the effectiveness of LGBTQ-affirmative CBT as it is translated into real-world settings.
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spelling doaj-art-31faa1ddbce04e6cba135668f024a80b2025-08-20T02:13:35ZengBMCImplementation Science Communications2662-22112024-11-015111710.1186/s43058-024-00657-xImplementing LGBTQ-affirmative cognitive-behavioral therapy: implementation strategies across five clinical trialsAudrey Harkness0Zachary A. Soulliard1Eric K. Layland2Kriti Behari3Brooke G. Rogers4Bharat Bharat5Steven A. Safren6John E. Pachankis7School of Nursing and Health Studies, University of MiamiDepartment of Psychology, Miami UniversityDepartment of Human Development and Family Sciences, University of DelawareDepartment of Psychology, Syracuse UniversityDepartment of Psychiatry, Chobanian & Avedisian School of Medicine Department of Psychiatry, Boston University, Boston Medical CenterPsychology Department, University of MiamiPsychology Department, University of MiamiDepartment of Social and Behavioral Sciences, Yale School of Public HealthAbstract Background LGBTQ-affirmative cognitive-behavioral therapy (CBT) is an evidence-based treatment for reducing transdiagnostic mental and behavioral health concerns among LGBTQ individuals. Preserving the effects of this intervention as it is translated into practice can maximize public health benefits. This study systematically identifies and evaluates implementation strategies for LGBTQ-affirmative CBT. Methods First, we identified and operationalized implementation strategies used across five trials of LGBTQ-affirmative CBT using the Pragmatic Implementation Reporting Tool. Second, we evaluated the relative importance of these strategies via a quantitative assessment (N = 31 unique trial implementers). Survey responses were analyzed descriptively within each trial. Across all trials, we organized strategies as (1) high priority, (2) moderate priority, and (3) optional (if resources are available) for implementing LGBTQ-affirmative CBT. Results Within each trial, we identified 20 or more implementation strategies that were used, many of which overlapped across trials. We identified nine high priority strategies (e.g., working with clients to engage them in LGBTQ-affirmative CBT), nine moderate priority strategies (e.g., conducting ongoing training in LGBTQ-affirmative CBT), and nine optional/resource dependent strategies (e.g., showing visual indicators of LGBTQ affirmation within the physical spaces where LGBTQ-affirmative CBT is delivered). Conclusions LGBTQ-affirmative CBT is a complex intervention requiring a package of implementation strategies. Our findings provide guidance for implementers in settings with different levels of resources regarding the highest priority strategies that may be needed to preserve the effectiveness of LGBTQ-affirmative CBT as it is translated into real-world settings.https://doi.org/10.1186/s43058-024-00657-xImplementation & disseminationMinority StressStigmaEffectivenessTranslational Research
spellingShingle Audrey Harkness
Zachary A. Soulliard
Eric K. Layland
Kriti Behari
Brooke G. Rogers
Bharat Bharat
Steven A. Safren
John E. Pachankis
Implementing LGBTQ-affirmative cognitive-behavioral therapy: implementation strategies across five clinical trials
Implementation Science Communications
Implementation & dissemination
Minority Stress
Stigma
Effectiveness
Translational Research
title Implementing LGBTQ-affirmative cognitive-behavioral therapy: implementation strategies across five clinical trials
title_full Implementing LGBTQ-affirmative cognitive-behavioral therapy: implementation strategies across five clinical trials
title_fullStr Implementing LGBTQ-affirmative cognitive-behavioral therapy: implementation strategies across five clinical trials
title_full_unstemmed Implementing LGBTQ-affirmative cognitive-behavioral therapy: implementation strategies across five clinical trials
title_short Implementing LGBTQ-affirmative cognitive-behavioral therapy: implementation strategies across five clinical trials
title_sort implementing lgbtq affirmative cognitive behavioral therapy implementation strategies across five clinical trials
topic Implementation & dissemination
Minority Stress
Stigma
Effectiveness
Translational Research
url https://doi.org/10.1186/s43058-024-00657-x
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