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

Area of Science:

• Psychology
• Public Health
• Implementation Science

Background:

• LGBTQ-affirmative cognitive-behavioral therapy (CBT) is an evidence-based treatment for LGBTQ individuals.
• Effective implementation is crucial for public health benefits.
• This study focuses on identifying and evaluating strategies for implementing LGBTQ-affirmative CBT.

Purpose of the Study:

• To systematically identify and evaluate implementation strategies for LGBTQ-affirmative CBT.
• To determine the relative importance of various implementation strategies.
• To provide guidance for resource-dependent implementation settings.

Main Methods:

• Operationalized implementation strategies from five trials using the Pragmatic Implementation Reporting Tool.
• Conducted a quantitative assessment with 31 unique trial implementers to evaluate strategy importance.
• Categorized strategies into high priority, moderate priority, and optional based on resource availability.

Main Results:

• Identified over 20 implementation strategies per trial, with significant overlap across studies.
• Nine high-priority strategies include client engagement in LGBTQ-affirmative CBT.
• Nine moderate-priority strategies involve ongoing training, and nine optional strategies relate to physical space indicators.

Conclusions:

• LGBTQ-affirmative CBT is a complex intervention necessitating a package of implementation strategies.
• Findings offer guidance for implementers on high-priority strategies to preserve intervention effectiveness.
• Recommendations are tailored for settings with varying resource levels.