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Implementing LGBTQ-affirmative CBT: study protocol for an effectiveness-implementation trial at 90 LGBTQ community
John E Pachankis1, Danielle Chiaramonte2, Hunter T Baldwin2
1Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA. john.pachankis@yale.edu.
BMC Health Services Research
|July 21, 2025
Summary
This study compares three training strategies for implementing LGBTQ-affirmative cognitive-behavioral therapy (CBT) in community centers. Findings will guide national implementation of this evidence-based practice for sexual and gender minorities (SGM).
Area of Science:
- Mental Health Disparities
- Implementation Science
- Evidence-Based Practices
Background:
- Sexual and gender minorities (SGM) face significant mental health disparities.
- Lack of tailored, evidence-based practices (EBPs) contributes to these disparities.
- LGBTQ-affirmative cognitive-behavioral therapy (CBT) is a key EBP for SGM mental health, with LGBTQ community centers being ideal implementation sites.
Purpose of the Study:
- To compare the effectiveness of three training strategies for implementing LGBTQ-affirmative CBT.
- To identify center-level moderators influencing implementation success.
- To examine the impact of training strategies on client mental health via organizational and provider mechanisms.
Main Methods:
- A hybrid type III effectiveness-implementation trial randomizing 90 centers to three additive training strategies: self-paced digital materials, materials plus live webinars, or materials plus webinars and local supervision.
- Primary outcome: provider fidelity assessed via simulated practice.
- Mixed-methods design capturing implementation determinants, mediators, and other outcomes; clinical effectiveness assessed via client surveys at 15 centers.
Main Results:
- (Study protocol; results pending) The trial will assess provider fidelity, implementation determinants (e.g., resources, characteristics), mediators (e.g., climate, self-efficacy), and intervention adaptation/sustainment.
- (Study protocol; results pending) Clinical effectiveness will be measured by client mental and behavioral health symptoms.
Conclusions:
- Research is needed to determine optimal nationwide implementation strategies for LGBTQ-affirmative CBT.
- This study aims to provide generalizable guidance for implementing EBPs in low-resource settings serving populations with mental health disparities.
- Findings will inform effective dissemination of LGBTQ-affirmative CBT within LGBTQ community centers.
Keywords:
Cognitive-behavioral therapyImplementation scienceMental healthSexual and gender minorityStigmaMore Related Videos
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