Mental Health Treatment Preferences of Sexual Minority Youth and Young Adults: Findings from Three Samples

A growing body of research among sexual minority (e.g., gay, lesbian, bisexual) populations has highlighted unique mental health treatment needs and barriers to care. Despite the rapid proliferation of novel treatments across diverse delivery modalities to address these needs and barriers, few studies have assessed sexual minority people's preferences for mental health treatment. This study described sexual minority youth and young adults' mental health treatment preferences regarding treatment focus (e.g., support in coping with LGBTQ-related stressful events), treatment setting (e.g., in-person, remote), and counselor involvement (e.g., counselor-led, self-guided). Participants included a sample of U.S. sexual minority youth enrolled in an online LGBTQ-affirmative therapy study (n=120), a population-based sample of sexual minority young adults in Sweden (n=472), and a community sample of U.S. sexual minority youth (n = 9,423). This study also explored whether demographic, mental health and mental health treatment, and minority stress factors were associated with preferences for treatment focus, treatment setting, and counselor involvement. Across samples, a higher proportion of participants endorsed counselor-led compared to self-guided treatment. Most participants across samples endorsed a desire for in-person treatment, while endorsement of remote treatment varied based on contextual factors (e.g., age, anxiety symptoms). Internalized stigma and family rejection were associated with increased likelihood of desiring a treatment focus on coping with LGBTQ-related stressful events. Findings emphasize the need to balance trade-offs between accessibility of services and treatment preferences when implementing interventions for this population at scale.