Training in LGBTQ-affirmative cognitive behavioral therapy: A randomized controlled trial across LGBTQ community centers.
Training in LGBTQ-affirmative cognitive behavioral therapy: A randomized controlled trial across LGBTQ community centers.
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DOI：
10.1037/ccp0000745
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发表时间：
2022-07
影响因子：
5.9
通讯作者：
Jackson, Skyler D
中科院分区：
文献类型：
--
作者：
Pachankis, John E;Soulliard, Zachary A;Seager van Dyk, Ilana;Layland, Eric K;Clark, Kirsty A;Levine, Deborah S;Jackson, Skyler D
这项随机对照试验研究了在LGBTQ(女同性恋者、男同性恋者、双性恋者、变性者、同性恋者)肯定的CBT中进行为期11周的同步(即实时)在线培训是否会导致美国20个州和世界各地的LGBTQ社区中心更多地采用这种做法。共有121名精神卫生服务提供者(MAGE=37.74；74.4%的顺性；76.9%的LGBTQ；60.3%的非西班牙裔/拉丁裔白人)被随机分配到立即(n=61)或等待4个月后(n=60)接受为期11周的培训。在基线以及基线后4个月和8个月，参与者自我报告他们的LGBTQ肯定能力、文化谦逊以及对LGBTQ肯定CBT背后的少数群体压力理论和实践技能的了解。为了客观地评估对LGBTQ阳性CBT的理解，参与者通过模拟练习演示了他们将如何对两个基于视频的临床插曲做出反应。与等待名单相比，立即培训的参与者在自我报告的文化能力(d=1.24)、少数民族压力知识(d=0.78)、LGBTQ-肯定的CBT知识(d=0.78)和LGBTQ-肯定的CBT技能熟悉度(d=0.91)和使用(d=0.96)方面有更大的改善；效果在基线后8个月持续存在。文化谦逊在不同条件下无显著差异(d=0.07)。在模拟练习的客观编码评估中，训练条件下的参与者表现出对LGBTQ肯定练习技能的更大吸收(d=0.82)。研究结果初步表明，精神卫生提供者可以接受培训，利用在线培训的低成本、高效率提供LGBTQ肯定的CBT。这种培训可以帮助向LGBTQ个人传播以证据为基础的心理保健及其在实践环境中的实施。
This randomized controlled trial examined whether an 11-week synchronous (i.e., real-time) online training in LGBTQ (lesbian, gay, bisexual, transgender, queer)-affirmative CBT could lead to increased uptake of this practice at LGBTQ community centers across 20 US states and internationally. A total of 121 mental health providers (Mage = 37.74; 74.4% cisgender; 76.9% LGBTQ; 60.3% non-Hispanic/Latinx White) were randomized to receive the 11-week training either immediately (n = 61) or after a 4-month wait (n = 60). At baseline and 4- and 8-months after baseline, participants self-reported their LGBTQ-affirmative competency, cultural humility, and knowledge of the minority stress theory and practice skills underlying LGBTQ-affirmative CBT. To objectively assess uptake of LGBTQ-affirmative CBT, participants demonstrated, through simulated practice, how they would respond to two video-based clinical vignettes. Compared to waitlist, participants in the immediate training condition reported greater improvements in self-reported cultural competence (d = 1.24), minority stress knowledge (d = 0.78), LGBTQ-affirmative CBT knowledge (d = 0.78), and LGBTQ-affirmative CBT skills familiarity (d = 0.91) and use (d = 0.96); effects persisted 8 months post-baseline. Cultural humility showed no significant difference by condition (d = 0.07). In objectively coded assessments of simulated practice, participants in the training condition demonstrated greater uptake of LGBTQ-affirmative practice skills (d = 0.82). Findings preliminarily suggest that mental health providers can be trained to deliver LGBTQ-affirmative CBT using the low-cost, efficient reach of online training. This training can help disseminate evidence-based mental healthcare to LGBTQ individuals and its implementation across practice settings.