Efficacy of affirmative cognitive behavioural group therapy for sexual and gender minority adolescents and young adults in community settings in Ontario, Canada

Shelley L. Craig, Andrew D. Eaton, Vivian W.Y. Leung, Gio Iacono, Nelson Pang, Frank Dillon, Ashley Austin, Rachael Pascoe, Cheryl Dobinson

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: This study tested the efficacy of AFFIRM, a brief affirmative cognitive-behavioural group intervention tailored to reduce psychosocial distress and improve coping among sexual and gender minority adolescents and young adults (SGMY). Method: SGMY (n = 138; M age = 22.44) were allocated to immediate 8-week AFFIRM intervention delivered at 12 community-based organisations or an 8-week waitlisted control. At baseline, post-intervention or post-waitlist, participants completed self-reported assessments of depression, hope, coping, and stress appraisal. Implementation outcomes of feasibility and acceptability were also assessed. Results: Compared to waitlist, SGMY in the intervention condition significantly reduced their depressive symptoms (b = − 5.79, p =.001) as well as increased reports of hope (agency: b = 0.84, p =.001; pathway: b = 0.79, p =.001), and coping by emotional support (b = 0.59, p <.001), instrumental support (b = 0.67, p <.001), positive framing (b = 0.59, p <.001), humour (b = 0.36, p =.014), planning (b = 0.49, p <.001) as well as reflective coping (b = 0.27, p =.009). Intervention participants were also less likely to perceive stress as a threat (b = − 0.43, p =.001), and more likely to perceive stress as challenge (b = 0.67, p <.001) and have the resources to deal with that stress (b = 0.38, p =.016) in comparison to waitlisted control participants. All outcomes had medium to large effect sizes. AFFIRM participants reported low attrition (8.5%) and high levels of engagement and acceptability (e.g. 99% agreed intervention was relevant to their lives). Over 63% of the community organizations that participated in the training hosted AFFIRM at least once during the study. Conclusions: Results demonstrate efficacy for the community-based implementation of an affirmative clinical intervention designed for SGMY to address depression and foster coping with universal and minority stressors.

Original languageEnglish (US)
Article number94
JournalBMC Psychology
Volume9
Issue number1
DOIs
StatePublished - Dec 2021

Keywords

  • Cognitive behavioural therapy
  • Community intervention
  • Coping
  • Depression
  • Sexual and gender minorities
  • Stress appraisal

ASJC Scopus subject areas

  • Psychology(all)

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