Pilot of a group cognitive behavioural therapy (CBT) program for trans young people experiencing minority stress

The intervention is the Trans Adolescent Group ThErapy for Alleviating Minority stress (TAG TEAM) program, which is a group cognitive behavioural therapy (CBT) program that focuses on experiences of minority stress. The TAG TEAM program was developed with trans young people in a co-design process. Trans young people who had attended the Royal Children’s Hospital Gender Service (RCHGS) participated in one 2-hour workshop and two 1.5-hour workshops over 6 weeks, during which they shared their experiences of being on the waitlist for and attending RCHGS, experiences of being a transgender young person, preferences for the content and delivery of a mental health intervention, and their opinions on the proposed mental health intervention. The TAG TEAM program sessions focus on themes related to minority stress and factors that protect against minority stress (e.g., community connectedness, discrimination and rejection, internalised stigma, pride), and CBT principles that will assist young people to manage their cognitive, emotional, and behavioural responses to minority stress (e.g., assigning and reviewing between-session activities, learning, and practicing techniques). The TAG TEAM program sessions are designed to include group discussion of the session themes, psychoeducation on CBT principles, activities practicing CBT techniques and skills, videos of trans adults exploring the session themes, and the assigning of between-session activities. Between-session activities will take approximately 1-2 hours per week during the program. The program consists of six two-hour sessions conducted weekly, either in-person at the Royal Children’s Hospital, Victoria or online via teleconferencing software. The program will be delivered and facilitated by a psychologist and trans peer worker with experience working with young people. 8 participants will be allocated to each group. The TAG TEAM program is manualised, and the facilitators will be trained in the treatment protocol by a senior clinician in the research team. The fidelity to the treatment protocol will be assessed by facilitators using a checklist at the end of each session to indicate whether each activity in the protocol was (0) not completed, and if so, a reason for non-completion, (1) partially completed, and if so, a reason for partial completion, or (2) completed. The fidelity ratings will be collated by a member of the research team and the facilitators will review their adherence to the protocol in fortnightly supervision sessions with a senior clinician in the research team.