LGBTQ
Conditions
Brief summary
The purpose of the proposed study is to train mental health providers (MHPs) at lesbian, gay, bisexual, transgender, and queer (LGBTQ) community centers across the United States in evidence-based, LGBTQ-affirmative cognitive-behavioral therapy (CBT).
Detailed description
The purpose of the proposed study is to train mental health providers (MHPs) at LGBTQ community centers across the United States in evidence-based, LGBTQ-affirmative cognitive-behavioral therapy (CBT). The primary objective of this study is to determine whether the LGBTQ-affirmative CBT training increases LGBTQ and CBT knowledge, clinical skills, and cultural humility among a sample of MHPs from LGBTQ community centers in the U.S. The proposed prospective study will follow a 2-arm waitlist randomized-controlled trial design where one group of MHPs will be randomized to receive the intervention training (i.e., the immediate training group) in LGBTQ-affirmative CBT, and the second group of MHPs will be randomized to a waitlist control group. The proposed mixed-methods study will consist of predominantly quantitative self-report measures, as well as a qualitative self-assessment of participants' LGBTQ-affirmative CBT clinical skills. All study measures will be administered online at three time points-- baseline, 4-months post-baseline, and 8-months post-baseline (changed prior to randomization from 3-months and 6-months, respectively)-- via the secure Yale Qualtrics survey software.
Interventions
BEHAVIORALLGBTQ-affirmative CBT training
Participants will take part in 11-week LGBTQ-affirmative CBT training via Zoom for 1-hour per week.
Sponsors
David R. Kessler, M.D. '55 Fund for LGBTQ Mental Health Research at Yale
Yale University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* 18+ years old * Fluent in English * Mental health provider (including, but not limited to licensed practicing counselors, licensed clinical social workers, licensed marital and family therapists, clinical/counseling psychologists, pre-doctoral psychology interns, third-year or greater graduate practicum students/externs) * Currently practicing in an LGBTQ community center that is coordinated by CenterLink, the coordinating hub for LGBTQ community centers in the U.S.
Exclusion criteria
* • Individuals unwilling or unable to give informed consent at the time of participation and/or not fitting the eligibility criteria outlined above
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Familiarity With LGBTQ-Affirmative CBT Skills | Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention | Familiarity with LGBTQ-affirmative CBT skills will be measured using a self-developed questionnaire by the researchers for the purpose of this study. This questionnaire consists of 7 items rated on a 5-point Likert scale for each item. An overall score of 35 (sum of all items) would be the highest possible score on the questionnaire and would indicate a high level of familiarity with LGBTQ-affirmative CBT skills. |
| Use of LGBTQ-Affirmative CBT Skills | Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention | Use LGBTQ-affirmative CBT skills will be measured using a self-developed questionnaire by the researchers for the purpose of this study. This questionnaire consists of 7 items rated on a 5-point Likert scale for each item. An overall score of 35 (sum of all items) would be the highest possible score on the questionnaire and would indicate a high level of use of LGBTQ-affirmative CBT skills. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Applied CBT Clinical Skills Competency | Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention | Competency in general CBT clinical skills will be measured by asking participants to provide responses to videos of fictional LGBTQ clients. Participants will watch 2 brief video clips (90 seconds each) of fictional clients presenting concerns they would like to address in psychotherapy. Participants will then be asked to write a brief paragraph describing what clinical approaches they would use in clinical treatment in order to address the challenges discussed by the fictional client. These written responses will be rated based on 22 items on a 2-point scale of 0 (did not mention at all), 1 (briefly discussed), and 2 (discussed in detail) to determine participants' LGBTQ-affirmative and general CBT skills. Items coded related to LGBTQ-affirmative CBT skills will not be double coded in the comparable items related to general CBT skills. Average scores will be taken such that 2 would be the highest possible score and would indicate a high level of competence in CBT clinical skills. |
| LGBTQ Cultural Humility | Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention | LGBTQ cultural humility will be measured using the Multidimensional Cultural Humility Scale (MCHS). This questionnaire is a 15-item self-report psychometrically validated measure assessing the extent to which respondents endorse an ability to maintain an other-oriented, interpersonal stance in relation to cultural identities most salient to clients. For the present study, items were adapted to specifically assess cultural humility as related to working with LGBTQ clients. An overall score of 90 (sum of all items) would be the highest possible score on the questionnaire and would indicate a high level of LGBTQ cultural humility. |
| Self-Reported LGBTQ Clinical Skills Competency | Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention | Competency in LGBTQ clinical skills will be measured using the Sexual Orientation Counselor Competency Scale (SOCCS) - Clinical Skills subscale. This subscale consists of 11-items from a psychometrically validated measure, based on a 7-point Likert scale assessing the extent to which respondents endorse clinical competence as related to their skills in working with clients of diverse sexual identities. For the present study, items have been adapted to specifically assess competence in clinical skills based on an LGBTQ-affirmative CBT framework. An overall score of 7 (arithmetic mean of all 11 items) would be the highest possible score and would indicate a high level of competence in LGBTQ clinical skills. |
| Content Knowledge of CBT/LGBTQ-Affirmative CBT | Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention | Content knowledge of CBT/LGBTQ-affirmative CBT will be measured using a self-developed, 10-item multiple-choice measure by the researchers for the purpose of this study based on past interventional studies of LGBTQ-affirmative CBT. An overall score of 10 (i.e., answering all 10-items correctly) would be the highest possible score on the measure and would indicate a high level of content knowledge of CBT/LGBTQ-affirmative CBT. |
| Acceptability of LGBTQ-affirmative CBT Training | Immediate Post-intervention | Acceptability of LGBTQ-affirmative CBT will measured using a self-developed questionnaire by the researchers based on past research on training acceptability. Participants will be asked to report how many of the 11 training sessions they attended. Participants will then be asked 2 qualitative questions in regard to which of the 11 training sessions they found most and least helpful. Participants will also be asked 7 questions based on a 5-point Likert scale regarding their interest and perceived benefit from the training. An overall score of 35 (sum of all items) on the Likert scale items would be the highest possible score on the measure and would indicate a high level of perceived acceptability of the LGBTQ-affirmative CBT training. |
| Content Knowledge of Minority Stress | Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-Intervention | Content knowledge of minority stress will be measured using a self-developed, 10-item multiple-choice measure by the researchers for the purpose of this study and based on past minority stress research. An overall score of 10 (i.e., answering all 10-items correctly) would be the highest possible score on the measure and would indicate a high level of content knowledge of minority stress. |
| Applied LGBTQ Clinical Skills Competency | Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention | Competency in LGBTQ clinical skills will be measured by asking participants to provide responses to videos of fictional LGBTQ clients. Participants will watch 2 brief video clips (90 seconds each) of fictional clients presenting concerns they would like to address in psychotherapy. Participants will then be asked to write a brief paragraph describing what clinical approaches they would use in clinical treatment in order to address the challenges discussed by the fictional client. These written responses will be rated based on 22 items on a 2-point scale of 0 (did not mention at all), 1 (briefly discussed), and 2 (discussed in detail) to determine participants' LGBTQ-affirmative and general CBT skills. Items coded related to LGBTQ-affirmative CBT skills will not be double coded in the comparable items related to general CBT skills. Average scores will be taken such that 2 would be the highest possible score and would indicate a high level of competence in LGBTQ clinical skills. |
Countries
United States
Participant flow
Recruitment details
Recruitment was conducted through an online flyer emailed to listservs of mental health providers at CenterLink LGBTQ community centers. An informal webinar was also held in October 2020 for mental health providers at CenterLink LGBTQ community centers to learn more about the study.
Participants by arm
| Arm | Count |
|---|---|
| Immediate Training Group Participants will take part in 11-week LGBTQ-affirmative CBT training via Zoom for 1-hour per week. The participants in the immediate training group will take part in the first 11-week course.
LGBTQ-affirmative CBT training: Participants will take part in 11-week LGBTQ-affirmative CBT training via Zoom for 1-hour per week. | 61 |
| Waitlist Control Group Participants will take part in 11-week LGBTQ-affirmative CBT training via Zoom for 1-hour per week. The participants in the waitlist control group will take part in the second 11-week course.
LGBTQ-affirmative CBT training: Participants will take part in 11-week LGBTQ-affirmative CBT training via Zoom for 1-hour per week. | 60 |
| Total | 121 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 14 | 15 |
| Overall Study | Withdrawal by Subject | 0 | 1 |
Baseline characteristics
| Characteristic | Immediate Training Group | Total | Waitlist Control Group |
|---|---|---|---|
| Age, Continuous | 39.74 years STANDARD_DEVIATION 11.36 | 37.74 years STANDARD_DEVIATION 10.55 | 35.72 years STANDARD_DEVIATION 9.33 |
| Age of Clients 13-17 | 5 Participants | 12 Participants | 7 Participants |
| Age of Clients 18-30 | 29 Participants | 58 Participants | 29 Participants |
| Age of Clients 31-50 | 23 Participants | 42 Participants | 19 Participants |
| Age of Clients <5-12 | 2 Participants | 4 Participants | 2 Participants |
| Age of Clients 51-65+ | 2 Participants | 5 Participants | 3 Participants |
| Education Degree Bachelor's Degree | 6 Participants | 20 Participants | 14 Participants |
| Education Degree Doctoral Degree | 3 Participants | 4 Participants | 1 Participants |
| Education Degree High School/GED or Associate's Degree | 2 Participants | 2 Participants | 0 Participants |
| Education Degree Master's Degree | 50 Participants | 95 Participants | 45 Participants |
| Employment Status Full-Time (40 Hours Per Week) | 37 Participants | 66 Participants | 29 Participants |
| Employment Status Other | 2 Participants | 8 Participants | 6 Participants |
| Employment Status Part-Time (Less Than 40 Hours Per Week) | 19 Participants | 31 Participants | 12 Participants |
| Employment Status Practicum Student/Intern | 3 Participants | 16 Participants | 13 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 15 Participants | 24 Participants | 9 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 46 Participants | 97 Participants | 51 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Number of Years Working in Mental Health | 6.85 years STANDARD_DEVIATION 7.42 | 6.13 years STANDARD_DEVIATION 7.11 | 5.40 years STANDARD_DEVIATION 6.77 |
| Number of Years Working with LGBTQ Clients | 4.33 years STANDARD_DEVIATION 5.37 | 3.58 years STANDARD_DEVIATION 4.39 | 2.82 years STANDARD_DEVIATION 2.95 |
| Primary Mode of Psychotherapy Family Therapy | 1 Participants | 1 Participants | 0 Participants |
| Primary Mode of Psychotherapy Group Therapy | 7 Participants | 16 Participants | 9 Participants |
| Primary Mode of Psychotherapy Individual Therapy | 52 Participants | 98 Participants | 46 Participants |
| Primary Mode of Psychotherapy Other | 1 Participants | 6 Participants | 5 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 3 Participants | 2 Participants |
| Race (NIH/OMB) Black or African American | 5 Participants | 13 Participants | 8 Participants |
| Race (NIH/OMB) More than one race | 11 Participants | 22 Participants | 11 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) White | 43 Participants | 81 Participants | 38 Participants |
| Region of Enrollment Canada | 1 participants | 1 participants | 0 participants |
| Region of Enrollment Uganda | 0 participants | 1 participants | 1 participants |
| Region of Enrollment United States | 60 participants | 119 participants | 59 participants |
| Sex/Gender, Customized Gender Identity : Cisgender Man | 14 Participants | 25 Participants | 11 Participants |
| Sex/Gender, Customized Gender Identity : Cisgender Woman | 29 Participants | 66 Participants | 37 Participants |
| Sex/Gender, Customized Gender Identity : Gender Non-Binary | 4 Participants | 12 Participants | 8 Participants |
| Sex/Gender, Customized Gender Identity : Gender Non-Conforming | 1 Participants | 3 Participants | 2 Participants |
| Sex/Gender, Customized Gender Identity : Genderqueer | 6 Participants | 7 Participants | 1 Participants |
| Sex/Gender, Customized Gender Identity : Other | 2 Participants | 5 Participants | 3 Participants |
| Sex/Gender, Customized Gender Identity : Transgender Man | 6 Participants | 6 Participants | 0 Participants |
| Sex/Gender, Customized Gender Identity : Transgender Woman | 1 Participants | 2 Participants | 1 Participants |
| Sexual Orientation Asexual | 1 Participants | 2 Participants | 1 Participants |
| Sexual Orientation Bisexual | 6 Participants | 13 Participants | 7 Participants |
| Sexual Orientation Gay | 13 Participants | 22 Participants | 9 Participants |
| Sexual Orientation Heterosexual/Straight | 14 Participants | 28 Participants | 14 Participants |
| Sexual Orientation Lesbian | 9 Participants | 18 Participants | 9 Participants |
| Sexual Orientation Other | 0 Participants | 1 Participants | 1 Participants |
| Sexual Orientation Pansexual | 7 Participants | 13 Participants | 6 Participants |
| Sexual Orientation Queer | 11 Participants | 24 Participants | 13 Participants |
| Theoretical Orientation Cognitive Behavioral (CBT) | 10 Participants | 27 Participants | 17 Participants |
| Theoretical Orientation Eclectic or Integrative | 23 Participants | 44 Participants | 21 Participants |
| Theoretical Orientation Existential | 0 Participants | 1 Participants | 1 Participants |
| Theoretical Orientation Humanistic/Person-Centered | 15 Participants | 29 Participants | 14 Participants |
| Theoretical Orientation Missing | 1 Participants | 1 Participants | 0 Participants |
| Theoretical Orientation Psychodynamic/Psychoanalytic | 2 Participants | 5 Participants | 3 Participants |
| Theoretical Orientation Solution-Focused | 9 Participants | 13 Participants | 4 Participants |
| Theoretical Orientation Third-Wave CBT | 1 Participants | 1 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 61 | 0 / 60 |
| other Total, other adverse events | 0 / 61 | 0 / 60 |
| serious Total, serious adverse events | 0 / 61 | 0 / 60 |
Outcome results
Primary
Familiarity With LGBTQ-Affirmative CBT Skills
Familiarity with LGBTQ-affirmative CBT skills will be measured using a self-developed questionnaire by the researchers for the purpose of this study. This questionnaire consists of 7 items rated on a 5-point Likert scale for each item. An overall score of 35 (sum of all items) would be the highest possible score on the questionnaire and would indicate a high level of familiarity with LGBTQ-affirmative CBT skills.
Time frame: Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention
Population: Participants in the Immediate training group started training immediately after randomization, and therefore, have no data for the four-month waiting period prior to receiving the intervention. Participants in the Waitlist control group started training four months after randomization and therefore, were not assessed at the four-month follow-up time point due to completion of the study.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Immediate Training Group | Familiarity With LGBTQ-Affirmative CBT Skills | Immediate Post-intervention | 24.34 score on a scale | Standard Error 0.66 |
| Immediate Training Group | Familiarity With LGBTQ-Affirmative CBT Skills | Immediate Pre-intervention | 18.30 score on a scale | Standard Error 0.76 |
| Immediate Training Group | Familiarity With LGBTQ-Affirmative CBT Skills | Four-month Post-intervention | 25.57 score on a scale | Standard Error 0.66 |
| Waitlist Control Group | Familiarity With LGBTQ-Affirmative CBT Skills | Immediate Post-intervention | 25.46 score on a scale | Standard Error 0.79 |
| Waitlist Control Group | Familiarity With LGBTQ-Affirmative CBT Skills | Four-month Pre-intervention | 19.00 score on a scale | Standard Error 0.66 |
| Waitlist Control Group | Familiarity With LGBTQ-Affirmative CBT Skills | Immediate Pre-intervention | 19.70 score on a scale | Standard Error 0.76 |
Primary
Use of LGBTQ-Affirmative CBT Skills
Use LGBTQ-affirmative CBT skills will be measured using a self-developed questionnaire by the researchers for the purpose of this study. This questionnaire consists of 7 items rated on a 5-point Likert scale for each item. An overall score of 35 (sum of all items) would be the highest possible score on the questionnaire and would indicate a high level of use of LGBTQ-affirmative CBT skills.
Time frame: Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention
Population: Participants in the Immediate training group started training immediately after randomization, and therefore, have no data for the four-month waiting period prior to receiving the intervention. Participants in the Waitlist control group started training four months after randomization and therefore, were not assessed at the four-month follow-up time point due to completion of the study.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Immediate Training Group | Use of LGBTQ-Affirmative CBT Skills | Immediate Pre-intervention | 16.77 score on a scale | Standard Error 0.67 |
| Immediate Training Group | Use of LGBTQ-Affirmative CBT Skills | Immediate Post-intervention | 22.93 score on a scale | Standard Error 0.72 |
| Immediate Training Group | Use of LGBTQ-Affirmative CBT Skills | Four-month Post-intervention | 24.02 score on a scale | Standard Error 0.69 |
| Waitlist Control Group | Use of LGBTQ-Affirmative CBT Skills | Immediate Pre-intervention | 18.46 score on a scale | Standard Error 0.77 |
| Waitlist Control Group | Use of LGBTQ-Affirmative CBT Skills | Four-month Pre-intervention | 17.53 score on a scale | Standard Error 0.66 |
| Waitlist Control Group | Use of LGBTQ-Affirmative CBT Skills | Immediate Post-intervention | 23.61 score on a scale | Standard Error 0.77 |
Secondary
Acceptability of LGBTQ-affirmative CBT Training
Acceptability of LGBTQ-affirmative CBT will measured using a self-developed questionnaire by the researchers based on past research on training acceptability. Participants will be asked to report how many of the 11 training sessions they attended. Participants will then be asked 2 qualitative questions in regard to which of the 11 training sessions they found most and least helpful. Participants will also be asked 7 questions based on a 5-point Likert scale regarding their interest and perceived benefit from the training. An overall score of 35 (sum of all items) on the Likert scale items would be the highest possible score on the measure and would indicate a high level of perceived acceptability of the LGBTQ-affirmative CBT training.
Time frame: Immediate Post-intervention
Population: This outcome was collected only during the assessment immediately following the intervention for each group.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Immediate Training Group | Acceptability of LGBTQ-affirmative CBT Training | 31.10 score on a scale | Standard Error 4.17 |
| Waitlist Control Group | Acceptability of LGBTQ-affirmative CBT Training | 30.57 score on a scale | Standard Error 5.16 |
Secondary
Applied CBT Clinical Skills Competency
Competency in general CBT clinical skills will be measured by asking participants to provide responses to videos of fictional LGBTQ clients. Participants will watch 2 brief video clips (90 seconds each) of fictional clients presenting concerns they would like to address in psychotherapy. Participants will then be asked to write a brief paragraph describing what clinical approaches they would use in clinical treatment in order to address the challenges discussed by the fictional client. These written responses will be rated based on 22 items on a 2-point scale of 0 (did not mention at all), 1 (briefly discussed), and 2 (discussed in detail) to determine participants' LGBTQ-affirmative and general CBT skills. Items coded related to LGBTQ-affirmative CBT skills will not be double coded in the comparable items related to general CBT skills. Average scores will be taken such that 2 would be the highest possible score and would indicate a high level of competence in CBT clinical skills.
Time frame: Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention
Population: Participants in the Immediate training group started training immediately after randomization, and therefore, have no data for the four-month waiting period prior to receiving the intervention. Participants in the Waitlist control group started training four months after randomization and therefore, were not assessed at the four-month follow-up time point due to completion of the study.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Immediate Training Group | Applied CBT Clinical Skills Competency | Immediate Pre-intervention | 0.10 units on a scale | Standard Error 0.01 |
| Immediate Training Group | Applied CBT Clinical Skills Competency | Immediate Post-intervention | 0.17 units on a scale | Standard Error 0.03 |
| Immediate Training Group | Applied CBT Clinical Skills Competency | Four-month Post-intervention | 0.14 units on a scale | Standard Error 0.02 |
| Waitlist Control Group | Applied CBT Clinical Skills Competency | Four-month Pre-intervention | 0.12 units on a scale | Standard Error 0.01 |
| Waitlist Control Group | Applied CBT Clinical Skills Competency | Immediate Pre-intervention | 0.12 units on a scale | Standard Error 0.01 |
| Waitlist Control Group | Applied CBT Clinical Skills Competency | Immediate Post-intervention | 0.11 units on a scale | Standard Error 0.02 |
Secondary
Applied LGBTQ Clinical Skills Competency
Competency in LGBTQ clinical skills will be measured by asking participants to provide responses to videos of fictional LGBTQ clients. Participants will watch 2 brief video clips (90 seconds each) of fictional clients presenting concerns they would like to address in psychotherapy. Participants will then be asked to write a brief paragraph describing what clinical approaches they would use in clinical treatment in order to address the challenges discussed by the fictional client. These written responses will be rated based on 22 items on a 2-point scale of 0 (did not mention at all), 1 (briefly discussed), and 2 (discussed in detail) to determine participants' LGBTQ-affirmative and general CBT skills. Items coded related to LGBTQ-affirmative CBT skills will not be double coded in the comparable items related to general CBT skills. Average scores will be taken such that 2 would be the highest possible score and would indicate a high level of competence in LGBTQ clinical skills.
Time frame: Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention
Population: Participants in the Immediate training group started training immediately after randomization, and therefore, have no data for the four-month waiting period prior to receiving the intervention. Participants in the Waitlist control group started training four months after randomization and therefore, were not assessed at the four-month follow-up time point due to completion of the study.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Immediate Training Group | Applied LGBTQ Clinical Skills Competency | Immediate Pre-intervention | 0.11 score on a scale | Standard Error 0.02 |
| Immediate Training Group | Applied LGBTQ Clinical Skills Competency | Immediate Post-intervention | 0.24 score on a scale | Standard Error 0.03 |
| Immediate Training Group | Applied LGBTQ Clinical Skills Competency | Four-month Post-intervention | 0.22 score on a scale | Standard Error 0.03 |
| Waitlist Control Group | Applied LGBTQ Clinical Skills Competency | Immediate Pre-intervention | 0.14 score on a scale | Standard Error 0.02 |
| Waitlist Control Group | Applied LGBTQ Clinical Skills Competency | Immediate Post-intervention | 0.31 score on a scale | Standard Error 0.03 |
| Waitlist Control Group | Applied LGBTQ Clinical Skills Competency | Four-month Pre-intervention | 0.12 score on a scale | Standard Error 0.02 |
Secondary
Content Knowledge of CBT/LGBTQ-Affirmative CBT
Content knowledge of CBT/LGBTQ-affirmative CBT will be measured using a self-developed, 10-item multiple-choice measure by the researchers for the purpose of this study based on past interventional studies of LGBTQ-affirmative CBT. An overall score of 10 (i.e., answering all 10-items correctly) would be the highest possible score on the measure and would indicate a high level of content knowledge of CBT/LGBTQ-affirmative CBT.
Time frame: Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention
Population: Participants in the Immediate training group started training immediately after randomization, and therefore, have no data for the four-month waiting period prior to receiving the intervention. Participants in the Waitlist control group started training four months after randomization and therefore, were not assessed at the four-month follow-up time point due to completion of the study.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Immediate Training Group | Content Knowledge of CBT/LGBTQ-Affirmative CBT | Immediate Pre-intervention | 5.36 score on a scale | Standard Error 0.24 |
| Immediate Training Group | Content Knowledge of CBT/LGBTQ-Affirmative CBT | Four-month Post-intervention | 6.48 score on a scale | Standard Error 0.28 |
| Immediate Training Group | Content Knowledge of CBT/LGBTQ-Affirmative CBT | Immediate Post-intervention | 6.77 score on a scale | Standard Error 0.3 |
| Waitlist Control Group | Content Knowledge of CBT/LGBTQ-Affirmative CBT | Four-month Pre-intervention | 5.48 score on a scale | Standard Error 0.21 |
| Waitlist Control Group | Content Knowledge of CBT/LGBTQ-Affirmative CBT | Immediate Pre-intervention | 5.46 score on a scale | Standard Error 0.26 |
| Waitlist Control Group | Content Knowledge of CBT/LGBTQ-Affirmative CBT | Immediate Post-intervention | 6.80 score on a scale | Standard Error 0.32 |
Secondary
Content Knowledge of Minority Stress
Content knowledge of minority stress will be measured using a self-developed, 10-item multiple-choice measure by the researchers for the purpose of this study and based on past minority stress research. An overall score of 10 (i.e., answering all 10-items correctly) would be the highest possible score on the measure and would indicate a high level of content knowledge of minority stress.
Time frame: Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-Intervention
Population: Participants in the Immediate training group started training immediately after randomization, and therefore, have no data for the four-month waiting period prior to receiving the intervention. Participants in the Waitlist control group started training four months after randomization and therefore, were not assessed at the four-month follow-up time point due to completion of the study.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Immediate Training Group | Content Knowledge of Minority Stress | Immediate Post-intervention | 8.05 score on a scale | Standard Error 0.21 |
| Immediate Training Group | Content Knowledge of Minority Stress | Immediate Pre-intervention | 7.02 score on a scale | Standard Error 0.19 |
| Immediate Training Group | Content Knowledge of Minority Stress | Four-month Post-intervention | 7.82 score on a scale | Standard Error 0.24 |
| Waitlist Control Group | Content Knowledge of Minority Stress | Immediate Pre-intervention | 7.04 score on a scale | Standard Error 0.26 |
| Waitlist Control Group | Content Knowledge of Minority Stress | Four-month Pre-intervention | 7.15 score on a scale | Standard Error 0.19 |
| Waitlist Control Group | Content Knowledge of Minority Stress | Immediate Post-intervention | 7.63 score on a scale | Standard Error 0.34 |
Secondary
LGBTQ Cultural Humility
LGBTQ cultural humility will be measured using the Multidimensional Cultural Humility Scale (MCHS). This questionnaire is a 15-item self-report psychometrically validated measure assessing the extent to which respondents endorse an ability to maintain an other-oriented, interpersonal stance in relation to cultural identities most salient to clients. For the present study, items were adapted to specifically assess cultural humility as related to working with LGBTQ clients. An overall score of 90 (sum of all items) would be the highest possible score on the questionnaire and would indicate a high level of LGBTQ cultural humility.
Time frame: Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention
Population: Participants in the Immediate training group started training immediately after randomization, and therefore, have no data for the four-month waiting period prior to receiving the intervention. Participants in the Waitlist control group started training four months after randomization and therefore, were not assessed at the four-month follow-up time point due to completion of the study.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Immediate Training Group | LGBTQ Cultural Humility | Immediate pre-intervention | 76.48 score on a scale | Standard Error 0.9 |
| Immediate Training Group | LGBTQ Cultural Humility | Immediate post-intervention | 77.34 score on a scale | Standard Error 0.88 |
| Immediate Training Group | LGBTQ Cultural Humility | Four-month Post-intervention | 78.55 score on a scale | Standard Error 0.74 |
| Waitlist Control Group | LGBTQ Cultural Humility | Immediate post-intervention | 77.27 score on a scale | Standard Error 1.27 |
| Waitlist Control Group | LGBTQ Cultural Humility | Four-month pre-intervention | 75.28 score on a scale | Standard Error 0.83 |
| Waitlist Control Group | LGBTQ Cultural Humility | Immediate pre-intervention | 75.76 score on a scale | Standard Error 1.03 |
Secondary
Self-Reported LGBTQ Clinical Skills Competency
Competency in LGBTQ clinical skills will be measured using the Sexual Orientation Counselor Competency Scale (SOCCS) - Clinical Skills subscale. This subscale consists of 11-items from a psychometrically validated measure, based on a 7-point Likert scale assessing the extent to which respondents endorse clinical competence as related to their skills in working with clients of diverse sexual identities. For the present study, items have been adapted to specifically assess competence in clinical skills based on an LGBTQ-affirmative CBT framework. An overall score of 7 (arithmetic mean of all 11 items) would be the highest possible score and would indicate a high level of competence in LGBTQ clinical skills.
Time frame: Four-month Pre-intervention, Immediate Pre-intervention, Immediate Post-intervention, Four-month Post-intervention
Population: Participants in the Immediate training group started training immediately after randomization, and therefore, have no data for the four-month waiting period prior to receiving the intervention. Participants in the Waitlist control group started training four months after randomization and therefore, were not assessed at the four-month follow-up time point due to completion of the study.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Immediate Training Group | Self-Reported LGBTQ Clinical Skills Competency | Immediate Pre-intervention | 3.31 score on a scale | Standard Error 0.17 |
| Immediate Training Group | Self-Reported LGBTQ Clinical Skills Competency | Immediate Post-intervention | 5.05 score on a scale | Standard Error 0.15 |
| Immediate Training Group | Self-Reported LGBTQ Clinical Skills Competency | Four-month Post-intervention | 5.33 score on a scale | Standard Error 0.13 |
| Waitlist Control Group | Self-Reported LGBTQ Clinical Skills Competency | Four-month Pre-intervention | 3.30 score on a scale | Standard Error 0.19 |
| Waitlist Control Group | Self-Reported LGBTQ Clinical Skills Competency | Immediate Pre-intervention | 3.14 score on a scale | Standard Error 0.18 |
| Waitlist Control Group | Self-Reported LGBTQ Clinical Skills Competency | Immediate Post-intervention | 5.03 score on a scale | Standard Error 0.19 |