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

Eaton, Andrew

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

dc.contributor.author	Eaton, Andrew
dc.date.accessioned	2022-04-21T21:28:31Z
dc.date.available	2022-04-21T21:28:31Z
dc.date.issued	2021-06-07
dc.description	his article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.	en_US
dc.description.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.	en_US
dc.description.authorstatus	Faculty	en_US
dc.description.peerreview	yes	en_US
dc.description.sponsorship	This study was funded by the Social Sciences and Humanities Research Council of Canada through a Partnership Grant (SSHRC #895-2018-1000) and by the Public Health Agency of Canada through their Community Action Fund (PHAC #1718-HQ-000697). Dr. Shelley Craig’s salary is supported by a Canada Research Chair in Sexual and Gender Minority Youth. Dr. Andrew Eaton’s salary is supported by an Endgame Leader Award from the Ontario HIV Treatment Network (OHTN). The funders had no role in the design of the study, data collection, analyses, interpretation of data, nor in writing the manuscript.	en_US
dc.identifier.citation	Craig, S.L., Eaton, A.D., Leung, V.W.Y. et al. Efficacy of affirmative cognitive behavioural group therapy for sexual and gender minority adolescents and young adults in community settings in Ontario, Canada. BMC Psychol 9, 94 (2021). https://doi.org/10.1186/s40359-021-00595-6	en_US
dc.identifier.doi	https://doi.org/10.1186/s40359-021-00595-6
dc.identifier.uri	https://hdl.handle.net/10294/14640
dc.language.iso	en	en_US
dc.publisher	BMC Psychology	en_US
dc.rights	Attribution 4.0	*
dc.rights.uri	https://creativecommons.org/licenses/by/4.0/	*
dc.subject	Sexual and gender minorities, Depression, Coping, Stress appraisal, Cognitive behavioural therapy, Community intervention	en_US
dc.title	Efficacy of affirmative cognitive behavioural group therapy for sexual and gender minority adolescents and young adults in community settings in Ontario, Canada	en_US
dc.type	Article	en_US