Project EQuIP: Empowering Queer Identities in Psychotherapy

Yale University

Status: Completed

Conditions: Sexual Minority Stress

Treatments: Behavioral: EQuIP (Empowering Queer Identities in Psychotherapy)

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03721276

R01MH109413 (U.S. NIH Grant/Contract)

2000020997

Details and patient eligibility

About

The aim of this study is to develop an evidence-based psychosocial intervention for sexual minority women. This intervention will specifically target the adverse mental and behavioral health outcomes disproportionately experienced by sexual minority women, including depression, suicidality, and alcohol abuse, which are known to be driven by stigma-related stressors associated with their sexual orientation (i.e., minority stress processes).

Full description

The purpose of this study is to adapt ESTEEM (Effective Skills to Empower Effective Men), developed by Dr. John Pachankis, to simultaneously target the multiple adverse health outcomes sexual minority women disproportionately face, including depression, suicidality, and alcohol abuse, that are linked to minority stress processes.

Project EQuIP will adapt the ESTEEM program for sexual minority women in three distinct phases. The focus of this registered protocol will be Phase 3, however Phases 1, 2 and 3 are described below.

Phase 1 will involve conducting interviews with 20 sexual minority women (SMW) who report experiencing depression, suicidality, and alcohol abuse. Information from these interviews will be used to gather insight from participants that can help inform the adaptation of a cognitive-behavioral treatment approach to specifically target sexual minority women's unique experiences with minority stress.

Phase 2 will involve consultation interviews with 10 community-based mental health experts who treat psychosocial health problems among at-risk SMW. Involvement of key community members in intervention design optimizes intervention dissemination and allows frontline professionals to shape the intervention that they would be most willing to implement. Input of mental health experts working with the SMW community will be used in order to translate existing, but largely untapped, clinical wisdom regarding SMW's minority stress experiences, mental health, and alcohol use into the development of the intervention.

Phase 3 will involve pilot testing the adapted cognitive-behavioral treatment through a randomized controlled trial with 60 SMW who report experiencing depression, anxiety, and alcohol abuse.

Enrollment: 60 patients

Sex: All

Ages: 18 to 35 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

For Phase 3

Inclusion Criteria:

• sexual minority status operationalized as identity (e.g., lesbian, bisexual, pansexual, queer)
• aged 18-35
• self-identification as a woman with the option of selecting multiple gender identities
• symptoms of anxiety or depression within the past 90 days (≥ 2.5 on the BSI-4 for either anxiety or depression)
• at least one instance of past-90-day heavy drinking (i.e., ≥ 4 drinks in one sitting)
• 6-month NYC residential stability and availability
• English fluency

Exclusion Criteria:

• active psychosis or active mania
• active suicidality or active homicidality
• currently in mental health treatment exceeding one day per month
• having received any cognitive-behavioral therapy treatment in the past 12 months
• evidence of gross cognitive impairment

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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60 participants in 2 patient groups

Therapy

Experimental group

Description:

Individuals assigned to therapy will receive 10 weekly individually-delivered sessions, directly after baseline assessment, that address minority stress mechanisms underlying SMW's depression, anxiety, and alcohol abuse.

Treatment:

Behavioral: EQuIP (Empowering Queer Identities in Psychotherapy)

Waitlist

Other group

Description:

Individuals assigned to waitlist will be put on a waitlist for 3 months after baseline assessment, after which they will also receive the same treatment as the therapy group.

Treatment:

Behavioral: EQuIP (Empowering Queer Identities in Psychotherapy)