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Cited by 105LGBTQ Health, Identity, and PolicyMental Health via WritingDigital Mental Health Interventions

Brief online interventions for LGBTQ young adult mental and behavioral health: A randomized controlled trial in a high-stigma, low-resource context.

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Pachankis, John E., Williams, Stacey L., Behari, Kriti, Job, Sarah, McConocha, Erin M., Chaudoir, Stephenie R.·2020·Journal of Consulting and Clinical Psychology
DOI 10.1037/ccp0000497PMC PMC7153536
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Abstract

OBJECTIVE: To identify scalable interventions for improving sexual minority mental health and health-risk behavior, this study tested the efficacy of two self-guided online writing interventions-expressive writing and self-affirmation. To reach sexual minority young adults living in high-stigma, low-resource settings, we developed and tested these interventions in Appalachian Tennessee. METHOD: In consultation with sexual minority young adults (n = 10) and stakeholders (n = 10) living in Appalachian Tennessee, we adapted these two writing interventions that we then delivered to 108 local sexual minority young adults (Mage = 23.68, SD = 3.11). Participants, representing diverse sexual and gender identities and socioeconomic backgrounds, were randomly assigned to participate in a 3-session expressive writing intervention, self-affirmation intervention, or neutral control. Participants completed mental health and health-risk behavior measures at baseline, postintervention, and 3-month follow-up. RESULTS: Compared to the neutral control, expressive writing exerted 3-month improvements in depressive symptoms (d = 0.48) and general psychological distress (d = 0.36) whereas self-affirmation exerted improvement in suicidal ideation (d = 0.62) and drug abuse (d = 0.59). Participants who were exposed to greater contextual minority stressors common in rural regions (i.e., discrimination and victimization) experienced significantly greater 3-month reductions in depression from expressive writing and self-affirmation compared to control. Those who experienced greater discrimination also experienced significantly greater 3-month reductions in suicidality from self-affirmation compared to control. CONCLUSION: Brief writing interventions exert significant impact on the mental health of young adult sexual minorities, especially those exposed to minority stress. Future research can consider strategies for population-level implementation, especially in high-stigma, low-resource settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

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  • Adapted mental and behavioral health interventions for stigmatized populations are most efficacious for individuals experiencing the highest degrees of internalized and interpersonal stigma.

    “For instance, adapted mental and behavioral health interventions for stigmatized populations have been found to be most efficacious for individuals experiencing the highest degrees of internalized and interpersonal stigma (e.g., Lee et al., 2019; Millar et al., 2016; Pachankis, Williams, et al., 2020).”

    From Guided internet-based LGBTQ-affirmative cognitive-behavioral therapy: A randomized controlled trial among sexual minority men in China (2024) · cites this paper as Pachankis, Williams, et al., 2020

    The Discussion (page unavailable in our copy) reports that sexual minority young adults with high levels of discrimination and victimization particularly benefited from the adapted writing interventions on depression. The Method’s Moderated Effects section identifies those two interpersonal or contextual exposures as the moderators examined; it does not establish greater efficacy among people with high internalized stigma. The claim also generalizes findings from this specific population and these interventions to stigmatized populations broadly. (LLM, conf=0.88)

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Cited by

Sorted by citations

Authors
Pachankis, J. E., Williams, S. L., Behari, K., Job, S., McConocha, E. M., & Chaudoir, S. R.
Affiliations
  • Yale University (US)
  • East Tennessee State University (US)
  • College of the Holy Cross (US)
ORCID
Venue
Journal of Consulting and Clinical Psychology
Publisher
American Psychological Association (APA)
Published
2020-05
Volume
88
Issue
5
Pages
429-444
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
DOI
10.1037/ccp0000497
PMC
PMC7153536
OpenAlex
W3016025111
Cited by
105
References
11
Citations by year
2026: 11 · 2025: 15 · 2024: 19 · 2023: 21 · 2022: 16 · 2021: 16 · 2020: 6 · 2019: 1
FWCI
16.12
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Digital Commons - East Tennessee State University (East Tennessee State University) (submittedVersion)
Funders
National Institute of Mental Health (R21MH113860)
Topics
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
  • Social Sciences › Psychology › Social Psychology › Mental Health via Writing
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
sexual minority young adults, LGBTQ mental health, expressive writing, self-affirmation, online intervention, minority stress, discrimination, suicidal ideation, depressive symptoms, drug abuse, health risk behaviors, rural mental health, stigma, resource-limited settings
MeSH terms
Sexual and Gender Minorities, Internet-Based Intervention, Adult, Behavioral Symptoms, Female, Humans, Male, Poverty, Psychotherapy, Tennessee, Young Adult, Social Stigma

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