LGBQ-affirmative cognitive-behavioral therapy for young gay and bisexual men’s mental and sexual health: A three-arm randomized controlled trial.
Open accessAbstract
OBJECTIVE: Effective Skills to Empower Effective Men (ESTEEM) represents the first intervention to address the psychological pathways through which minority stress undermines young sexual minority men's (SMM's) mental and sexual health using transdiagnostic cognitive-behavioral therapy. This study compared the efficacy of ESTEEM against two existing interventions. METHOD: = 52). RESULTS: of HIV transmission risk behavior at 8 months showed a nonsignificant difference between ESTEEM compared to HIV testing and counseling (RR = 0.69) and LGBQ-affirmative counseling (RR = 0.62). For secondary outcomes (e.g., depression, anxiety, substance use, suicidality, number of mental health diagnoses) at 8 months, ESTEEM had a larger effect size than the two comparison conditions, but these comparisons did not reach statistical significance when adjusting for the false discovery rate. Observed effect sizes for condition comparisons were smaller than the effect sizes used to power the study. In exploratory analyses, ESTEEM showed promise for reducing comorbidity. CONCLUSIONS: Because the control conditions were associated with stronger effects than anticipated, and given the heterogeneous nature of transdiagnostic outcomes, the study possessed insufficient power to statistically detect the consistently small-to-moderate benefit of ESTEEM compared to the two control conditions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Compared with active treatments, LGBTQ-affirmative CBT shows smaller but statistically significant improvements for co-occurring mental and behavioral health outcomes.
“When compared to active treatments (i.e., community-based affirmative counseling, HIV testing and counseling), LGBTQ-affirmative CBT shows smaller effects, but nonetheless statistically significant improvements for co-occurring mental and behavioral health outcomes (Pachankis, Harkness, Maciejewski, et al., 2022).”
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, Harkness, Maciejewski, et al., 2022
The Discussion reports small-to-moderate effects favoring ESTEEM over the two active treatments, but says most mental and behavioral health comparisons were not statistically significant after correction for multiple comparisons. The Results report a significant reduction in alcohol- and drug-related problems versus HIV testing and counseling, and a significant reduction in the number of comorbidities versus LGBQ-affirmative counseling—but not versus HIV testing and counseling. The claim overstates how broadly the improvements were statistically significant. (LLM, conf=0.88)
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TERAPIA COGNITIVO-COMPORTAMENTAL E A POPULAÇÃO LGBT: UMA REVISÃO INTEGRATIVA
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Self-citationCognitive Behaviour Therapy (CBT) for Sexual Minority Adults
Rimes, K. A. (2023) · Springer eBooks · doi:10.1007/978-3-031-37438-8_11
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Self-citationSetting the Stage for LGBTQ+ Affirmative Therapy
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Self-citationApplicability for Dimensional Diagnosis in Underrepresented and Epistemically Excluded Populations
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Self-citationFoley, J. D., Mayer, K. H., Iyer, S., Scheinbach, J., & Batchelder, A. (2026) · AIDS Patient Care and STDs · doi:10.1177/10872914261478191
The Rainbow Rift: LGBTQ+ Inclusivity and Wellbeing in the Ballet World
Watkin-Fairless, R. J., & van Dyk, I. S. (2026) · Journal of Dance Medicine & Science · doi:10.1177/1089313x261481623
- Authors
- Pachankis, J. E., Harkness, A., Maciejewski, K. R., Behari, K., Clark, K. A., McConocha, E., Winston, R., Adeyinka, O., Reynolds, J., Bränström, R., Esserman, D. A., Hatzenbuehler, M. L., & Safren, S. A.
- ORCID
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2022-06
- Volume
- 90
- Issue
- 6
- Pages
- 459-477
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC9446477
- OpenAlex
- W4225095219
- Cited by
- 112
- References
- 78
- Citations by year
- 2026: 28 · 2025: 27 · 2024: 28 · 2023: 19 · 2022: 9 · 2021: 1
- FWCI
- 19.61
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH109413)
- David R. Kessler, MD ’55 Fund
- Fund for Lesbian and Gay Studies at Yale
- Sponsor name not included (UL1TR00183)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Keywords
- esteem, sexual minority men, minority stress, HIV transmission risk behavior, HIV counseling and testing, depression, anxiety, suicidality, substance use, psychiatric comorbidity, sexual health
- MeSH terms
- Sexual and Gender Minorities, Sexual Health, Adolescent, Adult, Ethnicity, Humans, Male, Minority Groups, Sexual Behavior, HIV Infections, Cognitive Behavioral Therapy, Homosexuality, Male, Young Adult
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