Cited by 112LGBTQ Health, Identity, and PolicyHIV/AIDS Research and InterventionsCounseling Practices and Supervision

LGBQ-affirmative cognitive-behavioral therapy for young gay and bisexual men’s mental and sexual health: A three-arm randomized controlled trial.

Open access
Pachankis, John E., Harkness, Audrey, Maciejewski, Kaitlin R., Behari, Kriti, Clark, Kirsty A., McConocha, Erin, Winston, Roxanne, Adeyinka, Oluwaseyi +5 more·2022·Journal of Consulting and Clinical Psychology

Abstract

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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Research works printed but not linked: 5

  1. Dmitrienko A, & Tamhane AC (2010). Chapter 5: Gatekeeping Procedures in Clinical Trials In Dmitrienko A, Tamhane AC, & Bretz F (Eds.), Multiple Testing Problems in Pharmaceutical Statistics (1 ed.). Taylor and Francis Group, LLC.
  2. Fassinger RE (2000). Gender and sexuality in human development: Implications for prevention and advocacy in counseling psychology. In Brown SD & Lent RW (Eds.), Handbook of counseling psychology (pp. 346– 378). John Wiley & Sons, Inc.
  3. Pachankis JE, Hatzenbuehler ML, Rendina HJ, Safren SA, & Parsons JT (2015b). LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: A randomized controlled trial of a transdiagnostic minority stress approach. J Consult Clin Psychol, 83(5), 875– 889. 10.1037/ccp0000037 26147563 PMC4573250 · DOI · Paper page
  4. Ritter K, & Terndrup AI (2002). Handbook of affirmative psychotherapy with lesbians and gay men. Guilford Press.
  5. Sheehan D, Janavs J, Baker R, Sheehan K, Knapp E, & Sheehan M (2015). Mini international neuropsychiatric interview–version 7.0.0 DSM-5.2014. Harm Research Press, Tampa, FL.

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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.
Venue
Journal of Consulting and Clinical Psychology
Published
2022-06
Volume
90
Issue
6
Pages
459-477
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
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
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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