2 - (SYM 13) Effectiveness of an Online Single-session Minority Stress Intervention: Variation by Structural Stigma?

Background. Evidence suggests that psychotherapeutic interventions for minoritized youth may be less effective in higher-stigma environments. Project RISE, an online, single-session minority stress intervention for LGBQT+ youth, significantly reduces internalized stigma in users. However, the impact of structural stigma on program effectiveness remains unclear. To address this, we conducted a secondary analysis of a randomized controlled trial to examine how structural stigma impacts mental health outcomes for LGBTQ+ youth after Project RISE. 

Method. We analyzed data from N = 261 LGBTQ+ adolescents aged 13 to 16 years who engaged in Project RISE. Measures of internalized stigma, identity pride, hopelessness, depression, and anxiety were collected pre- and post-intervention as well as at a two-week follow up. We created a latent factor representing structural stigma using confirmatory factor analysis with five indicators of explicit and implicit attitudes associated with sexual and gender minorities at the county level. Moderation analyses were conducted to examine the associations between baseline county-level structural stigma and participant-level internalized stigma on internalized stigma, identity pride, hopelessness, depression, and anxiety at post-intervention and follow-up.

Results. Structural stigma did not significantly moderate baseline- to post-intervention or follow-up changes in youths’ hopelessness, depression, internalized stigma, or self-hatred over the course of the trial between baseline mental health outcomes and post-intervention or follow-up assessments (all p > .05). 

Conclusion. While structural stigma has the potential to lessen the effectiveness of psychotherapeutic interventions for LGBTQ+ youth, we did not find this to be true in the case of an online single-session intervention teaching adaptive responses to minority stress. Results speak to the potentially broad utility of this intervention for LGBTQ+ youth with limited access to mental health support.