Symposia
Dissemination & Implementation Science
Zachary Soulliard, Ph.D. (he/him/his)
Assistant Professor
Miami University
Oxford, Ohio
Eric Layland, PhD
Assistant Professor
University of Delaware
Newark, Delaware
Nick Hatch, B.S.
Graduate Student
Yale School of Public Health
New Haven, Connecticut
Ellie Pickering, B.A.
Graduate Student
Yale School of Public Health
New Haven, Connecticut
Benjamin Eisenstadt, B.A.
Postgraduate Associate
Yale School of Public Health
New York City, New York
Danielle Chiaramonte, PhD
Associate Research Scientist
Yale School of Public Health
New York City, New York
Kriti Behari, MA
Graduate Student
Syracuse University
Syracuse, New York
McKenna Freeman, B.A.
Graduate Student
Miami University
oxford, Ohio
Shruti S. S. Kinkel-Ram, M.A. (she/her/hers)
Clinical Psychology Doctoral Student
Miami University
Oxford, Ohio
Audrey Harkness, PhD (she/her/hers)
Assistant Professor
University of Miami
Coral Gables, Florida
John Pachankis, Ph.D.
Susan Dwight Bliss Associate Professor of Public Health (Social and Behavioral Sciences)
Yale School of Public Health
New Haven, Connecticut
Objectives: Given the recently established efficacy of training mental health providers in LGBTQ-affirmative CBT, the next step toward implementation can examine factors that prevent or enable implementation of the treatment across various contexts after training. To increase the reach of LGBTQ-affirmative CBT, the present study explored implementation determinants of this treatment from the perspective of providers working at LGBTQ+ community centers who recently completed a training in the treatment.
Methods: Mental health providers (N=30, Mage=39.93) affiliated with an LGBTQ+ community center were interviewed one year after participating in training in LGBTQ-affirmative CBT. Providers represented 22 centers across 15 states, and most held a masters degree (86.7%) and identified as part of the LGBTQ+ community (86.7%). Interview questions and study design were informed by the Consolidated Framework for Implementation Research (CFIR) and Health Equity Implementation Framework (HEIF). A framework analysis approach was used to qualitatively identify implementation determinants.
Results: Respondents identified a variety of implementation determinants, including a relative advantage of LGBTQ-affirmative CBT compared to other identity-affirmative treatments, capability to modify the treatment, and need for clinical supervision following initial trainings. Most determinants aligned with the Innovation domain of the CFIR. For example, providers identified a benefit in this treatment given its integration of LGBTQ-specific stressors with CBT skills, a missing component in other treatments. Many determinants also fit within the Cultural Factors of Recipients domain of the HEIF, such that providers identified need for modifications (e.g., specific content for trans/nonbinary stressors and inclusion of intersectional stressors experienced by clients of color). However, several providers reported a capability to tailor the treatment to address these and other specific needs of their LGBTQ+ clients.
Conclusions: Understanding factors that impact successful implementation of evidence-based care can help translate clinical practices to community settings. Findings from this study point to several barriers and facilitators to implementing LGBTQ-affirmative CBT, one of few evidence-based treatments for LGBTQ+ people’s mental health, in LGBTQ+ community centers nationwide. Specific strategies that could address the barriers and capitalize upon facilitators identified by the providers will be discussed.