Psychosocial Interventions for Mental Illness among LGBTQIA Youth: A PRISMA-Based Systematic Review
Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual (LGBTQIA) youth experience a unique range of psychosocial stressors often culminating in poor mental health outcomes. A systematic review of trials that evaluated psychosocial interventions for LGBTQIA youth aged 12–25 was undertaken to evaluate the effect of treatment components and participant-related variables on treatment outcome. The results suggest that creating safe, accepting places, discussion of shared experiences, and using a cognitive behavioural or attachment-based family therapy framework significantly decreased depression, sexual minority stress, anxiety and drug and alcohol use, and enhanced participant approval. LGBTQIA youth had poorer baseline mental health than non-LGBTQIA youth and experienced greater improvements. Further experimental research is needed to define effective treatment components and relevant individual factors to maximise treatment efficacy.
KeywordsLGBTQIA LGBT Youth Treatment Minority stress Mental health Review
EVDPH conceived of the study, participated in the design and coordination of the study, conducted the review and interpretation of the data, and drafted the manuscript; UM was the second reviewer in the full-text review process; JM participated in conceiving the study, its design, coordination and interpretation, and helped draft the manuscript. All authors read and approved the final manuscript.
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
The authors report no conflict of interest.
- Achenbach, T. M. (1991). Integrative guide for the 1991 CBCL/4-18, YSR, and TRF profiles. Burlington: Department of Psychiatry, University of Vermont.Google Scholar
- American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: APA DSM-IV.Google Scholar
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: APA DSM-IV-TR.Google Scholar
- Australian Bureau of Statistics. (2007). National survey of mental health and wellbeing (No.4235.0). Canberra: ACT.Google Scholar
- Australian Institute of Health and Welfare. (2014). Leading causes of death by sex and age group, 2012–2014. https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/data. Accessed 3 Jan 2018.
- Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory-II. San Antonio, TX: The Psychological Corporation.Google Scholar
- Beck, J. S., Beck, A. T., Jolly, J. B., & Steer, R. A. (2005). Beck youth inventories: For children and adolescents. San Antonia: Psychological Corporation.Google Scholar
- Centers for Disease Control and Prevention. (2012). Youth risk behaviour surveillance—United States, 2011. Morbidity and Mortality Weekly Report, 61(4), 11–12.Google Scholar
- Cochran, S. D., Sullivan, J. G., & Mays, V. M. (2003). Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. Journal of Consulting and Clinical Psychology, 71(1), 53.PubMedPubMedCentralCrossRefGoogle Scholar
- Derogatis, L. R., & Spencer, P. (1993). Brief symptom inventory: BSI. Upper Saddle River, NJ: Pearson.Google Scholar
- Derrogatis, L., Lipman, R., & Covi, I. (1973). The SCL-90: An outpatient psychiatric rating scale. Psychopharmacology Bulletin, 9(1), 13–28.Google Scholar
- Diamond, G. M., Diamond, G. S., Levy, S., Closs, C., Ladipo, T., & Siqueland, L. (2012). Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: A treatment development study and open trial with preliminary findings. Psychotherapy: Theory, Research, Practice, Training, 49(1), 62.CrossRefGoogle Scholar
- Godley, S. H., Meyers, R. J., Smith, J. E., Karvinen, T., Titus, J. C., Godley, M. D., et al. (2001). The adolescent community reinforcement approach for adolescent cannabis users, Cannabis Youth Treatment (CYT) series (Vol. 4). Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration.Google Scholar
- Greenglass, E., Schwarzer, R., & Laghi, F. (2008). The proactive coping inventory for adolescents. http://www.psych.yorku.ca/TheproactiveCopingInventoryFORADOLESCENTS.CA. Accessed 3 Jan 2018.
- Greenglass, E., Schwarzer, R., & Taubert, S. (1999). The proactive coping inventory (PCI): A multidimensional research instrument. Vyhledano, 3, 2011.Google Scholar
- Haas, A. P., Rodgers, P. L., & Herman, J. L. (2014). Suicide attempts among transgender and gender non-conforming adults. Work, 50, 59.Google Scholar
- Heron, M. P. (2017). Deaths: Leading causes for 2015. National Vital Statistics Reports, 66(5), 1–76.Google Scholar
- Higgins, J. P., & Green, S. (2011). Cochrane handbook for systematic reviews of interventions (Vol. 4). Hoboken: Wiley.Google Scholar
- Ioverno, S., Belser, A. B., Baiocco, R., Grossman, A. H., & Russell, S. T. (2016). The protective role of gay-straight alliances for lesbian, gay, bisexual, and questioning students: A prospective analysis. Psychology of Sexual Orientation and Gender Diversity, 3(4), 397–406. https://doi.org/10.1037/sgd0000193.PubMedPubMedCentralGoogle Scholar
- Justice, M. (2016). Social support and mental health among homeless youth: A multi-group SEM model of non-LGBT*, LGB, and Trans* Youth in Metro-Atlanta. Atlanta, GA: Georgia State University. (Unpublished master’s thesis).Google Scholar
- Leonard, W., Pitts, M., Mitchell, A., Lyons, A., Smith, A., Patel, S., & Barrett, A. (2012). Private Lives 2: The second national survey of the health and wellbeing of gay, lesbian, bisexual and transgender (GLBT) Australians. Melbourne, VIC: The Australian Research Centre in Sex, Health & Society, La Trobe University.Google Scholar
- Mental Health Foundation. (2016). Fundamental facts about mental health 2016. London: Mental Health Foundation. https://www.mentalhealth.org.uk/sites/default/files/fundamental-facts-about-mental-health-2016.pdf. Accessed 21 Apr 2018.
- Meyers, R. J., & Smith, J. E. (1995). Clinical guide to alcohol treatment: The community reinforcement approach. New York, NY: Guildford Press.Google Scholar
- Mohr, J., & Fassinger, R. (2000). Measuring dimensions of lesbian and gay male experience. Measurement and Evaluation in Counseling and Development, 33(2), 66–66.Google Scholar
- Mosher, W. D., Chandra, A., & Jones, J. (2005). Sexual behavior and selected health measures: Men and women 15–44 years of age, United States, 2002. Hyattsville, MD: Advance Data from Vital and Health Statistics no. 362, National Centre for Health Statistics.Google Scholar
- National LGBTI Health Alliance. (2016). Snapshot of mental health and suicide prevention statistics for LGBTI people. Newtown, NSW: National LGBTI Health Alliance.Google Scholar
- Olson, J., Schrager, S. M., Belzer, M., Simons, L. K., & Clark, L. F. (2015). Baseline physiologic and psychosocial characteristics of transgender youth seeking care for gender dysphoria. Journal of Adolescent Health, 57(4), 374–380. https://doi.org/10.1016/j.jadohealth.2015.04.027.PubMedGoogle Scholar
- Pachankis, J. E., Hatzenbuehler, M. L., Rendina, H. J., Safren, S. A., & Parsons, J. T. (2015). LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: A randomized controlled trial of a transdiagnostic minority stress approach. Journal of Consulting and Clinical Psychology, 83(5), 875.PubMedPubMedCentralCrossRefGoogle Scholar
- Poznanski, E. O., & Mokros, H. B. (1996). Children’s depression rating scale, revised (CDRS-R). Los Angeles: Western Psychological Services.Google Scholar
- Reynolds, W. (2002). Manual for the Reynolds Adolescent Depression Scale—Second Edition (RADS-2). Lutz, FL: Psychological Assessment Resources.Google Scholar
- Reynolds, W. M. (1987). Suicidal ideation questionnaire (SIQ). Odessa, FL: Psychological Assessment Resources.Google Scholar
- Rosario, M., & Schrimshaw, E. W. (2013). The sexual identity development and health of lesbian, gay, and bisexual adolescents: An ecological perspective. In C. J. Patterson & A. R. D'Augelli (Eds.), Handbook of psychology and sexual orientation (pp. 87–101). New York, NY: Oxford University Press.Google Scholar
- Saunders, J. B., Aasland, O. G., Babor, T. F., De la Fuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88(6), 791–804.PubMedCrossRefGoogle Scholar
- Yadegarfard, M., Meinhold-Bergmann, M. E., & Ho, R. (2014). Family rejection, social isolation, and loneliness as predictors of negative health outcomes (depression, suicidal ideation, and sexual risk behavior) among Thai male-to-female transgender adolescents. Journal of LGBT Youth, 11(4), 347–363.CrossRefGoogle Scholar