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LGBQ adults’ experiences of a CBT wellbeing group for anxiety and depression in an Improving Access to Psychological Therapies Service: a qualitative service evaluation

Published online by Cambridge University Press:  05 January 2021

Christopher E. M. Lloyd Open the ORCID record for Christopher E. M. Lloyd [Opens in a new window] ,
Katharine A. Rimes Open the ORCID record for Katharine A. Rimes [Opens in a new window]  and
David G. Hambrook Open the ORCID record for David G. Hambrook [Opens in a new window]
Christopher E. M. Lloyd
Affiliation:
London Metropolitan University, London, UK University of Derby, Derby, UK
Katharine A. Rimes
Affiliation:
King’s College London, London, UK
David G. Hambrook*
Affiliation:
King’s College London, London, UK Talking Therapies Southwark, South London and Maudsley NHS Foundation Trust, UK
*
*Corresponding author. Email: david.hambrook@slam.nhs.uk
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Abstract

Sexual minorities, including those identifying as lesbian, gay, bisexual or queer (LGBQ) are at heightened risk of experiencing mental health problems. Nationally, treatment outcomes within England’s Improving Access to Psychological Therapies (IAPT) services are worse for sexual minority patients than for heterosexuals. An IAPT service in London developed a cognitive behavioural therapy (CBT) group specifically for sexual minority patients to provide a safe, affirmative intervention to learn skills for overcoming depression, anxiety and stress. A qualitative online survey was emailed to all 59 service users who had completed the eight-session intervention, to explore their experiences inductively. Survey data were analysed using qualitative content analysis. Themes were identified in participants’ responses in order to establish which aspects of the group intervention were deemed to be helpful and unhelpful, and to explore suggestions for group improvement. Eighteen people completed the survey (response rate 30.5%). Respondents reported that they found the CBT frame of the group useful, with the LGBQ focus experienced as particularly beneficial, often enhancing engagement with CBT concepts and tools. In addition to generic elements of group therapy that some found difficult, others reported that intragroup diversity, such as generational differences, could lead to a reduced sense of connection. Several suggestions for group improvement were made, including incorporating more diverse perspectives and examples in session content and focusing more on issues relating to intersectionality. These results provide preliminary evidence that a culturally adapted CBT group intervention developed specifically for sexual minorities is acceptable and perceived as offering something unique and helpful.

Key learning aims

  1. (1) To identify the unique experiences and particular mental health disparities that LGBQ people face in life and why a culturally adapted LGBQ CBT group offers both a necessary and unique therapeutic tool to support sexual minorities.

  2. (2) To explore how a culturally adapted CBT group intervention for LGBQ people is experienced in practice, from the service user perspective. In particular, what aspects do LGBQ people find helpful, unhelpful and what might they suggest for future group improvement.

  3. (3) To consider how such CBT groups may be culturally adapted to benefit sexual minorities, including: what actions should be taken in future clinical practice to ensure improvements in the psychological treatment experiences of LGBQ people. Specifically, including the need to incorporate more inclusive and intersectional examples that engage and support recovery from psychological distress.

Keywords

groupIAPTqualitativesexual orientationservice evaluationtherapy
Type
Service Models, Forms of Delivery and Cultural Adaptations of CBT
Information
the Cognitive Behaviour Therapist , Volume 13 , 2020 , e58
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2021

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References

Further reading

British Psychological Society (BPS) (2017). Memorandum of understanding on conversion therapy in the UK. Available from: https://www.bps.org.uk/sites/www.bps.org.uk/files/Policy/Policy%20-%20Files/Memorandum%20of%20Understanding%20on%20Conversion%20Therapy%20in%20the%20UK%20%28Updated%29.pdf Google Scholar
British Psychological Society (BPS) (2019). Guidelines and Literature Review for Psychologists Working Therapeutically with Gender, Sexuality and Relationship Diversity. Available from: https://www.bps.org.uk/sites/bps.org.uk/files/Policy/Policy%20%20Files/Guidelines%20for%20psychologists%20working%20with%20gender%2C%20sexuality%20and%20relationship%20diversity.pdf Google Scholar
Foy, A. A., Morris, D., Fernandes, V., & Rimes, K. A. (2019). LGBQ+ adults’ experiences of Improving Access to Psychological Therapies and primary care counselling services: informing clinical practice and service delivery. The Cognitive Behaviour Therapist, 12. doi: 10.1017/S1754470X19000291 CrossRefGoogle Scholar
Government Equalities Office (2018). National LGBT Survey: Summary Report. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/722314/GEO-LGBT-Survey-Report.pdf Google Scholar
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