A call for ACTion: A systematic review of empirical evidence for the use of Acceptance and Commitment Therapy (ACT) with LGBTQI+ individuals

Fowler, James A.; Viskovich, Shelley; Buckley, Lisa; Dean, Judith

doi:10.1016/j.jcbs.2022.06.007

Cited by 13 publications

(12 citation statements)

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“…That said, others have noted how many proximal stressors may be accurate cognitive appraisals (Shulman et al, 2017), so great care needs to be taken to assess which cognitions should and should not be the target of restructuring efforts. Additionally, acceptance-based interventions may be advantageous in alleviating some facets of proximal stress (Fowler et al, 2022). However, these interventions may be less effective at reducing PTSD and anxiety symptoms, given that proximal stress was not related to these outcomes in this study.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the gender minority stress model in transgender and gender diverse college students.

Dolezal,

Decker,

Higgins

et al. 2023

Psychology of Sexual Orientation and Gender Diversity

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Section: Discussionmentioning

confidence: 99%

Evaluation of the gender minority stress model in transgender and gender diverse college students.

Dolezal,

Decker,

Higgins

et al. 2023

Psychology of Sexual Orientation and Gender Diversity

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Section: Acceptance and Commitment Therapymentioning

confidence: 99%

“…Prior work has illustrated how ACT and psychological flexibility may be helpful for supporting adaptive coping with lesbian, gay, bisexual, transgender, queer or questioning, and more (LGBTQ+) marginalization and related stressors (Fowler et al, 2022). For example, willingness/acceptance may be helpful in coping with the pervasive LGBTQ+ antagonism that occurs on an intrapersonal, interpersonal, and societal level (Fowler et al, 2022). Research shows that not only is greater psychological flexibility associated with less internalized transphobia/transnegativity and less nondisclosure of gender identity among TGE individuals, but also psychological flexibility moderates the relationship between TGE-related stressors and life satisfaction (Flynn & Bhambhani, 2021; Igarashi et al, 2022).…”

Section: Acceptance and Commitment Therapymentioning

confidence: 99%

“…Despite the promise of ACT in addressing the needs of LGBTQ+ individuals, there is a dearth of extensive psychotherapy research in this area, particularly among TGE individuals. To highlight, while there have been over 20 meta-analyses, based on 133 studies and 12,477 participants, on the evidence of ACT (Gloster et al, 2020), there has been only one review examining ACT in LGBTQ+ individuals, which included a mere five studies and a total of 66 participants (Fowler et al, 2022). Of these five studies, none had any TGE representation in their sample (Fowler et al, 2022).…”

Section: Acceptance and Commitment Therapymentioning

confidence: 99%

“…To highlight, while there have been over 20 meta-analyses, based on 133 studies and 12,477 participants, on the evidence of ACT (Gloster et al, 2020), there has been only one review examining ACT in LGBTQ+ individuals, which included a mere five studies and a total of 66 participants (Fowler et al, 2022). Of these five studies, none had any TGE representation in their sample (Fowler et al, 2022). Moreover, these studies neither measure common mental health constructs (e.g., depression) nor did they measure the acceptability or satisfaction of ACT using quantitative measures, both of which are critical to understanding the impacts of ACT in this population.…”

Section: Acceptance and Commitment Therapymentioning

confidence: 99%

See 2 more Smart Citations

Preliminary evaluation of an acceptance and commitment therapy group for transgender and gender expansive adults.

Chu¹,

Paton²,

Bradley³

et al. 2023

Professional Psychology: Research and Practice

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This study aimed to evaluate the outcomes, specifically in psychological inflexibility and depression, as well as satisfaction and utility, of a 12-week, structured acceptance and commitment therapy (ACT) group delivered to transgender and gender expansive (TGE) adults at a university-affiliated community mental health clinic. The sample included six TGE adults who consented and completed all study surveys. Psychological inflexibility significantly decreased by 6.5 scale points or 22.4% from pregroup (M = 29.00, SD = 7.29) to postgroup (M = 22.50, SD = 7.58), t(5) = 3.99, 95% CI [2.32, 10.68], p = .010. This was considered a medium effect size (Hedges’ g = 0.73, 95% CI [0.27, 1.20]). Depression decreased by 0.5 scale points or 5.2% from pregroup (M = 9.67, SD = 5.39) to postgroup (M = 9.17, SD = 3.82), though this was considered a negligible effect (g = 0.05, 95% CI [−0.12, 0.22]) and not statistically significant, t(5) = 0.65, 95% CI [−1.46, 2.46], p = .542. Quantitative measures revealed that group members reported high satisfaction and a positive therapeutic relationship. Group members rated the topic of committed actions and group discussions as most helpful. Findings suggest that ACT-based groups may be satisfactory and effective at reducing psychological inflexibility, but not depression, in TGE adults; however, more research is needed to address the dearth of evidence-based treatments for this population. We offer recommendations related to understanding the TGE community context, employing advanced clinical skills and TGE knowledge, setting expectations for group therapy, and gathering regular feedback.

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Digital mental health interventions: A narrative review of what is important from the perspective of LGBTQIA+ people

Fowler,

Buckley,

Muir

et al. 2023

J Clin Psychol

Self Cite

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ObjectivesDigital mental health interventions are a promising therapeutic modality to provide psychological support to LGBTQIA+ (lesbian, gay, bisexual, trans, Queer, intersex, asexual, plus other gender, sexual, and romantic minority identities) people. The aim of this narrative review is to explore how the LGBTQIA+ community has been engaged in the design of digital mental health interventions, how content has been tailored to the LGBTQIA+ community, and features identified as important by LGBTQIA+ participants.MethodsA total of 33 studies were included in this review from a larger yield of 1933 identified from systematic searches of five databases (PsycINFO, PubMed, Scopus, CINAHAL, and Medline). Data were analyzed narratively and using content analysis.ResultsOnly half of the studies reported engaging the LGBTQIA+ community in intervention designs. Interventions have been tailored in a variety of ways to support LGBTQIA+ individuals—such as through affirming imagery, recruitment through LGBTQIA+ networks, and designing content to focus specifically on LGBTQIA+ issues. A range of features were identified as important for participants, namely how content was tailored to LGBTQIA+ experiences, providing connection to community, and links to other relevant LGBTQIA+ resources. While not a primary aim, results also showed that a wide range of digital modalities can significantly improve a range of mental health problems.ConclusionDigital interventions are an acceptable and effective form of therapeutic intervention, but future research needs to focus on meaningful engagement of community members to inform design and implementation.

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A call for ACTion: A systematic review of empirical evidence for the use of Acceptance and Commitment Therapy (ACT) with LGBTQI+ individuals

Cited by 13 publications

References 84 publications

Evaluation of the gender minority stress model in transgender and gender diverse college students.

Evaluation of the gender minority stress model in transgender and gender diverse college students.

Preliminary evaluation of an acceptance and commitment therapy group for transgender and gender expansive adults.

Digital mental health interventions: A narrative review of what is important from the perspective of LGBTQIA+ people

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