Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Abstract

Purpose: Lesbian, gay, bisexual, and transgender (LGBT) individuals in Romania encounter pervasive stigma and discrimination and there is a high need for LGBT-competent mental health professionals (MHPs). We tested the impact of a pilot LGBT-affirmative training for MHPs in Romania on these professionals' LGBT-relevant attitudes, knowledge, and perception of clinical skills. Methods: We conducted a 2-day training for MHPs in Bucharest. Fifty-four attended and 33 provided training evaluation data at baseline and follow-up. Results: The majority of trainees were female (90%) and heterosexual (73%) with a mean age of 36.4 (SD = 7.7). From baseline to follow-up, trainees demonstrated a significant increase in perceived LGBT-relevant clinical skills (P < 0.001) and perceived knowledge (P < 0.05).LGBT-affirmative practice attitudes (P < 0.05) and comfort in addressing the mental health of LGBT individuals (P < 0.01) increased significantly, and homonegative and transnegative attitudes decreased significantly (P < 0.01). Negative attitudes toward LGBT individuals were low at both baseline and follow-up. The majority of trainees reported being highly interested in the training (84%), which they reported had prepared them to interact with and care for LGBT individuals (74%). Conclusion: This pilot training appeared to be effective in increasing perceived LGBT competence among participating MHPs. This type of training model needs to be tested further in a randomized controlled trial with longer follow-up periods to assess intervention durability and implementation of clinical skills. Future trainings can be incorporated into existing curricula. National accreditation bodies might consider encouraging such training as part of standard educational requirements.

How many sexual minorities are hidden? Projecting the size of the global closet with implications for policy and public health

“…Because high-stigma locales are particularly likely to both perpetuate the closet and to lack the affirmative resources necessary for reaching the closeted population, technology-assisted interventions might be especially warranted to empower both sexual minorities and the public health practitioners who could serve as allies in efforts to improve the wellbeing, equality, and dignity of this sizable segment of the global population. [34, 35].…”

An mHealth Intervention to Improve Young Gay and Bisexual Men’s Sexual, Behavioral, and Mental Health in a Structurally Stigmatizing National Context

“…Furthermore, structural barriers to implementing a relatively intensive intervention are modifiable to maximize dissemination and sustainability potential. Specifically, in related research [86], we recently trained 180 Romanian mental health providers in GBM-affirmative treatment and have created a mobile platform to provide them with ongoing LGBT-affirmative supervision so that our DMDN intervention, if efficacious pending rigorous testing, will persist after the study concludes. This approach provides a blueprint for sustainability and longer-lasting impact.…”

‘We must treat them like all the other people’: Evaluating the Integrated Key Populations Sensitivity Training Programme for Healthcare Workers in South Africa

“…25,26 Evidence from a European context indicates that reductions in structural discrimination and homo-negativity require a multilevel intervention approach, one component of which is enabling changes in attitudes and practices amongst individuals, groups and institutions. 27 Sensitisation-type training have been shown to have the potential for effecting change at each of these levels, shifting attitudes of individual participants directly and positively, and changing normative professional practice amongst health workers. 27…”

“…27 Sensitisation-type training have been shown to have the potential for effecting change at each of these levels, shifting attitudes of individual participants directly and positively, and changing normative professional practice amongst health workers. 27…”