An Internet-Based Intervention to Increase the Ability of Lesbian, Gay, and Bisexual People to Cope With Adverse Events: Single-Group Feasibility Study (Preprint)

Abstract

BACKGROUND Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people are at higher risk of mental health problems due to widespread hetero- and cisnormativity, including negative public attitudes toward the LGBTQ+ community. In addition to combating social exclusion at the societal level, strengthening the coping abilities of young LGBTQ+ people is an important goal. OBJECTIVE In this transdiagnostic feasibility study, we tested a 6-week internet intervention program designed to increase the ability of nonclinical LGBTQ+ participants to cope with adverse events in their daily lives. The program was based on acceptance and commitment therapy principles. METHODS The program consists of 6 web-based modules and low-intensity assistance for homework provided by a single care provider asynchronously. The design was a single-group assignment of 15 self-identified LGB community members who agreed to participate in an open trial with a single group (pre- and postintervention design). RESULTS Before starting the program, participants found the intervention credible and expressed high satisfaction at the end of the intervention. Treatment adherence, operationalized by the percentage of completed homework assignments (32/36, 88%) was also high. When we compared participants’ pre- and postintervention scores, we found a significant decrease in clinical symptoms of depression (Cohen <i>d</i>=0.44, 90% CI 0.09-0.80), social phobia (<i>d</i>=0.39, 90% CI 0.07-0.72), and posttraumatic stress disorder (<i>d</i>=0.30, 90% CI 0.04-0.55). There was also a significant improvement in the level of self-acceptance and behavioral effectiveness (<i>d</i>=0.64, 90% CI 0.28-0.99) and a significant decrease in the tendency to avoid negative internal experiences (<i>d</i>=0.38, 90% CI 0.09-0.66). The level of general anxiety disorder (<i>P</i>=.11; <i>d</i>=0.29, 90% CI –0.10 to 0.68) and alcohol consumption (<i>P</i>=.35; <i>d</i>=–0.06, 90% CI –0.31 to 0.19) were the only 2 outcomes for which the results were not statistically significant. CONCLUSIONS The proposed web-based acceptance and commitment therapy program, designed to help LGBTQ+ participants better manage emotional difficulties and become more resilient, represents a promising therapeutic tool. The program could be further tested with more participants to ensure its efficacy and effectiveness. CLINICALTRIAL ClinicalTrials.gov NCT05514964; https://clinicaltrials.gov/study/NCT05514964