Training mental health providers in queer-affirming care: A systematic review.

Abstract

The effectiveness of training for mental health professionals to increase queer-affirming (e.g., lesbian, gay, bisexual, pansexual) cultural competencies has not been well established. Though there is an assumption that training generally works to increase or improve knowledge, attitudes, and skills, it is unclear what training format, content, and pedagogical approaches are effective. To explore the effectiveness of cultural competency training interventions for mental health professionals, a systematic review of peer-reviewed empirical articles in English published between 2000 and 2020 was conducted. Studies were selected for inclusion if the article was empirical, evaluated a training or education related to working with queer clients, and participants were mental health providers or graduate level trainees. Independent data extraction was conducted by using predefined thematic content areas, including information about the research method, training content, training format, measures, outcomes, and recommendations. Data was reviewed for 13 studies and training duration varied from 1 hr to 1 year. Most studies measured knowledge, and some measured attitudes, skills, and self-efficacy. There is some evidence that queer cultural competency training helps to improve self-reported knowledge, attitudes, and skills for mental health professionals. However, given several limitations, including a lack of studies and various methodological challenges, clear conclusions cannot be made about the effectiveness of queer cultural competency training for mental health professionals, more broadly. Public Significance StatementEvidence-based queer-affirming training for mental health professionals is needed and a systematic review of this literature provides an overview of the current research. Training in this area tends to increase self-reported cultural competency, however, more research and rigorous methods are needed to continue testing the effectiveness of such training.

The empirical literature on training mental health providers in queer-affirming care: Considering the clinical implications.

“…The findings of Bettergarcia et al (2021) empirically validate the intuitive sense many of us already had, that is, that an analysis of the relevant articles generated more questions than they answered, and that there is no gold (or even silver or bronze) standard for trainings on providing queer-affirmative care in terms of content, modality, length, or audience. On one hand, these findings are disappointing.…”

“…We commend Bettergarcia et al (2021) on their thoughtful and thorough systematic review on mental health provider trainings in queer-affirming care. Prior published reviews have focused on sexual and gender minority-affirming therapies (O’Shaughnessy & Speir, 2018) but fewer have focused on the training needed to implement those therapies.…”

“…There is a growing (not stagnant) literature in this area, with more (not fewer) mental health researchers and clinicians turning their attention to these questions, and an increasing sense of urgency (not apathy) to improve our capabilities in queer-affirming care. Bettergarcia et al (2021) discuss clinical implications of their review, and we encourage readers to read and reflect on them, and to make a plan for how to incorporate their suggestions into your practice. Here we amplify a few key clinical takeaways.…”

“…They first conducted a content analysis to identify emergent themes, and then rated each entry in terms of how well it addressed those themes. There is substantial overlap in terms of core content suggested by the two articles—neither of which were themselves tests of interventions and so were not included in Bettergarcia et al’s (2021) review. We refer readers to these articles and hope they are fruitful sources of information about the range of topics that queer-affirming mental health training could include.…”

Planting gardens and growing beyond the guidelines: Introduction to the special issue.

“…In their comprehensive analysis, Velez et al (2021) identified neglected populations within sexual minority communities (e.g., persons of color, sexual and gender minority youth), understudied vocational contexts (e.g., unemployed populations, hiring practices), and limitations to research methodologies, and they offer fruitful directions for future research and intervention. Bettergarcia et al (2021) recognized the importance of professional training and education in the field of psychology. They conducted a systematic review of empirical scholarship published within a span of 20 years, exploring process and outcomes associated with queer cultural competency training for mental health practitioners.…”