What motivates community mental and behavioral health organizations to participate in LGBTQ+ cultural competency trainings?

Abstract

The constantly evolving language, understanding, and cultural context regarding the mental health of lesbian, gay, bisexual, transgender, queer, and other sexual and gender diverse individuals (LGBTQ+) require mental health providers to obtain LGBTQ+ cultural competency training to be affirmative and effective with this population. Unfortunately, many providers are not obtaining this ongoing training and mental health disparities continue to plague LGBTQ+ populations. Guided by the Consolidation Framework for Implementation Research (CFIR), we conducted eight focus groups with community mental and behavioral health organization (MBHO) administrators (e.g., directors, clinical supervisors) and therapists to explore what factors facilitated or inhibited their adoption and implementation of a multicomponent LGBTQ+ cultural competency training program that required administrator and therapist participation in multiple learning sessions over several months (i.e., workshop, clinical consultation, and organizational technical assistance). Results from template analysis supported CFIR-aligned themes, including characteristics of individuals, inner setting, outer setting, and process, and two additional codes—marketing and other/previous training opportunities—emerged from the focus group data. Findings suggest that therapists are motivated to engage in such a program because they want to feel more efficacious, and administrators see the benefits of LGBTQ+ training programs for their clientele and marketing. Barriers to adoption and implementation include cost and personnel resistance, although participants believed these barriers were surmountable. Emphasizing therapist efficacy, clientele need, and benefits for marketing mental and behavioral health services could motivate MBHOs’ and therapists’ adoption and implementation of LGBTQ+ cultural competency training.

LGBTQ+ cultural‐competence training effectiveness: Mental health organization and therapist survey outcome results from a pilot randomized controlled trial

“…While preparing for the SGDLC RCT, the COVID‐19 pandemic led to a conversion of all training components: initially planned as in‐person, to a virtual, synchronous, face‐to‐face format. The new virtual RCT was preceded by a preparatory implementation feedback study of the final SGDLC intervention components with three mental MHOs involving both administrators and therapists (Fish et al, 2022). The feasibility and acceptability of the SGDLC components during the RCT were previously reported (Fish et al, 2023, in press).…”

“…Prior papers describe the formative research for the SGDLC programme components and its feasibility and acceptability (Fish et al, 2022(Fish et al, , 2023. This paper reports on the RCT evaluation findings regarding the effectiveness of the SGDLC TTA programme.…”

Recommendations for the assessment of sexual and gender minority status in serious mental illness research and clinical care.

“…The need for effective treatments for SGM people with mental illnesses is pressing, both to improve overall quality of life and to reduce high rates of negative outcomes, such as suicide attempts and nonsuicidal self-injury (Fulginiti et al, 2021; Lipson et al, 2019; Toomey et al, 2018). For clinicians, it may be daunting to know where to begin when determining how to appropriately assess SGM status and incorporate this aspect of a client’s identity into therapy; indeed, many clinicians report they lack confidence and skills in how to implement such treatments (Fish et al, 2022; Rees et al, 2021; Rock et al, 2010; Shelton & Delgado-Romero, 2011). This is demonstrated in reduced access to services, as SGM groups have limited access to appropriate mental health care, with research showing only 12.6% of state approved mental health care facilities provide recommendations specific to SGM groups (Williams & Fish, 2020).…”