Counseling for Minority Stress

(MST Trial)

Overseen By Nicholas Borgogna (Assistant Professor), PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Alabama at Birmingham

Disqualifiers: Suicide attempt, Eating disorder, Narcotics, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 18

Duration: 16 weeks

80 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to help LGBTQ+ individuals manage stress from societal marginalization. Researchers seek to determine if Acceptance and Commitment Therapy (ACT) can reduce mental health issues and improve overall well-being by addressing these stressors. Participants will either receive this therapy or continue with usual counseling. This trial suits non-heterosexual individuals who have not attempted suicide in the past year and do not have a current eating disorder or history of psychosis. As an unphased trial, it offers a unique opportunity to contribute to research that could enhance mental health support for the LGBTQ+ community.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Acceptance and Commitment Therapy (ACT) is generally safe and well-received. A review found that ACT helps LGBTQ+ individuals by reducing mental health symptoms. Another study found that participants actively engaged in ACT and had low dropout rates, indicating its acceptability and feasibility.

While ACT primarily supports mental health, it also showed positive results in helping people quit smoking. This suggests that ACT can offer various benefits without major negative effects.

In short, ACT appears to be a safe choice for those seeking to reduce stress related to minority status and improve mental health. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Acceptance and Commitment Therapy (ACT) is unique because it combines mindfulness with behavioral change strategies, offering a fresh approach for managing minority stress. Unlike traditional talk therapy or medication that primarily targets symptom relief, ACT focuses on helping individuals accept their thoughts and feelings without judgment while committing to personal values and actions. This method empowers individuals to navigate stress more effectively, potentially leading to longer-lasting mental health benefits. Researchers are excited about ACT because it encourages personal growth and resilience, addressing the root causes of stress rather than just the symptoms.

What evidence suggests that Acceptance and Commitment Therapy might be an effective treatment for minority stress?

This trial will compare Acceptance and Commitment Therapy (ACT) with treatment as usual for addressing minority stress. Research has shown that ACT can help LGBTQ+ individuals manage the stress associated with minority status. Studies have found that ACT positively impacts anxiety and depression, common issues related to this stress. For individuals of various races, sexual orientations, and gender identities, ACT might address specific challenges they encounter. Some research suggests that ACT can lower psychological distress and improve quality of life. While it may not always directly reduce depression, ACT helps individuals become more adaptable in their thinking, which is important for mental health. ^{4 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for non-heterosexual LGBTQ+ individuals who are not currently dealing with a recent suicide attempt, eating disorder, narcotics use within the past 3 months, self-injury within the past 6 months, or any current or historical psychosis.

Inclusion Criteria

I identify as a member of the LGBTQ+ community.

Exclusion Criteria

Suicide attempt within the past 12 months

Narcotics use within the past 3 months

Current eating disorder

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

1 visit (virtual)

Treatment

Participants receive up to 16 sessions of acceptance and commitment therapy (ACT) delivered by Mr. Whittington under the supervision of Dr. Borgogna

16 weeks

16 visits (in-person)

Follow-up

Participants are invited to complete a survey at a 1 month follow-up to assess mental health and minority stress measures

4 weeks

1 visit (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Acceptance and Commitment Therapy

Trial Overview The study tests Acceptance and Commitment Therapy (ACT) as a treatment to reduce minority stress among LGBTQ+ people. The goal is to see if ACT can lower mental health issues and improve overall wellbeing by addressing internalized stigma from social marginalization.

How Is the Trial Designed?

Group I: Treatment Group Experimental Treatment 1 Intervention

Participants receiving acceptance and commitment therapy

Group II: Treatment as usual Active Control 1 Intervention

Unstructured counseling intervention

Who Is Running the Clinical Trial?

University of Alabama at Birmingham

Lead Sponsor

Trials

1,677

Recruited

2,458,000+

Published Research Related to This Trial

Acceptance and Commitment Therapy (ACT) can be effectively delivered by non-therapists, such as healthcare workers and teachers, providing a cost-efficient way to improve mental health care access for underserved populations.

The systematic review identified 19 unique ACT-informed interventions that showed positive outcomes, including increased pain tolerance, improved acceptance, and reduced psychological distress, indicating that these interventions can effectively enhance psychological flexibility and health behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptance and Commitment Therapy Informed Behavioral Health Interventions Delivered by Non-Mental Health Professionals: A Systematic Review. Arnold, T., Haubrick, KK., Klasko-Foster, LB., et al.[2023]

Acceptance and Commitment Therapy (ACT) is a promising form of therapy that incorporates mindfulness techniques and has shown effectiveness for various psychiatric disorders in adults.

Research on adapting ACT for youth is still developing, indicating a need for more studies to establish its efficacy and safety in younger populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptance and commitment therapy (ACT): advances and applications with children, adolescents, and families. Coyne, LW., McHugh, L., Martinez, ER.[2011]

Acceptance and Commitment Therapy (ACT) effectively enhances psychological flexibility and has shown efficacy in treating a variety of psychiatric disorders, including depression, anxiety, and PTSD, with a meta-analysis revealing an average effect size of 0.66 at post-treatment across 704 participants.

ACT not only improves mental health outcomes but also benefits other medical areas such as chronic pain management and smoking cessation, demonstrating its versatility and positive impact on quality of life.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Acceptance and commitment therapy]. Ducasse, D., Fond, G.[2019]

A national training initiative for Acceptance and Commitment Therapy for depression (ACT-D) led to a significant increase in therapist competency, with 96% of therapists achieving competency by the end of training, up from only 21% at the start.

Patient outcomes improved markedly, with average depression scores (BDI-II) decreasing from 30 to 19, indicating effective treatment, alongside increased quality of life scores and stronger therapeutic alliances.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training in and implementation of Acceptance and Commitment Therapy for depression in the Veterans Health Administration: therapist and patient outcomes. Walser, RD., Karlin, BE., Trockel, M., et al.[2022]

Acceptance and Commitment Therapy (ACT) has shown effectiveness in improving outcomes for patients with chronic pain and may also benefit those with mild to moderate depression, making it a valuable tool for general practitioners.

ACT employs mindfulness and acceptance strategies to help patients align their behaviors with their values, and it has shown preliminary benefits in various conditions, including obsessive-compulsive disorder and emotional issues after gastric band surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptance and commitment therapy - pathways for general practitioners. Smout, M.[2012]

Acceptance and Commitment Therapy (ACT) is designed to help individuals reduce emotional avoidance and enhance their ability to change behaviors, making it a valuable psychotherapy approach.

The techniques used in ACT are grounded in behavioral analysis, providing a structured way to address emotional challenges and promote psychological flexibility in adult outpatient settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptance and commitment therapy: Altering the verbal support for experiential avoidance. Hayes, SC., Wilson, KG.[2022]

Acceptance and Commitment Therapy (ACT) showed significant improvements in global mental health, depression, cognitive fusion, and values in complex clients treated by both psychologists and non-psychologists in a National Health Service setting.

The positive effects of ACT were partially maintained at a 3-month follow-up, indicating its potential long-term benefits, and outcomes were similar regardless of the therapist's professional background.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and Evaluation of Acceptance and Commitment Therapy Delivered by Psychologists and Non-Psychologists in an NHS Community Adult Mental Health Service: a Preliminary Analysis. Richardson, T., Bell, L., Bolderston, H., et al.[2018]

Acceptance and Commitment Therapy (ACT) significantly reduced anxiety and depression scores in 100 female students aged 16-18, with improvements observed immediately after the intervention and sustained 8 weeks later.

The quality of life for participants also improved significantly after the ACT sessions, indicating that this therapeutic approach can be beneficial for adolescents experiencing mild to moderate anxiety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of counseling based on acceptance and commitment therapy on anxiety, depression, and quality of life among female adolescent students. Shiri, S., Farshbaf-Khalili, A., Esmaeilpour, K., et al.[2022]

In a pilot study of 98 young and middle-aged patients undergoing PCI for myocardial infarction, those who received Acceptance and Commitment Therapy (ACT) showed significantly improved psychological resilience and self-management abilities compared to a control group receiving routine nursing.

Three months after the intervention, the ACT group had higher scores in both psychological resilience and self-management, indicating that ACT can effectively enhance these important skills in patients recovering from heart procedures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of acceptance and commitment therapy on self-management skills and psychological resilience of young and middle-aged patients underwent percutaneous transluminal coronary intervention for primary myocardial infarction: a pilot study. Cao, J., Sun, P., Zhang, L., et al.[2022]

Citations

1. sciencedirect.com sciencedirect.com/science/article/abs/pii/S2212144723000534

A systematic review of inclusion of minoritized populations ... ACT may be a potentially effective treatment for racial, sexual orientation and gender diverse people who experience unique stressors related to their ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10155421/

A randomized trial of acceptance-based behavioral therapy to ... Results from meta-analyses and systematic reviews show that ABBT approaches can have large effects on anxiety and depression [[19], [20], [21]].

3. link.springer.com link.springer.com/article/10.1007/s12671-024-02403-9

Affirmative Mindfulness, Acceptance, and Compassion ... In sum, minority stressors increase the risk for psychopathology and decrease the access to and benefit from affirmative evidence-based ...

4. researchgate.net researchgate.net/publication/372901265_Preliminary_evaluation_of_an_acceptance_and_commitment_therapy_group_for_transgender_and_gender_expansive_adults

Preliminary Evaluation of an Acceptance and Commitment ... Findings suggest that ACT-based groups may be satisfactory and effective at reducing psychological inflexibility, but not depression, in TGE ...

5. publications.aap.org publications.aap.org/pediatrics/article/156/4/e2025071134/204188/Acceptance-and-Commitment-Therapy-for-Parents-of

Acceptance and Commitment Therapy for Parents of ... Our study demonstrated that a 4-session ACT-based intervention significantly reduced parental psychological distress, improved QoL, enhanced ...

6. sciencedirect.com sciencedirect.com/science/article/abs/pii/S221214472200059X

A call for ACTion: A systematic review of empirical ... Results suggested that ACT can promote PF for LGBTQI+ individuals, consequentially leading to symptom reduction for a variety of mental health problems. ACT has ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2727477/

Acceptance and Commitment: Implications for Prevention ... ACT had significantly better smoking cessation outcomes (35 vs. 15%) at one-year follow-up. A decreased need to avoid smoking-related thoughts and feelings in ...

8. contextualscience.org contextualscience.org/files/ACT%20for%20Sexual%20Minorities%20Experiencing.pdf

ACT for Sexual Minorities Experiencing.pdf Acceptability & Feasibility. • Adherence to the treatment protocol was high, dropout was low, and participants appeared to be engaged and actively.

9. karger.com karger.com/pps/article/93/3/191/897981/Indicated-Stress-Prevention-Addressing-Adolescents

Indicated Stress Prevention Addressing Adolescents with ... The aim of the study was to investigate an eight-session group intervention using components of Acceptance and Commitment Therapy (ACT) enriched ...