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

Trial Summary

Will I have to stop taking my current medications?

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

What data supports the effectiveness of the treatment Acceptance and Commitment Therapy (ACT) for Counseling for Minority Stress?

Research shows that Acceptance and Commitment Therapy (ACT) can help improve mental health by reducing anxiety and depression and enhancing quality of life. It has been effective in various settings, including for adolescents and patients with heart conditions, suggesting it may also be beneficial for addressing minority stress. ^{1 2 3 4 5}

How is Acceptance and Commitment Therapy (ACT) unique compared to other treatments for minority stress?

Acceptance and Commitment Therapy (ACT) is unique because it focuses on helping individuals accept their thoughts and feelings rather than fighting them, and encourages them to live in accordance with their values, which can be particularly beneficial for managing minority stress. ^{3 6 7 8 9}

What is the purpose of this trial?

Lesbian, gay, bisexual, transgender, and queer+ (LGBTQ+) individuals experience a breadth of mental health disparities. Reducing these disparities is an area of key psychological research. Minority stress is theorized to be an underlying source of the disparities (Meyer, 2003). Minority stress can be conceptualized as the internalized stigma that results from experiences of social marginalization. By reducing minority stress, it is hypothesized that generalized mental illness indicators might be reduced and indicators of wellbeing increased.

Eligibility Criteria

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

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)

Treatment Details

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.

Participant Groups

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+

Findings from Research

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) 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) 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) 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]

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) 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) 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) 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]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Acceptance and Commitment Therapy Informed Behavioral Health Interventions Delivered by Non-Mental Health Professionals: A Systematic Review. [2023]

2. United States 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. [2018]

3. Switzerland pubmed.ncbi.nlm.nih.gov

Acceptance and commitment therapy: Altering the verbal support for experiential avoidance. [2022]

4. India 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. [2022]

5. England 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. [2022]

6. England 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. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Acceptance and commitment therapy (ACT): advances and applications with children, adolescents, and families. [2011]

8. Australia pubmed.ncbi.nlm.nih.gov

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

9. France pubmed.ncbi.nlm.nih.gov

[Acceptance and commitment therapy]. [2019]