Trial Outcomes & Findings for Assessing Mental Health Providers' Clinical Knowledge and Skills Via an Online Training on LGBTQ-affirmative Cognitive-behavioral Therapy (NCT NCT04559698)

Recruitment was conducted through an online flyer emailed to listservs of mental health providers at CenterLink LGBTQ community centers. An informal webinar was also held in October 2020 for mental health providers at CenterLink LGBTQ community centers to learn more about the study.

Assessing Mental Health Providers' Clinical Knowledge and Skills Via an Online Training on LGBTQ-affirmative Cognitive-behavioral Therapy

Familiarity with LGBTQ-affirmative CBT skills will be measured using a self-developed questionnaire by the researchers for the purpose of this study. This questionnaire consists of 7 items rated on a 5-point Likert scale for each item. An overall score of 35 (sum of all items) would be the highest possible score on the questionnaire and would indicate a high level of familiarity with LGBTQ-affirmative CBT skills.

Use LGBTQ-affirmative CBT skills will be measured using a self-developed questionnaire by the researchers for the purpose of this study. This questionnaire consists of 7 items rated on a 5-point Likert scale for each item. An overall score of 35 (sum of all items) would be the highest possible score on the questionnaire and would indicate a high level of use of LGBTQ-affirmative CBT skills.

Competency in LGBTQ clinical skills will be measured using the Sexual Orientation Counselor Competency Scale (SOCCS) - Clinical Skills subscale. This subscale consists of 11-items from a psychometrically validated measure, based on a 7-point Likert scale assessing the extent to which respondents endorse clinical competence as related to their skills in working with clients of diverse sexual identities. For the present study, items have been adapted to specifically assess competence in clinical skills based on an LGBTQ-affirmative CBT framework. An overall score of 7 (arithmetic mean of all 11 items) would be the highest possible score and would indicate a high level of competence in LGBTQ clinical skills.

Competency in LGBTQ clinical skills will be measured by asking participants to provide responses to videos of fictional LGBTQ clients. Participants will watch 2 brief video clips (90 seconds each) of fictional clients presenting concerns they would like to address in psychotherapy. Participants will then be asked to write a brief paragraph describing what clinical approaches they would use in clinical treatment in order to address the challenges discussed by the fictional client. These written responses will be rated based on 22 items on a 2-point scale of 0 (did not mention at all), 1 (briefly discussed), and 2 (discussed in detail) to determine participants' LGBTQ-affirmative and general CBT skills. Items coded related to LGBTQ-affirmative CBT skills will not be double coded in the comparable items related to general CBT skills. Average scores will be taken such that 2 would be the highest possible score and would indicate a high level of competence in LGBTQ clinical skills.

Competency in general CBT clinical skills will be measured by asking participants to provide responses to videos of fictional LGBTQ clients. Participants will watch 2 brief video clips (90 seconds each) of fictional clients presenting concerns they would like to address in psychotherapy. Participants will then be asked to write a brief paragraph describing what clinical approaches they would use in clinical treatment in order to address the challenges discussed by the fictional client. These written responses will be rated based on 22 items on a 2-point scale of 0 (did not mention at all), 1 (briefly discussed), and 2 (discussed in detail) to determine participants' LGBTQ-affirmative and general CBT skills. Items coded related to LGBTQ-affirmative CBT skills will not be double coded in the comparable items related to general CBT skills. Average scores will be taken such that 2 would be the highest possible score and would indicate a high level of competence in CBT clinical skills.

LGBTQ cultural humility will be measured using the Multidimensional Cultural Humility Scale (MCHS). This questionnaire is a 15-item self-report psychometrically validated measure assessing the extent to which respondents endorse an ability to maintain an other-oriented, interpersonal stance in relation to cultural identities most salient to clients. For the present study, items were adapted to specifically assess cultural humility as related to working with LGBTQ clients. An overall score of 90 (sum of all items) would be the highest possible score on the questionnaire and would indicate a high level of LGBTQ cultural humility.

Content knowledge of minority stress will be measured using a self-developed, 10-item multiple-choice measure by the researchers for the purpose of this study and based on past minority stress research. An overall score of 10 (i.e., answering all 10-items correctly) would be the highest possible score on the measure and would indicate a high level of content knowledge of minority stress.

Content knowledge of CBT/LGBTQ-affirmative CBT will be measured using a self-developed, 10-item multiple-choice measure by the researchers for the purpose of this study based on past interventional studies of LGBTQ-affirmative CBT. An overall score of 10 (i.e., answering all 10-items correctly) would be the highest possible score on the measure and would indicate a high level of content knowledge of CBT/LGBTQ-affirmative CBT.

Acceptability of LGBTQ-affirmative CBT will measured using a self-developed questionnaire by the researchers based on past research on training acceptability. Participants will be asked to report how many of the 11 training sessions they attended. Participants will then be asked 2 qualitative questions in regard to which of the 11 training sessions they found most and least helpful. Participants will also be asked 7 questions based on a 5-point Likert scale regarding their interest and perceived benefit from the training. An overall score of 35 (sum of all items) on the Likert scale items would be the highest possible score on the measure and would indicate a high level of perceived acceptability of the LGBTQ-affirmative CBT training.