Group mindful self-compassion training to improve mental health outcomes for LGBTQIA+ young adults: Rationale and protocol for a randomised controlled trial

https://doi.org/10.1016/j.cct.2021.106268Get rights and content

Abstract

Background

Young adults who are lesbian, gay, bisexual, trans, queer or questioning, intersex, asexual and other diverse genders and sexualities (LGBTQIA+) are more likely to experience mental health difficulties and are at significantly elevated risk of substance abuse, self-harm and suicide, relative to their heterosexual, endosex and cisgender peers. There is a need for effective mental health interventions for LGBTQIA+ young adults. Mindful Self-Compassion training is a promising approach; among LGBTQIA+ individuals, self-compassion accounts for more variation in mental health outcomes than bullying, victimization, and adverse childhood experiences combined. Furthermore, LGBTQIA+ individuals with high self-compassion report more positive identity and happiness, less self-stigma, and lower suicidality than those with low self-compassion.

Method

This paper outlines the rationale and protocol for a single-blind CONSORT-compliant randomised controlled trial, comparing group Mindful Self-Compassion to a delayed-treatment waitlist control group, for improving mental health, decreasing self-criticism and increasing self-compassion in LGBTQIA+ young adults (age 18–25 years). Mindful Self-Compassion training is an 8-week group program that focuses on cultivating self-compassion and mindfulness. While typically delivered as a face-to-face program, the proposed trial will investigate efficacy of the program when provided via videoconferencing.

Discussion

Videoconference Mindful Self-Compassion training has the potential to improve the mental health of Australian LGBTQIA+ young adults and provide a possible cost-effective, scalable intervention for this population. The proposed trial will be the first to determine its efficacy for LGBTQIA+ young adults and will provide the first data on the delivery of the program via videoconferencing.

Section snippets

List of abbreviations

LGBTQIA+Lesbian, Gay, Bisexual, Trans, and/or Queer or questioning, Intersex, Asexual and other diverse genders and sexualities
RCTRandomised Controlled Trial

Funding and registration

The study is funded by an Australian Rotary Health Mental Health Grant. It has been registered with the Australian and New Zealand Clinical Trials Registry.

Aims

The proposed study seeks to determine whether self-compassion training is an efficacious intervention for improving mental health in a community sample of LGBTQIA+ young adults. Within the broader domain of self-compassion interventions, established and empirically-supported intervention approaches include the Mindful Self-Compassion

Significance

This paper describes the protocol for a randomised controlled trial designed to assess the efficacy of a Mindful Self-Compassion training program for both increasing self-compassion and decreasing psychological distress and self-criticism for young adults who are LGBTQIA+. Although young adulthood is already a high-risk period for development of mental health difficulties [50], LGBTQIA+ young people are at even higher risk of developing a mental health disorder compared to their

Ethics approval and consent to participate

This study has received ethics approval from the University of Western Australia (HREC RA/4/20/6094).

All participants will fill out a consent form as part of their online screening questionnaire. The consent will specify that their (de-identified) data will be used for research purposes and that they consent to being invited to a follow-up interview.

Consent for publication

Not applicable.

Availability of data and materials

No datasets were analysed during the preparation of this protocol paper. Materials used are available, upon reasonable request, via contact with the corresponding author.

Funding

This research is funded by Australian Rotary Health as part of the Mental Health of Young Australians (0–25 years) Project Grants. Australia Rotary Health had no role in the study design, data collection and analysis, or the writing of the manuscript. AL is funded by an NHMRC Career Development Fellowship (#1148793).

Authors' contributions

AFJ and JO conceived of the study. AFJ, AL, PS, JO and YP initiated the study design and secured funding. Australian Rotary Health are grant holders. AFJ, CP and ZW compiled the draft protocol for review. All authors contributed to refinement of the study protocol and approved the final manuscript.

Declaration of Competing Interest

AFJ is a trained and/or certified facilitator of several compassion training programs, including Compassion Cultivation Training, Mindful Self-Compassion Training, Mindfulness-Based Compassionate Living, and Making Friends with Yourself. She is also the developer of the Self-Compassion Online program.

Acknowledgements

We would like to acknowledge and thank our Youth Reference Group members for their input into the study.

References (52)

  • A.J. Vigna et al.

    Does self-compassion facilitate resilience to stigma? A school-based study of sexual and gender minority youth

    Mindfulness.

    (2018)
  • A.J. Vigna et al.

    Does self-compassion covary with minority stress? Examining group differences at the interseciton of marginalized identities

    Self Identity

    (2018)
  • T. Hatchel et al.

    Peer victimization and suicidality among LGBTQ youth: the roles of school belongong, self-compassion, and parental support

    J. LGBT Youth

    (2019)
  • K.D. Neff

    Self-compassion: an alternative conceptualization of a healthy attitude toward oneself

    Self Identity

    (2003)
  • L.M. Gertler

    The Coming out Experience, Internalized Homophobia, and Self-Compassion in LGBQ Young Adults: The Wright Institute

    (2014)
  • D.A. Crews

    Exploring Self-Compassion with Lesbian, Gay, and Bisexual Person

    (2012)
  • D.C. Greene et al.

    Predicting adult LGBTQ happiness: impact of childhood affirmation, self-compassion, and personal mastery

    J. LGBT Issues Couns.

    (2015)
  • M. Ferrari et al.

    Self-compassion interventions and psychosocial outcomes: a meta-analysis of RCTs

    Mindfulness.

    (2019)
  • A. Finlay-Jones et al.

    A pilot study of the 8-week mindful self-compassion training program in a Chinese community sample

    Mindfulness.

    (2018)
  • A. Brown et al.

    Systematic review of barriers and facilitators to accessing and engaging with mental health care among at-risk young people

    Asia Pac. Psychiatry

    (2016)
  • J. McIntyre et al.

    Systems-level barriers in accessing supportive mental health services for sexual and gender minorities: insights from the provider’s perspective

    Canadian J. Commun. Mental Health.

    (2012)
  • A. Waling et al.

    Understanding LGBTI+ Lives in Crisis

    (2019)
  • P. Strauss et al.

    Trans Pathways: The Mental Health Experiences and Care Pathways of Trans Young People

    (2017)
  • Van Der Pol-Harney E, McAloon J

    Psychosocial interventions for mental illness among LGBTQIA youth: a PRISMA-based systematic review

    Adolescent Research Review.

    (2019)
  • S.R. Chaudoir et al.

    What reduces sexual minority stress? A review of the intervention “toolkit”

    J. Soc. Issues

    (2017)
  • R.W. Coulter et al.

    Mental health, drug, and violence interventions for sexual/gender minorities: a systematic review

    Pediatrics.

    (2019)

    • Cited by (11)

    • Using group-based interactive video teleconferencing to make self-compassion more accessible: A randomized controlled trial

      2023, Journal of Contextual Behavioral Science

    • Internet-based interventions to promote help-seeking for mental health in LGBTQ+ young adults: Protocol for a randomized controlled trial

      2022, Internet Interventions
      Citation Excerpt :

      Another study focused on examining facilitators and barriers of SGM youth help-seeking suggests that hearing others' positive past help-seeking experiences with MHPs is a help-seeking facilitator for participants (Zay Hta et al., 2021). Despite the positive impacts of group discussion on participants, at this moment, only psychotherapeutic interventions have incorporated it as the keystone of their curriculum (Craig et al., 2021; Finlay-Jones et al., 2021; Pachankis et al., 2015). Most interventions targeting the SGM population have not incorporated this element into their intervention curriculum, leaving a gap for this study to be bridged in the intervention field (Pachankis et al., 2020; Riggle et al., 2014).

    • Critical issues in cognitive behavioural therapy (CBT) with gender and sexual minorities (GSMs)

      2022, Cognitive Behaviour Therapist

    • Beyond the Centrality of Shame: How Self-Concealment and Fear of Receiving Compassion From Others Impact Psychological Suffering in Transgender Adults

      2024, Journal of Homosexuality

    • Everyday Discrimination and Mental Health Among Sexual and Gender Minority Adults: The Moderating Role of Self-Compassion

      2023, Psychology of Sexual Orientation and Gender Diversity

    • Exploring the Variables of the Psychological Well-Being of Mothers of Children with Autism Spectrum Disorder Through Self-Compassion and Psychological Hardiness

      2023, Journal of Autism and Developmental Disorders
    View all citing articles on Scopus
    View full text
    © 2021 Elsevier Inc. All rights reserved.