Promoting Mental Health and Coping Among Lgbtqia+ Youth during COVID-19: A Pilot Study of an Affirmative Mindfulness-Based Group Intervention

Background and Purpose: Sexual and gender minority youth (SGMY) experience significant mental health disparities compared to non-SGMY, particularly in the enduring pandemic. SGMY are also being subjected to significant political attacks and violence across the U.S., especially transgender/gender-diverse youth. SGMY are simultaneously overlooked in social work research and practice, with few evidence-informed interventions available. While political action and advocacy are required, SGMY also require culturally-responsive mental health supports in this current political climate.

Utilizing a community-based participatory action research (CBPAR) approach, this open pilot study tested a virtual mindfulness-based intervention (MBI) (Tuned In!), collaboratively developed with SGMY and community stakeholders. Tuned In! was primarily designed to promote SGMY mental health by developing coping strategies (e.g., self-advocacy, grounding, assertiveness) to effectively navigate the current sociopolitical context, reduce anxiety, depression, internalized oppression, and enhance identity affirmation, mindfulness, and self-compassion.

Methods: A pre-and post-test design evaluated changes in mental health outcomes. Using purposive sampling, SGMY participants (n=52) between the ages of 16 and 29 were recruited. Tuned In! consists of eight weekly sessions (90 minutes) and was facilitated by licensed clinicians (e.g., LCSW) trained in the intervention protocol.

Participants completed self-report measures at baseline and immediately following the intervention. Measures: Spielberger State-Trait Anxiety Inventory, Self-Compassion Scale, Child and Adolescent Mindfulness Measure, Beck Depression Inventory, a measure used to determine changes in internalized LGBTQIA+ oppression, and a qualitative satisfaction survey. The analytic approach included descriptive statistics, dependent sample t-tests, and thematic analysis.

Participants’ (16-29 yrs.) gender identities included: non-binary/gender fluid (39%), cis female/woman (37%), queer (27%), trans male/man (17%), trans female/woman (8%), cis male/man (12%), and agender (12%). Sexual orientation identities included: queer (44%), bisexual (39%), pansexual (19%), gay (17%), lesbian (15%), asexual (14%), and questioning (6%). Identified race/ethnicity included white/European (65%), East/South/Southeast Asian (21%), Black/African/Caribbean (8%), Latinx (8%), and Indigenous (2%). Categories are not mutually exclusive. Rates of engagement and retention were satisfactory as all participants completed the intervention and both pre-and post-assessments.

Results: Results indicated significant improvements in all outcome measures from pre-to post-test. SGMY reported decreased anxiety (t=-4.85, p<0.001, d = -.67), depression (t=-4.69, p<0.001, d = -.66), internalized LGBTQIA+ oppression (sexual minority identity = t=-3.14, p<0.05, d = -.45; gender minority identity = (t=-4.07, p<0.001, d = -.74), and increases in self-compassion (t=5.06, p<0.001, d = .71) and mindfulness (t=3.18, p<0.05, d = .45). Qualitative findings indicated satisfaction and acceptability: “It was helpful to be given practical practices...”;“I really enjoyed being able to have difficult discussions with my peers in a safe, well-coordinated setting.”

Conclusions and Implications: In considering the future of social work intervention science, this study provides support for potential benefits of this SGMY affirming social work intervention. High rates of engagement and retention suggest feasibility, acceptability, and utility of Tuned In!. Follow-up research already underway will scale up and evaluate (e.g., RCT) Tuned In! with larger samples and longitudinal design to assess the sustainability of outcomes over time. Adaptation considerations, particularly for SGMY of color, and implications for social work practice and research will be discussed.