Broadway-Horner, Matt

Broadway-Horner M.

Purpose The purpose of this commentary is to appraise and critically evaluate sexual minorities' mental health provision according to individual and systemic barriers to mental health care. It addresses the issue of health inequity by first exploring the background narrative that informs health inequalities and then moving forward in creating a health equity framework. Design/methodology/approach From the focus point of mad studies and queer theory. Findings In this critical commentary, the work alongside others will be viewed and discussed in terms of addressing individual and systemic barriers to mental health care. Furthermore, how this has been significantly influenced by the colonisation of mental health with its polarising language and increased marginalisation will be discussed. Practical implications Progress world view (PWV) will help sexual minorities receive the care needed. Social implications Through the decolonisation of mental health, there will be a new understanding that helps us achieve health equity by using a gay worldview lens called the PWV (Broadway-Horner, 2024). Originality/value In closing, recommendations for future research alongside policy implications for service restructuring implementation of a decolonising health service. This will include a national training package to increase self-efficacy levels. It brings together a cohesive understanding of the PWV within a larger body of work on sexual minorities and mental health.

Broadway-Horner M.

Purpose The purpose of this scoping review is to find studies testing out psychological interventions to help victims of conversion therapy. Life after conversion therapy can be devastating; nonetheless, what treatment modalities are available for this population? Design/methodology/approach This study adopts scoping review process using JBI protocol. Findings There are minimal results to conclude upon. The paper presents discussion on future research and inquiry. The author introduces a positive autoethnography, adapting the model created by Tedeschi and Calhoun (2004) to create the post-conversion recovery process to aid recovery. Research limitations/implications Eye movement desensitization and reprocessing and positive autoethnography offer valuable insights, but further research is needed to help survivors. Practical implications To reduce the current death-by-suicide trends, more education and training are needed to help this specialised group. Social implications The suicide rates for sexual minority conversion therapy victims are eight times higher than those of other sexual minority groups and isolation levels. A single point of entry pathway for conversion therapy survivors is needed. Originality/value To the best of the authors’ knowledge, this is the first review addressing gay conversion therapy and disfellowship. It requires further attention, and there are gaps in the knowledge that need to be filled.

Broadway-Horner M.

Purpose Since COVID-19, many services have burgeoned within the UK, but what about sexual minorities? Since the last review, there are appropriate therapies, but there is often inadequate research. The purpose of this mixed-method review synthesis looking into the efficacy of psychological therapies for sexual minorities. Seven studies were found in total. Design/methodology/approach A mixed-method review synthesis, three studies looking into the efficacy of psychological therapies for sexual minorities and four studies addressing the experiences of sexual minorities partaking in psychological therapies were identified. Findings These included three quantitative and four qualitative studies. The minority stress hypothesis is used to formulate problems, but challenges remain to confidentiality and privacy in this context. Therapists still operate within the heteronormative framework, discounting intersectionality in therapy conversations. Research limitations/implications Most studies have had low retention rates since 2021. It shows that minority stress needs to be accounted for at the ethics committee and research delivery levels. Practical implications Applying a heteronormative framework to sexual minorities is not working. An alternative progress world view is needed. Social implications Health-care clinicians strive for equitable care. Unfortunately, using an equitable health service scale adapted from Levesque et al. (2013), the rating is 3 out of 6. More work is needed to improve services. Originality/value Some services are reporting much improvement post-pandemic. Sadly, this is not the case for sexual minorities. Individual and systemic barriers remain.

Broadway-Horner M.

Purpose The purpose of this study is to investigate the use of positive autoethnography for the consequences of conversion therapy. Life after conversion therapy is, for many, a life-changing episode, especially when combined with disfellowship. In recent years, positive autoethnography has grown substantially. The work of Tedeschi and Calhoun (2004), from the school of positive psychology, focuses on posttraumatic growth following a traumatic event or series of events. Design/methodology/approach Qualitative approach of positive autoethnography. Findings This innovative case study highlights personal struggles with grief, depression and suicidal ideation. In addition, the time elapsed has enabled a process to juggle with alternative ideas moving forward in salvaging a form of identity. Research limitations/implications Treatment as usual psychological therapies (TAUPT) provide many unhelpful triggers due to the same jargon used in both conversion therapy and TAUPT. Away from TAUPT, this writing exercise may help as a stand-alone post-conversion recovery process. Practical implications The post-conversion recovery process will offer much-needed help with only a few face-to-face meetings to aid the posttraumatic growth writing exercise. Social implications The suicide rates for sexual minority conversion therapy victims are eight times higher than those of other sexual minority groups and isolation levels. A single point of entry pathway for conversion therapy survivors is needed. Originality/value To the best of the author’s knowledge, the first of its kind to apply positive autoethnography using the model as a framework to understand the post-conversion therapy experience, looks for growth in five areas: relating to others, new possibilities, personal strength, spiritual change and appreciation of life.

Broadway-Horner M., Credland N.

Background: COVID-19 presented critical care nurses with significant challenges. Due to the volume of patients requiring intensive care, bed capacity was quadrupled virtually overnight, with non-critical care trained staff re-deployed into intensive care units (ICUs) to support existing teams. This increased workload, acuity of patients, increased death, lack of visiting due to infection prevention measures, and the need to support re-deployed staff, had a significant impact on staff wellbeing and psychological health. Aim: The aim of this paper is to reflect upon the author's experiences as a nurse consultant in supporting critical care nurses delivering care in ICUs to critically ill patients with COVID-19. Sources: The experiences of critical care nurses working during the COVID-19 pandemic, which were gathered from conversations via the semi-structured psychological first aid (PFA) process. Discussion: Advanced practitioner ‘four pillar thinking’ is a critical in-service development that can be used to bring about a responsive, robust and vigorous service in and outside of any future pandemics. Summary and implications: Critical care nurses' psychological health and wellbeing was, and still has been, significantly impacted by providing treatment during COVID-19. To ensure the wellbeing of the staff group, healthcare professionals need to identify support mechanisms that will continue to ensure their mental health and wellbeing remain intact. Such measures will enable them to deliver expert care at times of increased demand, as well as support recruitment and retention strategies. This experience highlighted the importance of providing psychological first aid within support services to critical care staff.

Kar A., Das N., Broadway-Horner M., Kumar P.

Intimate partner violence (IPV) has been a significant public health problem in same-sex relationships. However, health policies across the globe do not address IPV causing a massive gap in health and economic burden. In the last decade, crucial missing links have been established, and researchers tried to connect the dots of this severe health disparity. This intersectionality has found the impact of race, gender, class, physical ability, and legal framework of IPV in lesbian, gay, and bisexual (LGB) relationships. However, preventive strategies, training programs, and dialogues in the clinical field about IPV are from heteronormative lenses. This particular bias can perpetuate the issue and will remain one of the leading causes of health burden in the LGB population. This article reviews the lacunae in health policies regarding same-sex IPV, highlights its impact on minority mental health, and calls for attention to train health-care professionals regarding the same.

Broadway-Horner M.

Broadway-Horner M., Kar A., Pemberton M., Ventriglio A.

To identify psychological interventions that improve outcomes for those who overdose, especially amongst Lesbian, Gay, Bisexual, Transgender, Intersex and Questioning populations.To recognize and assess the results from all studies including randomized control trials (RCTs) that have studied the efficiency of psychiatric and psychological assessment of people who have depression that undergo non-suicidal self-injury (NSSI) by self-poisoning, presenting to UK Accident and Emergency Departments.A scoping review of all studies including RCTs of psychiatric and psychological therapy treatments. Studies were selected according to types of engagement and intervention received. All studies including RCTs available in databases since 1998 in the Wiley version of the Cochrane controlled trials register in 1998 till 2021, Psych INFO, Medline, Google Scholar and from manually searching of journals were included. Studies that included information on repetition of the NSSI behaviour were also included. Altogether this amounts to 3900 randomized study participants with outcome data.Seven trials reported repetition of NSSI as an outcome measure which were classified into four categories. Problem-solving therapy is indicated as a promising therapy and has shown to significantly reduce repetition in participants who NSSI by overdosing than patients in the control treatment groups consisting of standard after care.The data show that manualized cognitive therapy psychological intervention was more effective than TAU after care. However, these differences are not statistically significant with p = .15; CI 0.61, 1.0 which crosses the line of no effect. And psychodynamic interpersonal therapy is more effective than the standard treatment. Despite being only one study in this subgroup the analysis shows a statistical significance with p = .009, CI 0.08; 0.7.

Broadway-Horner M., Kar A.

In the past few decades, affirmative therapies for sexual minorities have burgeoned. These are appropriate therapies but often there is a lack of adequate research. We set out to study the research evidence available. For this mixed-methods review, we identified 15 studies looking into the experiences of lesbian, gay and bisexual people in psychological therapies. These included nine qualitative, five quantitative and one mixed method studies. Minority stress hypothesis may explain some of the major difficulties LGB individuals face. Studies showed computer based therapies may reduce or even eliminate unhelpful responses on part of the therapist. Challenges related to confidentiality and privacy in this context remain. Therapists may focus on minority stress but other stressors and not just discrimination may contribute to various mental health problems and their clinical presence. And finally, divergent findings found internalized homophobia may best explain discrimination-based minority stress and that therapist self-disclosure of own sexuality produced better results than the therapists who did not self-disclose. These findings are discussed and future directions for research are identified.

Broadway-Horner M., Kar A.

In recent years, although research into support mechanisms for managing distress experienced by Lesbian Gay and Bisexual (LGB) communities has increased. Stigma-related discrimination related to sexual minority status remains. This is further compounded by stigma against mental illnesses thus creating double jeopardy. This review will outline recent discoveries by exploring existing theories highlighting factors that explain health disparities for cisgender LGB people. It appears that the experience of the LGB population and the use of psychological therapies is varied across the spectrum. Some focus upon symptom reduction as part of the experience, but others talk about not being validated. Some mention minority stress constructs, alongside the psychological mediation framework, which offers a potential theoretical understanding of the experiences of the LGB population who receive psychological therapies.

Written by internationally recognized experts, this comprehensive CBT clinician's manual provides disorder-specific chapters and accessible pedagogical features. The cutting-edge research, advanced theory, and attention to special adaptations make this an appropriate reference text for qualified CBT practitioners, students in post-graduate CBT courses, and clinical psychology doctorate students. The case examples demonstrate clinical applications of specific interventions and explain how to adapt CBT protocols for a range of diverse populations. It strikes a balance between core, theoretical principles and protocol-based interventions, simulating the experience of private supervision from a top expert in the field.

Serfaty M., Broadway-Horner M., Hassiotis A.

Broadway-Horner M.

This paper seeks to explore the aspects of being made homeless or internally displaced person (IDP) and how the team attempted to assess this. The team of 10 psychological researchers and statisticians spent a day at five camps in four locations within Kegalle, Sri Lanka. The languages within the team are Tamil, English, and Sinhalese. The aim to find out if depression, anxiety, and trauma symptoms are evident within child, adolescents, and adults categories, 3 months after the landslide triggered by the Storm Roanu, May 2016. The participants volunteered to be interviewed using self-report measures. The psychological researchers did have undergraduate and postgraduate degrees in psychology. While the project lead had clinical experience, the researchers did not and so this was their first field trip. The research was granted ethical clearance by the ethics board at the Cooperative Institutional Research Program (CIRP), Colombo. Unfortunately, due to low numbers, a significance is problematic and so this paper addresses the experience and lessons learned by implication for professional growth and future research with IDP. However, the impact on men’s health becomes clear as the team discovers the psychosocial aspects of being homeless. Purpose – This paper seeks to explore the aspects of being made homeless or internally displaced person (IDP) and how the team attempted to assess this. Design/methodology/approach – The team of 10 psychosocial researchers headed up by Matt BroadwayHorner, Consultant Nurse in Mental Health and Learning Disabilities, spent a day at five camps in four locations within Kegalle, Sri Lanka. The languages within the team are Tamil, English, and Sinhalese. The aim was to find out if depression, anxiety, and trauma symptoms are evident within child, adolescent, and adult categories, 3 months after the landslide triggered by the Storm Roanu, May 2016. The participants volunteered to be interviewed using self-report measures. The research was granted ethical clearance by the ethics board at CIRP, Colombo. Findings – unfortunately, due to low numbers, a significance is problematic for child and adolescents. The significance is seen in the adult population and so this paper addresses the experience and lessons learned by implication for professional growth and future research with IDP. However, the impact on men’s health becomes clear as the team discovers the psychosocial aspects of being homeless. Research limitations/implications – due to the unpredictability of IDP, the numbers were less than what was predicted by the Red Cross and UNICEF. Furthermore, we were not allowed a second visit and so could not compare and contrast data. Originality/value – much is written on IDP, but this is the first paper on this specific landslide and so adds to the knowledge base.

Broadway-Horner M.

Broadway-Horner M.

Using survey data to measure the impact of a disaster on local population. Not enough people to make meaningful significance. Discussion on themes running through the field work<div><div><b>Procedure</b></div><div>The participants were clustered into three different groups, which was divided according to age (Children, Adolescence, and Adults). The assessments utilized in the study were Kessler Psychological Distress Scale (K10+), Child Psychosocial Distress Screener (CPDS), The Children’s Revised Impact Scale (CRIES 13) and Patient Health Questionnaire (PHQ 9). The sample consisted of 12 children, 13 adolescents and 51 adults in total. Interviews were mainly carried out in the language of Tamil and Sinhalese</div></div><div><br></div>

Thu K.S., Linn N., Chuemchit M.

Kruse M.I., Baas-Sylvester K., Wildeman V., Clarizio A., Upadhye S., Bigham B.L.

Intersex people make up 1.7–4% of the population of North America. A recent scoping review of emergency department (ED) relevant literature for the care of sexual and gender minorities found almost no representation of this population. Intersex people have unique equity, diversity, and inclusion needs in the ED, so we undertook a review of international guidelines to identify ED-relevant recommendations. Using the PRISMA criteria, we systematically searched OVID Medline, EMBASE, CINAHL, and the gray literature for any clinical practice guideline (CPG) or best practice statement (BPS) published until Oct 21, 2022. We included articles in English, which included care of intersex people of any age, in any setting, region, or nation, and were of national or international in scope. We excluded primary research, systematic or narrative reviews, non-CPS or BPS statements, editorials, articles of regional or individual hospital scope, or if a more recent version had been published. Recommendations relevant to the ED were identified and the guideline and recommendations scored for quality using the AGREE-II and AGREE-REX tools respectively. Of 1599 studies identified, 1400 studies were excluded, 199 full-text reviews completed, and 95 studies included for evaluation. There were no ED-relevant recommendations found among these guideline documents. A systematic review of the literature for ED-relevant guidelines for the care of Intersex populations returned no results. Given the risk of increasing barriers to care for intersex people, and the increasing use of the ED for primary care, the requirements of Intersex people need to be investigated and integrated into future development of a CPG for care of sexual and gender minority populations in the ED.

Rojas-Saffie J.P., García-Matte N., Silva-Beyer V.

Basu P., Sharma T., Kandpal S., Sinha R.

This introductory chapter provides an entry point to the volume by conceptualizing the family, examining various forms of documented family violence, and offering an overview of social work interventions. While certain patterns of violence—especially those targeting women—are prevalent across cultures, others are shaped by specific contexts. The chapter synthesizes the diverse perspectives within the volume to present a nuanced understanding of these complexities. It concludes by emphasizing the need for culturally tailored, multifaceted approaches that can effectively address family violence.

Weiss Goitiandia S., Agarwal A., Banerjee S.C., Bhoo-Pathy N., Bose C., Chittem M., Gursahani R., Ramakrishnan L., Rana S., Salins N., Segarmurthy M.V., Thiyam A., Rosa W.E.

Basu P., Sharma T., Kandpal S., Sinha R.

This introductory chapter provides an entry point to the volume by conceptualizing the family, examining various forms of documented family violence, and offering an overview of social work interventions. While certain patterns of violence—especially those targeting women—are prevalent across cultures, others are shaped by specific contexts. The chapter synthesizes the diverse perspectives within the volume to present a nuanced understanding of these complexities. It concludes by emphasizing the need for culturally tailored, multifaceted approaches that can effectively address family violence.

Broadway-Horner M.

Purpose The purpose of this commentary is to appraise and critically evaluate sexual minorities' mental health provision according to individual and systemic barriers to mental health care. It addresses the issue of health inequity by first exploring the background narrative that informs health inequalities and then moving forward in creating a health equity framework. Design/methodology/approach From the focus point of mad studies and queer theory. Findings In this critical commentary, the work alongside others will be viewed and discussed in terms of addressing individual and systemic barriers to mental health care. Furthermore, how this has been significantly influenced by the colonisation of mental health with its polarising language and increased marginalisation will be discussed. Practical implications Progress world view (PWV) will help sexual minorities receive the care needed. Social implications Through the decolonisation of mental health, there will be a new understanding that helps us achieve health equity by using a gay worldview lens called the PWV (Broadway-Horner, 2024). Originality/value In closing, recommendations for future research alongside policy implications for service restructuring implementation of a decolonising health service. This will include a national training package to increase self-efficacy levels. It brings together a cohesive understanding of the PWV within a larger body of work on sexual minorities and mental health.

Leonard W.

Hughes S., Davies L., Monaghan U., Stennett M.

Dental anxiety is a common phenomenon in the general population and may be more prevalent in people with learning disabilities. There is growing interest in the use of cognitive behaviour therapy (CBT) approaches, including within dental anxiety management. However, relatively little is known regarding the application of CBT approaches in dental anxiety management for patients with learning disabilities. This paper outlines details of the implementation of a CBT-based dental anxiety pathway for patients with learning disabilities treated in a special care dental service in England. The pathway is modelled on the utilisation of skills from the dental team (dental nurses and dentists) to deliver a combination of talking sessions, desensitisation and positive affirmation in five distinct stages. Early feedback from service users following implementation of this pathway indicates successful acceptance of dental care with a decreased use of sedative adjuncts.

de Moura J.Q., Saratt M.M., da Silva S.C., Silva V.C., Murta S.G., Habigzang L.F.

Abstract Background Dating violence in adolescence is a serious public health issue due to its significant impact on mental health and its significant predictive value for intimate partner violence in adulthood. Universal and selective programs can contribute to the prevention of this issue. Nonetheless, there are few selective programs with evidence of feasibility in contexts of social vulnerability. Objective The present study examined evidence of the feasibility of a dating violence selective prevention program for girls in foster care by monitoring process indicators during the implementation phase of a pilot study. Methods The program, originally designed for adolescents in the general population, was adapted to the context of girls at risk. The pilot study was conducted in the southern region of Brazil and involved the participation of six girls aged between 15 and 17. Both quantitative and qualitative measures were used, and the data were explored through frequency analysis, the Jacobson and Truax test, and content analysis. Results The study identified favorable evidence regarding demand, acceptability, and adaptation of the intervention. On the other hand, contextual and institutional barriers hindered recruitment and restricted the reach of the intervention. Conclusion Although there are changes to be made to improve the program’s applicability in its specific context, it should be emphasized that this study provides evidence to maintain the methods and content of the intervention.

Kiliç Bayageldi N., Kaloğlu Binici D.

AbstractIn the present cross‐sectional study, we determined the self‐efficacy of nurses to apply psychological first aid (PFA) during disasters. The study sample consisted of 580 nurses working in Turkey. The data were collected online between July and November 2022 using the “Personal Information Form” and the “PFA Application Self‐Efficacy Scale.” The data were analyzed using descriptive statistical methods (number, percentage, mean, and standard deviation), generalized linear models, Bonferroni correction, and linear regression analysis. The mean PFA scale scores of male nurses, nurses working in intensive care units, working as service nurses, nurses who have previously received PFA training and applied PFA in disaster situations were higher. Moreover, 91.3% of nurses did not receive PFA training and 90.3% did not receive PFA service earlier, 31.0% did not apply for PFA, 18.3% did not know about PFA. The mean score of the PFA practice self‐efficacy scale of nurses was 131.61 ± 19.41. There exists an urgent requirement to develop nurses' PFA application self‐efficacy. It is recommended that nurses should be provided repeated PFA training and applied studies focusing on PFA interventions.

Fasoli F., Hegarty P., O’Rourke S., Frost D.M.

Tubman J.G., Lee J., Moore C.

This cross-sectional study documented between-group differences in risk factors associated with sexual victimization histories in an ethnically and racially diverse sample of transgender emerging adults ( N = 248, ageM = 22.61 years). The sample was recruited using the Internet-based CloudResearch platform to answer questionnaires assessing predictors for recent experiences of intimate partner violence (IPV). Participants were categorized into four groups based on cross-classified self-reports of child sexual abuse (CSA) and recent sexual IPV, prior to the use of multivariate analysis of variance to evaluate mean score differences for past-year substance use, minority stressor, and relationship functioning variables. Participants reporting sexual IPV reported higher scores for all substance use variables, while transfeminine participants reported significantly higher scores for alcohol use problems and negative consequences related to substance use. Participants reporting both CSA and sexual IPV also reported the highest scores for everyday discrimination. Participants who experienced sexual IPV also reported the highest scores for internalized sexual stigma. Sexual revictimization among transgender adults occurs in the context of harmful patterns of substance use and several minority stressors. Our findings have implications for healthcare or counseling services for transgender emerging adults who have experienced multiple forms of victimization, substance use problems, and minority stressors, including the importance of trauma-informed and integrated intervention services, and specialized training for service providers.

Kharwar S., Singh P.

Evidence of experienced discrimination by the lesbian, gay, bisexual and transgender (LGBT) individuals makes it necessary to investigate antecedents of prejudice towards them. Desired social contact (DSC) and social distancing practices towards LGBT community may be related to the knowledge about and attitudes towards the LGBT community. However, the inter-construct mechanism underlying such practices needs to be investigated. Considering this need, the present study explored the relationship between knowledge, attitude, DSC and social distance practices towards the LGBT community. A total of 315 heterosexual participants (male—184, female—131; Mage = 24.66, SDage = 3.38) were contacted through emails and social media between November 2021 and February 2022 and requested to fill the questionnaires. The findings indicate that the relationships between knowledge, DSC and social distancing practices are significantly mediated by attitudes towards the LGBT community. The standardized indirect effect of knowledge (via attitude) on DSC was statistically significant (β = 0.47; 95% CI, 0.54, 0.40; p = 0.005). Also, knowledge’s standard indirect effect (via attitude) on social distancing was statistically significant (β =  − 0.25; 95% CI, − 0.32, − 0.16; p = 0.005). The findings assert that knowledge about and attitude towards LGBT community play a crucial role in shaping social contact and social distancing practices towards them. Increased knowledge about alternative sexualities may effectively reduce negative attitudes and social distancing practices and create a more inclusive and accepting society for sexual minority groups. Policymakers should strive to enhance the knowledge of general populations concerning sexuality and homosexual attractions through awareness programs and formal teaching.

Leonard W.

Pitt M., Taylor P., Dunlop B.J.

Broadway-Horner M.

Purpose Since COVID-19, many services have burgeoned within the UK, but what about sexual minorities? Since the last review, there are appropriate therapies, but there is often inadequate research. The purpose of this mixed-method review synthesis looking into the efficacy of psychological therapies for sexual minorities. Seven studies were found in total. Design/methodology/approach A mixed-method review synthesis, three studies looking into the efficacy of psychological therapies for sexual minorities and four studies addressing the experiences of sexual minorities partaking in psychological therapies were identified. Findings These included three quantitative and four qualitative studies. The minority stress hypothesis is used to formulate problems, but challenges remain to confidentiality and privacy in this context. Therapists still operate within the heteronormative framework, discounting intersectionality in therapy conversations. Research limitations/implications Most studies have had low retention rates since 2021. It shows that minority stress needs to be accounted for at the ethics committee and research delivery levels. Practical implications Applying a heteronormative framework to sexual minorities is not working. An alternative progress world view is needed. Social implications Health-care clinicians strive for equitable care. Unfortunately, using an equitable health service scale adapted from Levesque et al. (2013), the rating is 3 out of 6. More work is needed to improve services. Originality/value Some services are reporting much improvement post-pandemic. Sadly, this is not the case for sexual minorities. Individual and systemic barriers remain.

Gonot-Schoupinsky F., Weeks M., Carson J.

Purpose The purpose of this opinion piece is to present a case for the potential of positive autoethnography (PosAE) as a new autoethnographic approach. Design/methodology/approach This work resulted from on-going discussions between the authors as to the practicalities and benefits of associating the qualitative approach of autoethnography with the field of positive psychology. Findings PosAE is proposed to encourage writers to actively reflect on the importance for themselves, and their readers, of including positive narrative elements, prospective visions and exploratory trajectories in their work. Research limitations/implications This research builds on existing research that has included positive psychology in autoethnography. As positive psychology is grounded in empirical research, the authors are suggesting that PosAE is allied to pragmatic autoethnography. Practical implications PosAE offers to facilitate positive thought, affect and strategies that could improve well-being. For example, some people struggling with serious health issues, and those helping them, may find it useful for articulating conditions and envisioning, even experiencing, positive change. Social implications With so many lives impacted by mental health issues globally, and with rapidly changing societies struggling to provide stability and purpose, an autoethnography that provides tools such as PERMA (Positive emotions, Engagement, Positive Relationships, Meaning, Accomplishments/Achievements) to communicate the positive seems timely. Originality/value To the best of the authors’ knowledge, this is the first time the creation of an autoethnographic approach explicitly linked to positive psychology has been proposed.

Hambrook D.G., Aries D., Benjamin L., Rimes K.A.

AbstractBackground:Stigma against lesbian, gay, bisexual or queer (LGBQ) people may increase their risk of mental illness and reduce their access to and/or benefit from evidence-based psychological treatments. Little is known about the feasibility, acceptability and effectiveness of adapted psychological interventions for sexual minority individuals in the UK.Aims:To describe and evaluate a novel LGBQ Wellbeing group therapy for sexual minority adults experiencing common mental health problems, provided in a UK Improving Access to Psychological Therapies (IAPT) service.Method:An eight-session LGBQ Wellbeing group intervention was developed drawing on CBT and LGBQ affirmative principles. We compare the socio-demographic and clinical characteristics of patients who completed and dropped out of the groups, and explore changes in self-reported symptoms of depression, anxiety and functional impairment.Results:Over eight courses provided, 78 service-users attended at least one session, of whom 78.2% completed the intervention (drop-out rate 21.8%). Older participants were more likely to drop out. There was a lower proportion of female and bisexual or ethnic/racial minority individuals than would be expected. There were significant reductions in severity of depression, anxiety and functional impairment following the group, and more than half of those who completed the intervention needed no further treatment.Conclusions:There was preliminary evidence of the feasibility of, and potential clinical benefit in, a group therapy intervention for sexual minority adults experiencing common mental health problems. Future research should investigate access and outcomes for participants with additional social disadvantage, e.g. those who are female, older, bisexual or ethnic/racial minority.

Pachankis J.E., Soulliard Z.A., Seager van Dyk I., Layland E.K., Clark K.A., Levine D.S., Jackson S.D.

This randomized controlled trial examined whether an 11-week synchronous (i.e., real-time) online training in lesbian, gay, bisexual, transgender, queer, and other sexual or gender diverse (LGBTQ)-affirmative cognitive behavioral therapy (CBT) could lead to increased uptake of this practice at LGBTQ community centers across 20 U.S. states and internationally.A total of 121 mental health providers (Mage = 37.74; 78.5% LGBTQ; 60.3% non-Hispanic/Latinx White) were randomized to receive the 11-week training either immediately (n = 61) or after a 4-month wait (n = 60). At baseline and 4 and 8 months after baseline, participants self-reported their LGBTQ-affirmative competency, cultural humility, and knowledge of the minority stress theory and practice skills underlying LGBTQ-affirmative CBT. To objectively assess uptake of LGBTQ-affirmative CBT, participants demonstrated, through simulated practice, how they would respond to two video-based clinical vignettes.Compared to wait-list, participants in the immediate training condition reported greater improvements in self-reported cultural competence (d = 1.24), minority stress knowledge (d = 0.78), LGBTQ-affirmative CBT knowledge (d = 0.78), and LGBTQ-affirmative CBT skills familiarity (d = 0.91) and use (d = 0.96); effects persisted 8 months postbaseline. Cultural humility showed no significant difference by condition (d = 0.07). In objectively coded assessments of simulated practice, participants in the training condition demonstrated greater uptake of LGBTQ-affirmative practice skills (d = 0.82).Findings preliminarily suggest that mental health providers can be trained to deliver LGBTQ-affirmative CBT using the low-cost, efficient reach of online training. This training can help disseminate evidence-based mental health care to LGBTQ individuals and support its implementation across practice settings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Broadway-Horner M., Kar A., Pemberton M., Ventriglio A.

To identify psychological interventions that improve outcomes for those who overdose, especially amongst Lesbian, Gay, Bisexual, Transgender, Intersex and Questioning populations.To recognize and assess the results from all studies including randomized control trials (RCTs) that have studied the efficiency of psychiatric and psychological assessment of people who have depression that undergo non-suicidal self-injury (NSSI) by self-poisoning, presenting to UK Accident and Emergency Departments.A scoping review of all studies including RCTs of psychiatric and psychological therapy treatments. Studies were selected according to types of engagement and intervention received. All studies including RCTs available in databases since 1998 in the Wiley version of the Cochrane controlled trials register in 1998 till 2021, Psych INFO, Medline, Google Scholar and from manually searching of journals were included. Studies that included information on repetition of the NSSI behaviour were also included. Altogether this amounts to 3900 randomized study participants with outcome data.Seven trials reported repetition of NSSI as an outcome measure which were classified into four categories. Problem-solving therapy is indicated as a promising therapy and has shown to significantly reduce repetition in participants who NSSI by overdosing than patients in the control treatment groups consisting of standard after care.The data show that manualized cognitive therapy psychological intervention was more effective than TAU after care. However, these differences are not statistically significant with p = .15; CI 0.61, 1.0 which crosses the line of no effect. And psychodynamic interpersonal therapy is more effective than the standard treatment. Despite being only one study in this subgroup the analysis shows a statistical significance with p = .009, CI 0.08; 0.7.

Bhugra D., Killaspy H., Kar A., Levin S., Chumakov E., Rogoza D., Harvey C., Bagga H., Owino – Wamari Y., Everall I., Bishop A., Javate K.R., Westmore I., Ahuja A., Torales J., et. al.

Sexual orientation is a key determinant of the identity of human beings. It has also been seen as a social determinant of health. People whose sexual orientation is non-heterosexual or sexual minorities or sexually diverse are included in the broad umbrella term LGBT (Lesbian, Gay, Bisexual, and Transgender) which is a commonly used acronym in activism, social policy, and subsequently cultural literature. For this reason, this Commission focuses primarily on sexual orientation i.e. lesbian, gay and bisexual (LGB) groups. We have used terms non-heterosexual, sexual minorities or sexual variation interchangeably. We have not considered asexual individuals as research in the field is too limited. We are cognisant of the fact that topics relating to mental health and sexual orientation discussed in this Commission will intersect with other issues of personal, cultural and social identity, and will thus be relevant to individuals including many transgender individuals. The inclusion of mental health issues relevant to gender-diverse individuals as well as gender identity is important and deserves its own separate detailed discussion. The exact number of sexually diverse individuals in a population is often difficult to estimate but is likely to be somewhere around 5% of the population. Rates of various psychiatry disorders and suicidal ideation and acts of suicide in LGB populations are higher than general population and these have been attributed to minority stress hypothesis. Elimination of inequality in law can lead to reduction in psychiatric morbidity in these groups. However, these are all diverse groups but even within each group there is diversity and each individual has a distinct and unique experiences, upbringing, responses to their own sexual orientation, and generating varying responses from families, peers and friends as well as communities (including healthcare professionals). The mental healthcare needs of sexual minority individuals vary and these variations must be taken into account in design, development and delivery of healthcare and policies. Improving access to services will help engagement and outcomes and also reduce stigma. The commission recommends that there is no role for so-called conversion therapies and other recommendations are made for clinicians, researchers and policymakers.

Morris D.D., Fernandes V., Rimes K.A.

Sexual minorities (individuals with a lesbian, gay, bisexual, queer, or other non-heterosexual identity) are at elevated risk of developing common mental health disorders relative to heterosexual people, yet have less favourable mental health service experiences and poorer treatment outcomes. We investigated the experiences of sexual minority service users accessing mental health services for common mental health problems (e.g. depression or anxiety) in the UK. We recruited 26 sexual minority adults with experiences of being referred to Improving Access to Psychological Therapies (IAPT) or primary care counselling services. Semi-structured interviews explored participants' experiences of service use and views on service development. Interviews were analysed using thematic analysis. Barriers to effective relationships with practitioners included service users' fears surrounding disclosure, and practitioners' lack of understanding and/or neglect of discussions around sexuality. Regarding service development, participants highlighted the value of seeing practitioners with shared identities and experiences, visible signs of inclusivity, sexual minority training, tailored supports, and technological adjuncts. Our findings offer insights into possible contributory factors to treatment inequalities, and highlight potential methods for improving service provision for sexual minorities.

Marchi M., Arcolin E., Fiore G., Travascio A., Uberti D., Amaddeo F., Converti M., Fiorillo A., Mirandola M., Pinna F., Ventriglio A., Galeazzi G.M.

Research evidence has consistently documented a higher risk of suicidality in the Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ) population. This systematic review and meta-analysis aimed to report a detailed description of research data regarding the risk of Attempted Suicide (SA), Suicide Ideation (SI), and Non-Suicidal Self-Injury (NSSI) behaviours for LGBTIQ people and their subgroups. Medline, Scopus, PsycINFO, and EMBASE were searched for studies reporting a comparative estimation of SA, SI, and NSSI rates among LGBTIQ population and the general population (i.e. heterosexual/cisgender), without restrictions on participants' age and setting for the enrolment. Pooled analyses were based on odds ratios (ORs, with 95% CIs), estimated through inverse variance models with random effects. Fifty studies were selected for the quantitative synthesis and included fifty samples involving 3.735.601 controls and 87.252 LGBTIQ people. LGBTIQ people reported an increased risk of SA (OR:4.36[95%CI:3.32;5.71]), SI (OR:3.76[95%CI:3.02;4.69]), and NSSI (OR:4.24[95%CI:3.23;5.55]). Among LGBTIQ subgroups, the Bisexual group has shown the highest risk of suicidality (SA, OR:6.71; SI, OR:5.04; NSSI, OR: 5.03), followed by the Lesbian-Gay for attempted suicide (SA, OR:6.03), and the Transgender-Intersex-Queer for suicide ideation and non-suicidal self-injury (SI and NSSI, OR:3.42). The quality of the evidence ranged from low to moderate. Our findings have shown that LGBTIQ people report a higher risk of suicidality compared with their cisgender/heterosexual peers. This evidence may contribute to the public awareness on LGBTQI mental health needs and suggest supportive strategies as well as preventive interventions (e.g. supportive programs, counselling, and destigmatizing efforts) as parts of a tailored health-care planning aimed to reduce psychiatric morbidity and mortality in this at-risk population.

Broadway-Horner M., Kar A.

In recent years, although research into support mechanisms for managing distress experienced by Lesbian Gay and Bisexual (LGB) communities has increased. Stigma-related discrimination related to sexual minority status remains. This is further compounded by stigma against mental illnesses thus creating double jeopardy. This review will outline recent discoveries by exploring existing theories highlighting factors that explain health disparities for cisgender LGB people. It appears that the experience of the LGB population and the use of psychological therapies is varied across the spectrum. Some focus upon symptom reduction as part of the experience, but others talk about not being validated. Some mention minority stress constructs, alongside the psychological mediation framework, which offers a potential theoretical understanding of the experiences of the LGB population who receive psychological therapies.

Mohammed Na'aim M.S., Rajamanickam R., Nordin R.

In Malaysia, matters pertaining to domestic violence are governed by the Domestic Violence Act 1994 (DVA 1994) (Act 521). The DVA 1994 uses the term “domestic violence†rather than “intimate partner violence†(IPV). Definition of domestic violence not only describe the types of domestic violence are, it also identifies the victims of domestic violence. Those who fall under the category of domestic violence victims may seek legal protection under the DVA 1994 namely protection orders, compensation and access to a rehabilitation programme. Unlike domestic violence, the term ‘IPV’ is not defined by the DVA 1994. This may raise a question regarding the status of IPV victims on whether they are protected under the said Act. The research examines the definitions of domestic violence and IPV, how the DVA 1994 protects domestic violence victims, and to what extent legal protection is given to IPV victims. This article adopts the doctrinal legal research involving a detailed analysis of the DVA 1994, the Penal Code (Act 574), the Criminal Procedure Code (Act 593) and case law. This research found that the definition of IPV within the DVA 1994 arguably cover only spouses and former spouses, leaving other unmentioned intimate relationships such as cohabitation and dating partner outside of the application of the Act. Although not covered by the DVA 1994, if individuals in such relationships are harmed by their partners, they can lodge a police report for violation of the criminal provisions of the Penal Code for legal action to be taken.

Waite L.R.

Abstract This study seeks to deepen the conversation between Jungian individuation and yogic awakening to explore the question ‘Who am I?’ from a psycho-spiritual perspective. Through focusing on yogic experience, the study explores how Jungian therapeutic benefits might be gained through modern yoga practice. Four long-time yoga practitioners took part in the study that involves ten hours’ worth of ethnographic interviews. The transcripts were analysed using Jungian techniques to identify key themes, symbols, and meanings from the archetypal story patterns of the participants’ yoga histories. The resulting themes represent a potential hermeneutic model for recognising Jung’s analytic psychology within the experiences of the four practitioners. Based on these findings, future research is recommended that is conducted over a longer interview period with practitioners of Non-dual Shaiva Tantra. The ethnographic interview process could include physical yoga practices and an explicit dissection of Jungian concepts to widen the conversation between Jung and yoga.

Bishop J., Crisp D., Scholz B.

Lesbian, gay and bisexual (LGB) people report greater dissatisfaction with counselling and psychotherapy services than their heterosexual counterparts. Greater dissatisfaction with these services may result from experiences of microaggressions resulting from a lack of service provider cultural competence. The present study aimed to investigate what culturally competent provision of service means to LGB people through understanding their actual and ideal experience of accessing a counsellor or psychologist. Twenty-one LGB participants responded to six literature-driven questions in a semi-structured interview format regarding their actual and ideal experiences of accessing a counsellor or psychologist. Two themes were developed from the results: the importance of creating a safe space, and modifiable and non-modifiable service provider traits. LGB participants discussed being more willing to disclose and discuss their sexual orientation in services that created a safe space. LGB participants perceived counsellors and psychologists as more culturally competent if they demonstrated: inclusive intention, awareness of heteronormativity, knowledge about issues impacting LGB people and openness to diversity. Counsellors and psychologists who were younger or LGB were perceived by LGB participants to be more culturally competent. Based on the results, recommendations for counsellors and psychotherapists include recognition of the importance of creating a safe space and demonstrating affirming care to LGB people.

Santoniccolo F., Trombetta T., Rollè L.

Same-Sex Intimate Partner Violence (SSIPV) is a complex issue that can be severely damaging. When involved in SSIPV, victims and perpetrators sometimes choose to seek help. The help-seeking process, however, can be difficult. Experiences of help-seeking seem to vary and may be positive or negative depending on several factors, some of which appear to be specific to lesbian, gay, and bisexual (LGB) people involved in a same-sex relationship. A systematic review of the literature has been conducted across four databases following the PRISMA statement guidelines. Out of 410 screened abstracts, 78 articles were selected for full-text review. Following the inclusion and exclusion criteria, 21 studies were included in the current review. Thematic analysis was conducted on these studies and results were discussed by three reviewers. Help-seekers tended to use informal sources of help, perceived to be ambivalently helpful. Formal sources tended to be utilized sparingly, except for counselors. Many formal sources were perceived to be unhelpful, and most of the studies identified several barriers to services that prevented effective help. Formal and helpful sources were perceived as knowledgeable and sensitive about LGB themes. While existing research is limited, formal services that can provide effective care for SSIPV appear scarce. Barriers to services seem widespread, limiting accessibility. Existing services would benefit from increasing their knowledge and sensitivity on SSIPV-specific themes. The development of policies, programs, and interventions that aim to provide effective help is needed, as well as more research.

Salway T., Juwono S., Klassen B., Ferlatte O., Ablona A., Pruden H., Morgan J., Kwag M., Card K., Knight R., Lachowsky N.J.

Background “Conversion therapy” practices (CTP) are organized and sustained efforts to avoid the adoption of non-heterosexual sexual orientations and/or of gender identities not assigned at birth. Few data are available to inform the contemporary prevalence of CTP. The aim of this study is to quantify the prevalence of CTP among Canadian sexual and gender minority men, including details regarding the setting, age of initiation, and duration of CTP exposure. Methods Sexual and gender minority men, including transmen and non-binary individuals, aged ≥ 15, living in Canada were recruited via social media and networking applications and websites, November 2019—February 2020. Participants provided demographic data and detailed information about their experiences with CTP. Results 21% of respondents (N = 9,214) indicated that they or any person with authority (e.g., parent, caregiver) ever tried to change their sexual orientation or gender identity, and 10% had experienced CTP. CTP experience was highest among non-binary (20%) and transgender respondents (19%), those aged 15–19 years (13%), immigrants (15%), and racial/ethnic minorities (11–22%, with variability by identity). Among the n = 910 participants who experienced CTP, most experienced CTP in religious/faith-based settings (67%) or licensed healthcare provider offices (20%). 72% of those who experienced CTP first attended before the age of 20 years, 24% attended for one year or longer, and 31% attended more than five sessions. Interpretation CTP remains prevalent in Canada and is most prevalent among younger cohorts, transgender people, immigrants, and racial/ethnic minorities. Legislation, policy, and education are needed that target both religious and healthcare settings.