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Sexual and gender minority (SGM) emerging-adult college students experience unprecedented rates of psychopathology. They are also more likely to experience barriers to accessing traditional mental health resources and spiritual support groups and are more apt to seek support in alternative ways, such as through campus LGTBQIA+ support groups and online communities. Spiritual-mind-body (SMB) group wellness programming may fill an important role as a more accessible service for SGM students and as an adjunct to individual mental health services. The primary aim of the present study is to investigate the utility of Awakened Awareness for Adolescents and Emerging Adults (AA-A), a group SMB wellness intervention designed to support spiritual individuation and mental health, to support SGM college student spirituality, mental health, psychological, and psychosocial wellness. A secondary aim was to examine differences in SGM students’ response to AA-A when delivered online versus in-person using exploratory analyses. Participants were 116 non-clinically referred, self-selected undergraduates aged 18-25. Self-report measures captured spiritual well-being, psychological well-being, psychosocial well-being, and symptoms of psychopathology. SGM students’ rate of enrollment in AA-A was compared to broader university and national college demographics using chi-square analyses. SGM and non-SGM student engagement in AA-A was measured by the average number of sessions attended and compared using an independent sample t-test. SGM and non-SGM student pre-intervention wellness was compared using independent sample t-tests. Changes in wellness at post-intervention were assessed using paired sample t-tests, and differences in post-intervention changes in wellness were analyzed as a function of ethnicity and SGM status using independent sample t-tests and ANOVAs of change scores. Exploratory two-way ANOVAs were conducted and interactions between SGM status and AA-A delivery method on well-being change scores were analyzed to determine whether SGM students responded uniquely from their peers to the online delivery format. SGM students had greater spiritual and wellness support needs at pre-intervention as compared with their non-SGM peers and were twice as likely to enroll in AA-A, and more likely to stay and engage in the program. SGM students had statistically parallel rates of improvement across most measures of well-being, and statistically even greater rates of improvement on some psychological and psychosocial measures of well-being capturing negative self-talk and self-concept. Among students who participated in AA-A delivered online and during the COVID-19 pandemic, SGM students benefitted more than their non-SGM peers. Findings support the feasibility and acceptability of the AA-A intervention to support SGM college student spiritual well-being and mental health across both in-person and online delivery methods, and exploratory analyses indicate that the online delivery method may be a particularly helpful format for SGM students to engage.

This study compares U.S. university counseling center therapy outcomes of Sexual Minority (SM) students who attend religiously-affiliated compared to SM peers who attend non religiously-affiliated institutions. Using archival data from the Center for Collegiate Mental Health (CCMH), we examined psychotherapy outcomes of 4257 SM student clients.We analyzed pre-treatment symptoms and post-treatment outcomes based on differences in Distress Index (DI) scores. We used the reliable change index (RCI) to separate outcomes into four groups based on the change in distress index level: no change, deteriorating, reliably improved, recovered from pre-treatment to post-treatment. Our participants (n = 4257) attended 34 religiously and non-religiously affiliated institutions (matched by geographical location, size, and percentage of the student body that were SM and sought therapy at the college counseling center). We found that SM students at religiously affiliated institutions had lower pretreatment and posttreatment distress scores than their peers at non-religiously affiliated institutions. Furthermore, gay students across universities consistently presented with lower distress than lesbian, bisexual, questioning, or self-identifying students. However, a larger proportion of SM students at non-religiously affiliated institutions achieved a reliable change status of recovered from their presenting distress levels, while a larger proportion of SM students at religiously affiliated institutions remained in the no change category. We found a significant effect of religious affiliation and Sexual Orientation (SO) on pretreatment distress scores, F(2, 4255) = 18.395, p < .001, and posttreatment distress scores, F(1, 4255)=15.199, p = .035), with moderate effect sizes (d=.137, and .061, respectively). Our findings emphasize the importance of culturally competent and affirming practices, ensuring that interventions resonate with the varied religious and cultural experiences of SM individuals. This is not just a research endeavor; it is a collective responsibility to foster campuses that prioritize the mental health and well-being of every student.

Historically, health services have pathologized individuals because of their sexual orientation or gender identity, which contributes to avoiding or delaying seeking care and consequent later-stage diagnoses when many treatments are less effective. One determinant of seeking health care is the extent to which people feel accepted and welcome by health care providers. In recent years, progress has been made in some settings by improving patient experiences among people with different sexual orientations and gender identities. But there are few published studies on the healthcare experiences of people who identify with asexuality. This exploratory study aims to understand asexual (ace) individuals' experiences to inform ways to improve patient experience and health promotion. Grounded in phenomenological theory, a semi-structured qualitative interview was conducted via Zoom with 43 ace participants recruited from social media platforms. Through reflexive thematic analysis, it was concluded: (1) The continued lack of knowledge and understanding of asexuality and influence of compulsory sexuality in healthcare results in non-affirmative approaches to care, which negatively impacts ace patients’ healthcare experience, (2) Patients report having positive healthcare experiences with providers who exercised cultural competency and humility, providing care in a patient-centered, trauma-informed approach, and (3) Institutional factors drive patients’ overall healthcare experience. Implications of the findings and ideas for how healthcare practices and policies can be improved to be welcoming to ace patients are discussed. More empirical research is needed to understand the health needs of the ace community, with the long-term goal of improving the availability and accessibility of healthcare services.

Despite legal and policy advancements in South Africa, prejudice, discrimination and victimisation are still a reality for many lesbian, gay and bisexual (LGB) people in the country. The Psychological Society of South Africa (PsySSA) has embarked on a process to develop lesbian, gay, bisexual, transgender and intersex (LGBTI) affirmative practice guidelines for psychology professionals, when working with these client populations. As a part of the larger objective, this research study highlights LGB people’s experiences of psychotherapy and counselling in South Africa as possible inputs for the mentioned practice guidelines. Qualitative in-depth interviews were conducted with selected participants. The results indicate that some aspects of LGB people’s experiences are similar to those of anyone in psychotherapy or counselling, but also that there are distinct differences. Negative experiences were almost exclusively due to the counsellor being disaffirming of the client's sexual orientation. Self-acceptance and the development of alternative perspectives of sexuality were more prominent outcomes of counselling compared to studies among broader populations. The participants’ feedback on a list of affirmative statements provides a potential basis for future affirmative practice guidelines. / Psychology / M. A. (Clinical Psychology)