Co-Producing LGBTQ-Affirmative DBT Protocols.

N/ANot Yet RecruitingNCT06966193

King's College London32 enrolled

Overview

Aims: 1. To co-produce new intervention parts that meet the needs of LGBTQ+ people at risk of self-harm or suicidal thoughts, with LGBTQ+ people and DBT therapists. These intervention parts will be integrated into a Dialectical Behaviour Therapy (DBT) intervention, that is provided earlier in a persons mental health care journey, than DBT is usually targeted at. 2. To assess how acceptable and feasible the co-production process was for participants, and how well it achieved co-production principles (e.g. participants feel supported, that the aims were transparent, etc). Why is This Important? Young people who identify as lesbian, gay, bisexual, transgender, queer, and with other minoritised gender and sexual identities (LGBTQ+) are much more likely to self-harm and experience suicidal thoughts than cisgender-heterosexual (non-LGBTQ+) people. They also experience barriers when accessing mental health support. Some of these barriers come from a lack of support tailored towards their needs as an LGBTQ+ person. This often means that things get worse before they access the right support, and so are often seen in higher-intensity interventions (tier 4 or tertiary care), like DBT. What The Investigators Plan to Do: The investigators plan to hold some focus groups with three different groups of people to co-produce the new intervention parts. The three groups include: 1. A group of LGBTQ+ young people (13-21 years old) who have completed a at full DBT programme recently. 2. A group of LGBTQ+ young people (13-21 years old) who have never been in a full DBT programme but experienced similar difficulties. 3. A group of DBT therapists who have supported LGBTQ+ young people before. The investigators will seek feedback from participants about how acceptable they found the study (e.g. how satisfied they were with the process), how feasible it was (e.g. were they able to attend and was it practice?), and how well they stuck to the coproduction principles (e.g. how supported they felt).

Study Type

OBSERVATIONAL

Enrollment

Conditions

Self-Harm

Eligibility

Sex: ALLMin age: 13 YearsMax age: 21 YearsHealthy volunteers:

Medical Language ↔ Plain English

DBT Cohort Young Person Sample 1 Inclusion criteria will include that the young person: 1. Is aged 13 to 21 years old; 2. has completed at least four months of comprehensive DBT (i.e. inclusive of all four modes of intervention; Linehan, 1993; Miller et al., 2006; Rathus \& Miller, 2015) in the past 24 months or have completed at least four months of DBT and are still in a comprehensive DBT programme; 3. identifies as LGBTQ+ (including those questioning or unsure about their orientation/identity); 4. is willing and able to participate in the study. While no specific inclusion or exclusion criteria will be placed on other variables, typically to be eligible for a DBT programme, young people would need to have a history of self-harm and/or suicidal behaviours, difficulties with emotion regulation, and potentially difficulties with the remaining symptom list within borderline/emotionally unstable personality disorder. Recruitment size is based on PPI recommendations regarding effective group sizes, with allowances for sample attrition. Non-DBT Cohort Young Person Sample 2 Inclusion criteria will follow similar to sample 1. The young person: 1. Is aged 13 to 21 years old; 2. has not accessed and is not currently enrolled in a comprehensive DBT programme; 3. has experienced difficulties with LGBTQ-related identity confusion, managing stigma experiences, and connecting with similar others; 4. identifies as LGBTQ+ (including those questioning or unsure about their orientation/identity); 5. is willing and able to participate in the study (i.e. are based in the UK and can attend the in-person and online groups). No other inclusion or exclusion criteria will be systematically implemented for this group. DBT Therapist Sample Inclusion criteria: 1. Currently practicing or having completed (or recently finished, within the past 12 months) a comprehensive DBT programme as a DBT therapist. In order to practice as a DBT therapist, they must hold a professional qualification recognised by appropriate healthcare regulators. 2. Having experience working with at least one LGBTQ+ client in DBT, who was aged between 13 and 21 years at the time. 3. Being willing and able to participate in the study.

Outcomes

Primary Outcomes

Feasibility/Recruitment

Whether the investigators are able to recruit the intended numbers of participants to each group by the start of the focus groups (baseline).

Time frame: Baseline

Feasibility/Attrition

Participant attrition rates at baseline, during the study, and at outcome measure completion (12 weeks from baseline).

Time frame: Baseline, during the focus groups (12 weeks in duration), and at outcome measure completion (12 weeks from baseline)

Feasibility/Focus Group Content and Delivery

The count frequency of focus groups, individual sessions, and duration of each taken will be recorded. The content of the focus groups will be documented. The number of facilitators of each type will also be documented.

Time frame: For the duration of the focus groups (12 weeks)

Acceptability/Session Satisfaction

Self-report question at the end of each focus group/individual session: How satisfied were you with the focus group/individual session? \[Response Options: Very Satisfied, Satisfied, Neutral, Unsatisfied, Very Unsatisfied\]. \[Prompt\] Can you tell us why you gave that rating? \[Prompt\] what would have improved your satisfaction?

Time frame: At the end of each focus group (6 focus groups over 12 weeks)

Acceptability/Satisfaction with the Study

End of study feedback: How satisfied were you with the focus group/individual sessions overall? Response Options: Very Satisfied, Satisfied, Neutral, Unsatisfied, Very Unsatisfied. Prompts to elicit qualitative feedback. How satisfied were you with the final version of the intervention protocols that we all produced together? Response Options: Very Satisfied, Satisfied, Neutral, Unsatisfied, Very Unsatisfied. Prompts to elicit qualitative feedback.

Time frame: End of Study (12 weeks post baseline)

Acceptability/Recommend to Others

End of study feedback: Would you recommend this study to other potential LGBTQ+ people if we were to run the study again? \[Response Options\] Yes, No, Maybe \[Prompt\] Can you tell us why you gave that rating?