School of Social Work, Boston College, Chestnut Hill, Massachusetts (Price, Rakhilin, Johansen, Collins); Department of Psychology, Harvard University, Boston (Price); School of Public Health, Yale University, New Haven (Pachankis); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Lyon); Lynch School of Education and Human Development, Boston College, Chestnut Hill, Massachusetts, and School of Professional Psychology, Spalding University, Louisville (Allen).
Psychiatr Serv. 2024 Nov 1;75(11):1075-1083. doi: 10.1176/appi.ps.20230460. Epub 2024 Jun 19.
Transgender youths are more likely than cisgender youths to need mental health care because of their high exposure to discrimination and victimization, including within health care systems. Accordingly, transgender youths have low care satisfaction and high rates of treatment dropout, further exacerbating existing mental health inequities. To reduce these inequities, mental health providers need knowledge and skills to enhance transgender youths' treatment engagement and benefits. However, a comprehensive set of practices addressing the needs of transgender youth patients and their providers does not exist. The authors developed gender-affirming psychotherapy (GAP), an evidence-informed set of skills and principles to augment mental health treatments for transgender youths.
GAP was developed by using a human-centered design, a methodological approach for creating interventions that prioritize the needs of key stakeholders, which in this study included mental health providers and transgender youths and their parents (N=36). A scoping review of the literature and stakeholder focus groups were conducted to create GAP, which encompasses core principles and skills to enhance mental health services for transgender youths.
GAP encompasses 27 principles and 38 skills, organized within 10 domains. All principles and skills were designed to be relevant for various provider types (e.g., psychiatrists and social workers) and to be flexibly adapted to meet diverse patient needs.
GAP offers a scalable and flexible approach to addressing the growing mental health care needs of transgender youths. The findings of this study suggest that a human-centered design is a feasible and efficient method for developing interventions to address health inequities.
由于 transgender 青少年面临更高的歧视和受害风险，包括在医疗保健系统中，他们比 cisgender 青少年更有可能需要心理健康护理。因此，transgender 青少年的护理满意度较低，治疗中断率较高，进一步加剧了现有的心理健康不平等现象。为了减少这些不平等现象，心理健康提供者需要掌握知识和技能，以增强 transgender 青少年的治疗参与度和获益。然而，目前还没有一套全面的实践方法来满足 transgender 青年患者及其提供者的需求。作者开发了性别肯定心理疗法（GAP），这是一套基于证据的技能和原则，旨在增强针对 transgender 青少年的心理健康治疗。
使用以人为中心的设计方法来开发 GAP，这是一种创建干预措施的方法，该方法优先考虑关键利益相关者的需求，在本研究中，这些利益相关者包括心理健康提供者以及 transgender 青少年及其父母（N=36）。进行了文献综述和利益相关者焦点小组，以创建 GAP，其中包括增强针对 transgender 青少年的心理健康服务的核心原则和技能。
GAP 包括 27 条原则和 38 项技能，分为 10 个领域。所有原则和技能的设计都旨在适用于各种类型的提供者（例如精神病医生和社会工作者），并能灵活地适应不同患者的需求。
GAP 提供了一种可扩展且灵活的方法，可满足 transgender 青少年不断增长的心理健康护理需求。这项研究的结果表明，以人为中心的设计是一种可行且有效的方法，可用于开发解决健康不平等问题的干预措施。
