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Current Projects

Santa Clara County LGBTQ Clinical Academy

Investigators: Kimberly F. Balsam, Ph.D., Liz McConnell, Ph.D., Predair Robinson, Ph.D., Jayme Peta, Ph.D., & Em Matsuno, Ph.D.

Description: The goal of this project is to develop, conduct, and evaluate an in-depth, advanced 40-hour training on LGBTQ+ cultural competence for mental health practitioners in Santa Clara County.  With funding from Santa Clara County and collaboration with the county’s Office of Behavioral Health and Office of LGBTQ+ Affairs, we developed this unique approach to ensuring that mental health service providers working in the public sector with the county's most vulnerable populations are meeting the unique needs and concerns of diverse LGBTQ+ clients in a culturally responsive and effective manner.  Our evaluation examined the effects of the training on providers’ knowledge, skills, and attitudes towards LGBTQ+ affirmative clinical work.  

The Enby Project: Understanding Minority Stress and Resilience among Nonbinary People

Investigators: Em Matsuno, Ph.D., Kimberly F. Balsam, Ph.D., Nat Bricker, B.A., & Elizabeth Savarese, B.A.

Description: The aim of the Enby Project is to identify the unique types of minority stressors that nonbinary people experience and what helps them manage those stressors, with the ultimate goal of developing and validating the first nonbinary minority stress and resilience scale. Having this assessment tool is crucial in understanding the relationship between minority stressors, resilience factors and mental health outcomes as well as evaluating the impact of interventions on reducing minority stress for nonbinary people. Data has been collected from five focus groups and six individual interviews with over half of participants identifying as a person of color. Thematic analysis is currently under way with the goal of adapting the minority stress model for nonbinary people.

Gender Kaleidoscope Study 

Investigators: Kimberly Balsam, Ph.D., Arielle Webb., M.S., Em Matsuno, Ph.D., Nat Bricker, B.A., & Elizabeth Savarese, B.A.

Description: The Gender Kaleidoscope Study examines gender in all of its myriad forms within LGBTQ+ communities, with a special focus on individuals whose gender identity and expression fall outside of the binary.  This longitudinal study focuses on relationships between gender identity and expression, sexual identity, relationships, well-being, stressors and resilience among diverse LGBTQ+ people. We collected data from 473 ethnically and racially diverse adults in October/November 2019 and followed up with these participants again in April/May 2020 to examine changes in well-being over time in the context of the COVID-19 pandemic. We intend to conduct a survey of participants again in 2021 and will continue to examine how individual and social contextual changes impact LGBTQ+ individuals over time. 

Mental Health and Well-being of LGBTQ Latinx Adults

Investigators: Itzel Anaya, B.A., Kimberly F. Balsam, Ph.D., Alinne Barrera, Ph.D., & Teceta Tormala, Ph.D.

Description: Gender and sexual minority (GSM) Latinx immigrants experience multiple minority stressors related to their immigration status, racial/ethnic identity, sexual orientation and/or gender identities.  Prior research suggests that these individuals also possess unique strengths that can help them overcome these adverse life experiences. This study recruited GSM Latinx individuals, including bilingual and monolingual Spanish speakers, in order to characterize stressors and resilience factors. We collected data from 185 GSM Latinx adults in California in Spring/Summer 2020. Data analysis on the perceived experiences of discrimination, well-being, mental health outcomes, and LGBTQ Latinx identity integration, as well as differences between monolingual and bilingual GSM Spanish speakers, has been completed.

CLEAR Small Grants Program Study: Is Dialectical Behavior Therapy a Good Fit for Transgender and Gender Non-Binary Patients? 

Principal Investigator and Grant Recipient: Rachel Weiler, M.S., M.Sc. 

Description: Numerous studies have demonstrated that rates of mental health problems, including suicidality, are significantly higher among transgender and gender non-binary (TGNB) adults than in the general population. Evidence suggests this is partially driven by pervasive invalidation of gender experience and expression, leading to severe emotion dysregulation. This study will empirically examine Dialectical Behavior Therapy (DBT) as a possible approach to reducing suicidality and emotion dysregulation in TGNB populations. TGNB patients enrolled in a DBT Skills Group at the Stanford University School of Medicine outpatient psychiatric clinic are invited to participate in this research.

Over the first year of the study, we have collected pre- and post-group self-report measures (n=12) that provide information on emotion regulation and suicidality. We will more data this year and perform a quantitative analysis to examine the treatment’s effectiveness. In addition to quantitative data, we are also collecting qualitative data that could help providers better tailor this treatment to the TGNB population. Thus far, we have conducted three focus groups (n=7) with TGNB participant in which they share their experience of an LGBTQ+ DBT group and offer suggestions for future improvements. We plan to conduct several more rounds of focus groups this year. In November of 2020, initial qualitative findings from the focus groups were shared in a poster presentation at the Association for Behavioral and Cognitive Therapies annual conference and was a recipient of the Elsie Ramos Memorial Student Poster Award.

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