Workshops

The SGDLC Program consists of three main components: (1) SGDLC workshop for therapists and administrators, (2) SGDLC organizational technical assistance for administrators, and (3) SGDLC clinical consultation for therapists (see Fig. 1). The virtual rather than in-person, on-site provision of the SGDLC allowed the provision of the workshop and clinical consultation sessions to therapists from two organizations combined in each cohort.

The workshop is a 7-hour didactic and interactive seminar delivered virtually at the start of the training program and led by two clinician facilitators who are experts in sexual health, sexual orientation, and gender-identity topics related to mental health and health care. The workshop included four modules: (1) interrogating stereotypes, examining comfort, and understanding the importance of language; (2) LGBTQ+ health disparities and obstacles to care; (3) facilitating sexual health conversations in mental health care; and (4) providing affirmative care and health conversations. The workshop for each cohort was scheduled so that the two intervention organization administrators and therapists could participate together. This was both a cost-efficiency decision and an educational opportunity for cross-organization sharing and learning. The workshop time was largely determined by the administrator and therapist’s choice from options provided by the trainers. Zoom was used as the virtual venue for the workshops. The workshop modules were presented over two consecutive days for cohorts 1 and over one day during cohort 2 due to scheduling conflicts. All participants who completed the 7-hour workshop were offered 7 continuing education units (CEUs) from the National Association of Social Workers (NASW).

Eligibility for the program was assessed in three phases. Our first phase was at the organizational level—eligible mental health organizations were required to (1) have two lead administrators willing to serve as point persons for the study (henceforth referred to as “administrators”); (2) have a minimum of five mental health providers (henceforth referred to as “therapists”) eligible and willing to participate in the program; (3) be able to make autonomous decisions regarding the organization’s policies and procedures (e.g., paperwork changes); and (4) not be explicitly branded as an LGBTQ+ focused, substance use rehabilitation, or faith-based services organization. Once organizations were deemed eligible, research staff scheduled an “orientation” meeting with administrators to confirm their eligibility, review the study components and timeline, and discuss the next steps. Following the orientation, administrators solicited interest in the study from a targeted six eligible therapists—five being the minimum and seven being the maximum to remain eligible—from their organization to participate in the study by sharing a therapist orientation video and an FAQ page. Administrators were also required to complete an organization-level online baseline comprehensive assessment of their LGBTQ+ climate and a participant contact form.
The second phase of organizational eligibility focused on therapist eligibility. Once recruited by administrators, therapists were asked to complete a baseline self-assessment of their demographics, client demographics, and their LGBTQ+ competence, which allowed researchers to assess eligibility. Therapists were required to (1) be either provisionally or fully licensed therapists (i.e., clinical social workers, mental health counselors, licensed professional counselors, licensed psychologists, and licensed marriage and family therapists), (2) work at the organization for a minimum of 20 hours a week, and (3) have at least 10 active clients 16 years old or older at the enrolled organization. If administrator and therapist participants appeared eligible, a research team member contacted them to clarify any remaining questions about eligibility.
Organizations took about 3 weeks to complete all enrollment data collection. Once eligibility screening was completed, organizations were officially enrolled in the study and randomized to a study condition (i.e., intervention or control). The intervention and control condition therapists received a list of approximately 15 publicly accessible free online LGBTQ+ clinical competency webinars (https://www.samhsa.gov/lgbtq-plus-behavioral-health-equity?&), whereas the intervention condition therapists also received the SGDLC workshop and SGDLC clinical consultations. The intervention, but not control, condition administrators received the SGDLC workshop and the SGDLC technical assistance. To facilitate engagement in the program components, all study administrators and therapists were given access to an informational website outlining their study condition’s program components, related resources, and timeline of tasks. They were also added to the study condition email list, which provided weekly email updates for administrators and therapists with instructions for upcoming training and data collection activities.