Adapting Clinical Skills to Telehealth - Applications of Affirmative Cognitive-Behavioral Therapy with LGBTQ+ Youth

Sep 5, 2026

Uploaded by Patrick

Online social work services such as telehealth and virtual care expand clinical options for marginalized groups, including LGBTQ+ youth, especially as COVID-19 accelerates adoption. Existing literature offers ethics, standards, and legal guidance, yet provides limited direction on translating offline clinical competencies to telehealth settings for this population. This paper addresses the gap by presenting examples from AFFIRM, an affirmative CBT group intervention delivered remotely, including key delivery considerations, required clinical skills, and adaptation guidance through a case study.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Background and Rationale

AFFIRM Telehealth Adaptation

Clinical Skills and Strategies

Case Study and Guidance

Clinical Social Work Journal [https://doi.org/10.1007/s10615-021-00796-x](https://doi.org/10.1007/s10615-021-00796-x) Adapting Clinical Skills to Telehealth: Applications of Affirmative Cognitive‑Behavioral Therapy with LGBTQ+ Youth Shelley L. Craig1 · Gio Iacono2 · Rachael Pascoe1 · Ashley Austin3 Accepted: 2 February 2021 © The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021 Abstract Online social work services (e.g., telemental health; telebehavioral health; virtual care; telehealth) present significant opportunities for clinical social workers to provide effective care to marginalized populations, such as LGBTQ+ youth. The COVID-19 pandemic has led to an increased focus on telehealth, and while there are excellent resources to guide ethics, standards, and legal decisions (NASW, n.d.), there is less guidance in the literature to specifically inform the adaptation of offline clinical skills to telehealth, particularly for LGBTQ+ youth. To address this gap, we present examples from our experience offering AFFIRM, an affirmative cognitive behavioral therapy (CBT) group intervention now being delivered through telehealth. Specifically, this paper will: (a) describe the key considerations for the delivery of CBT via telehealth to youth; (b) detail specific clinical skills and strategies to enable successful online implementation; (c) describe the adaptation approach through a case study of cognitive restructuring with a transgender youth; (d) and offer specific guidance to support clinicians to adapt their clinical skills to the virtual environment. Keywords LGBTQ+ youth · Telehealth · Affirmative practice · Cognitive behavioral therapy · Mental health Telehealth has been defined as the “remote provision of healthcare services using technology to exchange information for the diagnosis, treatment, and prevention of disease”(Kaiser Family Foundation 2020, para 2) . Telehealth, regarded as a critical modality to support marginalized and underserved populations (Camhi et al. 2020), provides significant opportunities for clinical innovation (Kahn 2015) . Marginalized populations, such as LGBTQ+ (e.g., lesbian, gay, bisexual, transgender, queer, questioning) youth, maybe a population that most benefits from virtual care given their well-documented mental health disparities and use of information communication technologies (ICTs) to cultivate social support and build resilience (Craig et al. 2015, 2020 ; * Gio Iacono[gio.iacono@uconn.edu](gio.iacono@uconn.edu) 1 Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4, Canada 2 School of Social Work, University of Connecticut, 38 Prospect Street, Hartford, CT 06103-2814, USA 3 Ellen Whiteside McDonnell School of Social Work, Barry University, 11300 NE 2nd Avenue, Miami Shores, FL 33161-6695, USA McInroy and Craig 2018) . LGBTQ+ youth continue to be among the most disadvantaged populations globally compared to their straight and cisgender counterparts (EGALE 2020 ; Human Right Campaign Foundation 2020. LGBTQ+ youth face disproportionate discrimination in multiple domains, such as a lack of employment and educational opportunities, barriers to essential health and mental health services, higher rates of homelessness, social isolation, and family rejection that contribute to increased suicidality, depression and other mental health vulnerabilities (EGALE 2020 ; Fowlkes 2020 ; Russell and Fish 2016 ; Taylor et al. 2011 ; True Colors United 2020; Whittington et al. 2020) . Minority stress theory provides an empirically supported theoretical framework for understanding the issues LGBTQ+ youth experience (Meyer 2003). According to minority stress theory, LGBTQ+ populations experience health and mental health disparities due to distinct anti-LGBTQ+ stressorsand discrimination that are perpetuated through structural and interpersonal stigma. Anxiety, depressi

FAQs

Which elements of CBT delivery for youth does the paper emphasize?

It emphasizes key considerations for delivering CBT via telehealth, specific clinical skills and strategies for online implementation, and an adaptation approach illustrated through a case study.

Sep 5, 2026

Uploaded by Patrick