Connection Failure: Systemic Disadvantages Facing the LGBTQ+ Community in Therapy and how to Address them

This paper examines the experiences of members of the LGBTQ+ community in accessing mental health care in Ottawa, Canada, both positive and negative, and what might be done to improve outcomes. The paper includes a literature review of empirical studies and theoretical works about conducting therapy with LGBTQ+ clients, as well as the results of a pilot study conducted by the researcher to examine in depth the experience of a small sample of LGBTQ+ clients in Ottawa (N=4). Through semi-structured interviews, the researcher found that three out of four participants had experienced some dissatisfaction with how their identity was addressed in therapy, and as a result their overall well-being had suffered. This implies that therapists could be doing more to connect with their LGBTQ+ clients, potentially through better educating themselves on the issues affecting the community, as recommended by the participants. Increasing therapist knowledge would likely improve mental health outcomes for LGBTQ+ clients.

Acceptability and Feasibility of the Mindfulness Based Program for Infertility (PBMI)

IntroductionInfertility is described as a low-control stressor that may induce psychopathological symptoms. The Mindfulness Based Program for Infertility (MBPI) is a structured intervention targeting infertile women that aims to cultivate mindfulness and acceptance skills. The MBPI efficacy was tested in 55 infertile women who completed the program and 37 women in a control group. By the end of the MBPI, women who attended the program revealed a significant decrease in depressive symptoms, internal and external shame, entrapment and defeat. Inversely, they showed significant improvement in mindfulness skills and self-efficacy to deal with infertility.AimsDetermine the MBPI feasibility and acceptability.MethodsThe MBPI includes 10 weekly sessions, in a group format, with the duration of about 2 hours each. Participants’ recruitment was supported by the Portuguese Fertility Association. Fifty-five female participants with an infertility diagnosis who were pursuing medical treatment for infertility completed a questionnaire specifically developed to address the acceptability and satisfaction with the MBPI at the end of the 10th session.ResultsParticipants scored as “very useful” most of the MBPI components (mindfulness practice, acceptance skills, values clarification, psychoeducation on stress and fertility-related lifestyle factors), except for the yoga component. The same pattern was found for the utility information, group support, small group exercises, contact with the therapist, progress notes and MBPI materials. The mean score for satisfaction with the therapist knowledge/competence was 9.55 (maximum: 10), the MBPI quality 8.91 and the MBPI global utility 8.95.ConclusionsThe MBPI showed to be feasible and well accepted by participants.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Promoting the Use of Measurement Tools in Practice: A Mixed-Methods Study of the Activities and Experiences of Physical Therapist Knowledge Brokers

Background The use of knowledge brokers (KBs) has been recommended as a mechanism to facilitate the use of research evidence in clinical practice. However, little has been written regarding the practical implementation of the KB role. Objectives This article (1) describes the brokering activities of 24 pediatric physical therapist KBs (in Ontario, Alberta, and British Columbia, Canada), and (2) reports KBs' perceptions of the utility of their role and their experiences with the brokering process. Design A mixed-methods research design was used in this investigation, which was part of a larger knowledge translation (KT) study that demonstrated the effectiveness of using KBs to implement a group of evidence-based measurement tools into practice. Methods The KBs completed weekly activity logs, which were summarized and described. Semi-structured telephone interviews with KBs were analyzed qualitatively to provide insight into their perceptions of their role and the brokering process. Major interview themes were identified and verified through member checking. Results Brokering activities varied considerably as KBs adapted to meet the needs of their colleagues. The KBs indicated that they highly valued the connection to the research community and spoke of the enthusiastic engagement of their physical therapist colleagues (and others in their organization) in the brokering process. They discussed the importance of understanding the practice context and organizational factors that could affect knowledge transfer. The KBs spoke of the need to dedicate time for the role and had a strong sense of the supports needed to implement a KB role in future. Conclusions Considerable variation in brokering activities was demonstrated across KB participants. The KBs perceived their role as useful and indicated that organizational commitment is crucial to the success of this KT strategy.