Co-Producing LGBTQ-Affirmative DBT Protocols.

NCT ID: NCT06966193

Last Updated: 2025-05-15

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 32 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2025-10-01
• Study Completion Date: 2026-07-30

Brief Summary

Aims:

1. To co-produce new intervention parts that meet the needs of LGBTQ+ people at risk of self-harm or suicidal thoughts, with LGBTQ+ people and DBT therapists. These intervention parts will be integrated into a Dialectical Behaviour Therapy (DBT) intervention, that is provided earlier in a persons mental health care journey, than DBT is usually targeted at.

2. To assess how acceptable and feasible the co-production process was for participants, and how well it achieved co-production principles (e.g. participants feel supported, that the aims were transparent, etc).

Why is This Important? Young people who identify as lesbian, gay, bisexual, transgender, queer, and with other minoritised gender and sexual identities (LGBTQ+) are much more likely to self-harm and experience suicidal thoughts than cisgender-heterosexual (non-LGBTQ+) people. They also experience barriers when accessing mental health support. Some of these barriers come from a lack of support tailored towards their needs as an LGBTQ+ person. This often means that things get worse before they access the right support, and so are often seen in higher-intensity interventions (tier 4 or tertiary care), like DBT.

What The Investigators Plan to Do:

The investigators plan to hold some focus groups with three different groups of people to co-produce the new intervention parts. The three groups include:

1. A group of LGBTQ+ young people (13-21 years old) who have completed a at full DBT programme recently.

2. A group of LGBTQ+ young people (13-21 years old) who have never been in a full DBT programme but experienced similar difficulties.

3. A group of DBT therapists who have supported LGBTQ+ young people before.

The investigators will seek feedback from participants about how acceptable they found the study (e.g. how satisfied they were with the process), how feasible it was (e.g. were they able to attend and was it practice?), and how well they stuck to the coproduction principles (e.g. how supported they felt).

Conditions

Self-Harm; Suicidal; Emotional Dysregulation

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: RETROSPECTIVE

Study Groups

DBT Cohort Young Person Sample 1

Six to 12 young people who have completed at least four months of DBT, including those who did not complete the entire intended duration of the intervention or those still in the intervention, will be recruited via purposive sampling via the National & Specialist CAMHS DBT Service. If the investigators are unable to recruit sufficient numbers, they will seek to recruit from the adult DBT service within South London & Maudsley NHS Foundation Trust.

Inclusion criteria will include that the young person:

1. Is aged 13 to 21 years old;

2. has completed at least four months of comprehensive DBT (i.e. inclusive of all four modes of intervention; Linehan, 1993; Miller et al., 2006; Rathus & Miller, 2015) in the past 24 months or have completed at least four months of DBT and are still in a comprehensive DBT programme;

3. identifies as LGBTQ+ (including those questioning or unsure about their orientation/identity);

4. is willing and able to participate in the study.

No interventions assigned to this group

Non-DBT Cohort Young Person Sample 2

Six to 12 young people who have experienced difficulties with at least one of the identified intervention targets (identity confusion, managing stigma experiences, and connecting with similar others) will be recruited from CAMHS and from community organisations (e.g. LGBTQ+ charities).

Inclusion criteria will follow similar to sample 1. The young person:

1. Is aged 13 to 21 years old;

2. has not accessed and is not currently enrolled in a comprehensive DBT programme;

3. has experienced difficulties with LGBTQ-related identity confusion, managing stigma experiences, and connecting with similar others;

4. identifies as LGBTQ+ (including those questioning or unsure about their orientation/identity);

5. is willing and able to participate in the study (i.e. are based in the UK and can attend the in-person and online groups).

No interventions assigned to this group

DBT Therapist Sample

Four to eight DBT therapists will be recruited via purposive sampling via the National & Specialist CAMHS DBT Service and Adult DBT Services in South London & Maudsley NHS Foundation Trust. Inclusion criteria will include:

1. Currently practicing or having completed (or recently finished, within the past 12 months) a comprehensive DBT programme as a DBT therapist. In order to practice as a DBT therapist, they must hold a professional qualification recognised by appropriate healthcare regulators.

2. Having experience working with at least one LGBTQ+ client in DBT, who was aged between 13 and 21 years at the time.

3. Being willing and able to participate in the study.

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

1. Is aged 13 to 21 years old;

2. has completed at least four months of comprehensive DBT (i.e. inclusive of all four modes of intervention; Linehan, 1993; Miller et al., 2006; Rathus & Miller, 2015) in the past 24 months or have completed at least four months of DBT and are still in a comprehensive DBT programme;

3. identifies as LGBTQ+ (including those questioning or unsure about their orientation/identity);

1. Is aged 13 to 21 years old;

2. has not accessed and is not currently enrolled in a comprehensive DBT programme;

3. has experienced difficulties with LGBTQ-related identity confusion, managing stigma experiences, and connecting with similar others;

4. identifies as LGBTQ+ (including those questioning or unsure about their orientation/identity);

5. is willing and able to participate in the study (i.e. are based in the UK and can attend the in-person and online groups).

1. Currently practicing or having completed (or recently finished, within the past 12 months) a comprehensive DBT programme as a DBT therapist. In order to practice as a DBT therapist, they must hold a professional qualification recognised by appropriate healthcare regulators.

2. Having experience working with at least one LGBTQ+ client in DBT, who was aged between 13 and 21 years at the time.

3. Being willing and able to participate in the study.

Exclusion Criteria

Non-DBT Cohort Young Person Sample 2

DBT Therapist Sample

• Minimum Eligible Age: 13 Years
• Maximum Eligible Age: 21 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

South London and Maudsley NHS Foundation Trust

OTHER

Sponsor Role: collaborator

King's College London

OTHER

Sponsor Role: lead

Responsible Party

Jake Camp

Adjunct Senior Lecturer

Responsibility Role: PRINCIPAL_INVESTIGATOR

Central Contacts

Jake Camp, DClinPsy, MSc, BSc (Hons).

Role: CONTACT

Jake.camp@kcl.ac.uk

020 7848 0002

Patrick Smith, PhD, MSc, BSc

Role: CONTACT

Patrick.smith@kcl.ac.uk

020 7848 0002

Other Identifiers

NIHR304071

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

1072

Identifier Type: -

Identifier Source: org_study_id