Mental HealthNCT05140174
Psychotherapy Interventions to Support Transgender, Two-Spirit, and Nonbinary People of Color
A study testing Radical Healing and Internalized Stigma (RHIS) Training in people with Mental Health, run by University of Wisconsin, Madison at 1 site in United States.
Trial summary
The proposed research will use a community-based participatory research (CBPR) approach to engage with community organizations to design and implement a project that trains therapists to provide effective, supportive, and engaged therapy to two-spirit, transgender, and nonbinary (2STNB) clients most impacted by… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Mental Health
- What is being tested?
- Radical Healing and Internalized Stigma (RHIS) Training
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 51 participants
- Where
- 1 siteUnited States
- Study dates
- 14 Jan 2022to 10 Aug 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- fluent in written and spoken English and/or Spanish
- willingness to participate in pre/ post/ session-by session assessments and 15 individual psychotherapy treatment sessions
- individual identifies as transgender, Two-Spirit, or nonbinary (or somewhere along the gender minority spectrum)
- individual identifies as Black, Indigenous/Native, or otherwise as a person of color
- not currently in individual therapy with another therapist
Who cannot join
- reports current, unmanaged serious/persistent mental health symptoms requiring inpatient treatment (e.g., hallucinations, delusions)
- individual does not identify as transgender, Two-Spirit, or nonbinary (or somewhere along the gender minority spectrum)
- currently in therapy with an individual therapist
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Incorporating Radical Healing and Addressing Internalized Transnegativity in Psychotherapy for Transgender, Two-Spirit, and Nonbinary People of Color: An Open Clinical Trial
The proposed research will use a community-based participatory research (CBPR) approach to engage with community organizations to design and implement a project that trains therapists to provide effective, supportive, and engaged therapy to two-spirit, transgender, and nonbinary (2STNB) clients most impacted by barriers in accessing mental health care. 10 2STNB licensed mental health therapists will be identified and 50 2STNB of their clients will be enrolled and can expect to be on study for 10-20 months.
Read the detailed description
The long-term aim of this research is to ensure that therapists have access to training and engage in effective psychotherapy that ultimately reaches Two-spirit, transgender, and nonbinary (2STNB) clients who are the most impacted by unequal systems that create mental health concerns. To make real improvement in reaching TNB populations who lack the most access to mental health care, therapists must be properly trained and data from clients about their mental health experiences must be obtained. The proposed research will use a community-based participatory research (CBPR) approach to engage with community organizations to design and implement a project that trains therapists to provide effective, supportive, and engaged therapy to TNB clients most impacted by barriers in accessing mental health care.
Intervention:
- Therapist Training: The Radical Healing and Internalized Stigma (RHIS) training provides education to therapists on radical healing and internalized stress. The ten therapists employed by the study will engage in an 8 hour intensive training by consultants hired to be on this study.
- Participants:
- T0 - baseline surveys
- T1a to T1p - psychotherapy sessions (session complete within 11 months)
- T2 - end intervention surveys
- T3 - post intervention follow up (up to 6 months post intervention)
Aim 1: Determine best methods for recruiting 2STNB clients (e.g., increasing access to care), with attention to specific populations and barriers (BIPOC, lack of trust, finances, identity match, etc.)
Aim 2: Examine the feasibility/acceptability of a specialized training for therapists that focuses on healing and internalized stigma
Aim 3: Longitudinally investigate the impact of access to mental health care (e-therapy) on 2STNB people's well-being/mental health.
Endpoints:
The primary endpoint of the study is to determine if the study actually improved access to mental health care for study participants--this will be determined through qualitative interviewing. An additional endpoint is determining feasibility/acceptability of the study, which will also be assessed via qualitative methods.
A secondary endpoint for this study will be to determine if clients experienced psychological improvement in their mental health over the course of the study.
- Conditions
- Mental Health
- Being tested
- Radical Healing and Internalized Stigma (RHIS) Training
- Keywords
- mental health care, training, transgender, nonbinary, two spirit, access
- Medical subject headings
- Psychological Well-Being
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Radical Healing and Internalized Stigma (RHIS) TrainingOther
8-hour RHIS training includes, readings that discuss radical healing and internalized stigma, access to didactic information regarding radical healing and internalized stigma. Therapists will role play certain scenarios that may involve minority stress experiences and discuss with the trainers different types of responses that could be therapeutic. The training will focus on the most up to date research regarding transgender mental health, minority stress, radical healing, and role-plays that focus on these processes.
| Study group | Role | What they receive |
|---|---|---|
| RHIS Informed Psychotherapy | Experimental | Therapists will be trained in Radical Healing and Internalized Stigma (RHIS) and meet with their clients as part of their usual care for 15 tele-psychotherapy sessions Receives: Other: Radical Healing and Internalized Stigma (RHIS) Training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants who Find the Intervention Acceptable
Acceptability of the Intervention will be assessed qualitatively via semi-structured interviews post intervention.
Measured: up to 20 months
Number of Participants Who Find Intervention Feasible
Feasibility of the Intervention will be assessed qualitatively via semi-structured interviews post intervention.
Measured: up to 20 months
Number of Participants Who Indicate Barriers to Therapy Were Decreased
Participant Satisfaction with RHIS Intervention will be assessed qualitatively by semi-structured interview with researcher where access to mental health will be queried.
Measured: up to 20 months
Secondary outcomes (7)
Change in Percent "Yes" on Yes/No subscales on Gender Minority Stress and Resilience Measure (GMSR)
Designed for use with transgender, nonbinary, and gender nonconforming people, the GMSR measure is one of the few that assesses gender identity-related constructs. It was designed to take into account unique gender minority stressors, such as internalized transphobia, and concealment of identity, and resilience factors including community connectedness and pride. The first 3 sub-scales for gender-related discrimination, gender-related rejection, and gender-related victimization are yes/no responses, where 'yes' responses indicated gender-related discrimination, rejection, and victimization.
Measured: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Change in Gender Minority Stress and Resilience Measure (GMSR) Scores
Designed for use with transgender, nonbinary, and gender nonconforming people, the GMSR measure is one of the few that assesses gender identity-related constructs. It was designed to take into account unique gender minority stressors, such as internalized transphobia, and concealment of identity, and resilience factors including community connectedness and pride. The last sub-scales are given on a 5-point Likert response scale (Strongly Disagree = 0 to Strongly Agree = 4) and responses are summed. Higher scores are indicative of greater phenomena. Sub-scales are as follows:
- Non-Affirmation: 6-items (0-24)
- Internalized Transphobia: 8-items (0-32)
- Pride: 8-items (0-32)
- Negative Expectations for Future Events: 9-items (0-36)
- Non-Disclosure: 5-items (0-20)
- Community Connectedness: 5-items (0-20)
Measured: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Change in Outcome Questionnaire-45 (OQ-45) Score
The OQ-45 is a measure of how a person has felt in the past week. Total possible range of scores from 0-180, where the higher the score, the more disturbed the participant.
Measured: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Change in Depression, Anxiety, and Stress Scale (DASS) Scores
The DASS is a measure of how perceived depression, anxiety, and stress in the past week. Total possible range of scores for each domain is 0-21, where higher scores indicate more severe depression, anxiety, and stress.
Measured: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Change in Coping with Discrimination Scale (CDS) Score
CDS is a 25-item scale measuring five specific strategies (i.e., education/advocacy, internalization, drug and alcohol use, resistance, and detachment) that minority individuals may use when coping with experiences of prejudice and discrimination. Items are responded to on a 6-point Likert-type scale ranging from 1 = never like me to 6 = always like me, for a range of 25 - 150. The investigators will analyze a longitudinal change through time, where better coping is evidenced by higher scores.
Measured: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Change in Schwartz Outcome Scale Score
This is a 10-item measure of how someone feels over the previous 7 days. Total possible range of scores is 0-100 where higher scores indicate improved outcome.
Measured: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Change in Client Task Specific Change Measure
This is a 16-item measure of how someone feels they've changed. Total possible range of scores is 16-112, where higher scores indicate improved outcome.
Measured: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Dec 2021
- Study start14 Jan 2022
- Primary completion10 Aug 2023
- Study completion10 Aug 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Mental HealthStudies of the same condition, open and under way.
- More trials run by University of Wisconsin, MadisonThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- Uncontrolled psychotherapy trial (longitudinal study with no control group)
- Masking
- None (open label)
- Enrolment
- 51 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Wisconsin, Madison
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Stephanie Budge, Principal investigator, University of Wisconsin, Madison
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05140174
- Sponsor's protocol ID
- 2021-1133
- Other IDs
- A171600, Protocol Version 12/1/2021
- Status last verified
- Aug 2023
- First submitted
- 17 Nov 2021
- Last updated
- 31 Aug 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Budge SL, Ben L, Lynn S, Tebbe EA. A Thematic Analysis of Teletherapy Benefits and Challenges for Two Spirit, Transgender, and Nonbinary People of Color: Qualitative Results from the HOPE Trial. Telemed J E Health. 2026 Mar;32(3):289-296. doi: 10.1177/15305627251399268. Epub 2026 Feb 3.
PubMed 41313600
Study at a glance
From the registry record, last updated by the sponsor on 31 Aug 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Incorporating Radical Healing and Addressing Internalized Transnegativity in Psychotherapy for Transgender, Two-Spirit, and Nonbinary People of Color: An Open Clinical Trial
- ClinicalTrials.gov ID
- NCT05140174
- Acronym / sponsor ID
- 2021-1133
- Conditions
- Mental Health
- Keywords
- mental health care, training, transgender, nonbinary, two spirit, access
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 51 participants (actual)
- Lead sponsor
- University of Wisconsin, MadisonUniversity, hospital or other
- Study start
- 14 Jan 2022 (actual)
- Primary completion
- 10 Aug 2023 (actual)
- Study completion
- 10 Aug 2023 (actual)
- First posted
- 1 Dec 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The proposed research will use a community-based participatory research (CBPR) approach to engage with community organizations to design and implement a project that trains therapists to provide effective, supportive, and engaged therapy to two-spirit, transgender, and nonbinary (2STNB) clients most impacted by barriers in accessing mental health care. 10 2STNB licensed mental health therapists will be identified and 50 2STNB of their clients will be enrolled and can expect to be on study for 10-20 months.
Detailed description
The long-term aim of this research is to ensure that therapists have access to training and engage in effective psychotherapy that ultimately reaches Two-spirit, transgender, and nonbinary (2STNB) clients who are the most impacted by unequal systems that create mental health concerns. To make real improvement in reaching TNB populations who lack the most access to mental health care, therapists must be properly trained and data from clients about their mental health experiences must be obtained. The proposed research will use a community-based participatory research (CBPR) approach to engage with community organizations to design and implement a project that trains therapists to provide effective, supportive, and engaged therapy to TNB clients most impacted by barriers in accessing mental health care.
Intervention:
- Therapist Training: The Radical Healing and Internalized Stigma (RHIS) training provides education to therapists on radical healing and internalized stress. The ten therapists employed by the study will engage in an 8 hour intensive training by consultants hired to be on this study.
- Participants:
- T0 - baseline surveys
- T1a to T1p - psychotherapy sessions (session complete within 11 months)
- T2 - end intervention surveys
- T3 - post intervention follow up (up to 6 months post intervention)
Aim 1: Determine best methods for recruiting 2STNB clients (e.g., increasing access to care), with attention to specific populations and barriers (BIPOC, lack of trust, finances, identity match, etc.)
Aim 2: Examine the feasibility/acceptability of a specialized training for therapists that focuses on healing and internalized stigma
Aim 3: Longitudinally investigate the impact of access to mental health care (e-therapy) on 2STNB people's well-being/mental health.
Endpoints:
The primary endpoint of the study is to determine if the study actually improved access to mental health care for study participants--this will be determined through qualitative interviewing. An additional endpoint is determining feasibility/acceptability of the study, which will also be assessed via qualitative methods.
A secondary endpoint for this study will be to determine if clients experienced psychological improvement in their mental health over the course of the study.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- Uncontrolled psychotherapy trial (longitudinal study with no control group)
| Arm | Type | Receives |
|---|---|---|
| RHIS Informed Psychotherapy | Experimental | Other: Radical Healing and Internalized Stigma (RHIS) TrainingTherapists will be trained in Radical Healing and Internalized Stigma (RHIS) and meet with their clients as part of their usual care for 15 tele-psychotherapy sessions |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- fluent in written and spoken English and/or Spanish
- willingness to participate in pre/ post/ session-by session assessments and 15 individual psychotherapy treatment sessions
- individual identifies as transgender, Two-Spirit, or nonbinary (or somewhere along the gender minority spectrum)
- individual identifies as Black, Indigenous/Native, or otherwise as a person of color
- not currently in individual therapy with another therapist
Key exclusion criteria (3 listed)
- reports current, unmanaged serious/persistent mental health symptoms requiring inpatient treatment (e.g., hallucinations, delusions)
- individual does not identify as transgender, Two-Spirit, or nonbinary (or somewhere along the gender minority spectrum)
- currently in therapy with an individual therapist
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Radical Healing and Internalized Stigma (RHIS) Training8-hour RHIS training includes, readings that discuss radical healing and internalized stigma, access to didactic information regarding radical healing and internalized stigma. Therapists will role play certain scenarios that may involve minority stress experiences and discuss with the trainers different types of responses that could be therapeutic. The training will focus on the most up to date research regarding transgender mental health, minority stress, radical healing, and role-plays that focus on these processes. | Other | RHIS Informed Psychotherapy |
Primary outcome
Number of Participants who Find the Intervention Acceptable
Time frame: up to 20 months
Acceptability of the Intervention will be assessed qualitatively via semi-structured interviews post intervention.
Number of Participants Who Find Intervention Feasible
Time frame: up to 20 months
Feasibility of the Intervention will be assessed qualitatively via semi-structured interviews post intervention.
Number of Participants Who Indicate Barriers to Therapy Were Decreased
Time frame: up to 20 months
Participant Satisfaction with RHIS Intervention will be assessed qualitatively by semi-structured interview with researcher where access to mental health will be queried.
7 secondary outcomes
Change in Percent "Yes" on Yes/No subscales on Gender Minority Stress and Resilience Measure (GMSR)
Time frame: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Change in Gender Minority Stress and Resilience Measure (GMSR) Scores
Time frame: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Change in Outcome Questionnaire-45 (OQ-45) Score
Time frame: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Change in Depression, Anxiety, and Stress Scale (DASS) Scores
Time frame: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Change in Coping with Discrimination Scale (CDS) Score
Time frame: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Change in Schwartz Outcome Scale Score
Time frame: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Change in Client Task Specific Change Measure
Time frame: baseline, post-intervention (up to 14 months), follow-up (up to 20 months)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 31 Aug 2023.
- Derived from this study: PubMed 41313600Budge SL, Ben L, Lynn S, Tebbe EA. A Thematic Analysis of Teletherapy Benefits and Challenges for Two Spirit, Transgender, and Nonbinary People of Color: Qualitative Results from the HOPE Trial. Telemed J E Health. 2026 Mar;32(3):289-296. doi: 10.1177/15305627251399268. Epub 2026 Feb 3.
- Individual participant dataSharing planned: No
Related trials for Mental Health
Not yet recruiting
Effect of Stress Ball Use During Femoral Arterial Sheath Removal After Coronary Angiography
Femoral Arterial Sheath Removal, Stress Ball
Not yet recruiting
Preventive and Personalized Digital Emotion Regulation Skills Intervention to Reduce Depression and Anxiety in Youths With Adverse Childhood Experiences
Adverse Childhood Experience, Depression / Major Depressive Disorder
Recruiting
Effect of a Brief Daily Digital Meditation on Well-Being in US Young Adults (BEGIN II)
Mental Health and General Well-being
Recruiting
NightWare and Cardiovascular Health in Women With PTSD
Post Traumatic Stress Disorder, Cardiovascular Diseases
Active, not recruiting
Intervention to Address Disparate Mental Health Consequences of COVID-19 Pandemic on Latinx and African Newcomers
Mental Health Issue, Mental Health Disorder
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Stephanie Budge principal investigator
University of Wisconsin, Madison
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Radical Healing and Internalized Stigma (RHIS) Training in people with Mental Health, run by University of Wisconsin, Madison at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 31 Aug 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Participants who Find the Intervention Acceptable (time frame: up to 20 months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05140174, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Aug 2023.