Psychology, Department of


First Advisor

Debra A. Hope

Date of this Version



A dissertation presented to the faculty of the Graduate College at the University of Nebraska in partial fulfillment of requirements for the degree of Doctor of Philosophy

Major: Psychology

Under the supervision of Professor Debra A. Hope

Lincoln, Nebraska, September 2020


Copyright 2021, Natalie Holt


Mental health disparities amongst sexual and gender minority (SGM) individuals are spurred by exposure to minority stressors and sustained by mediators of problems with emotion regulation, social support, and cognitive processes. Emerging clinical research suggests empirically supported behavioral health treatments can be culturally adapted to address these mental health disparities, however less work has focused on the prevention of symptoms. The present study developed a brief preventive intervention targeting mediators of the minority stress model for SGM youth and young adults aged 17 to 26. Focus groups with 8 SGM participants informed development to ensure the content and delivery of the intervention was culturally appropriate. Intervention components included psychoeducation on the minority stress model, skills for emotion regulation, compiling lists of local affirming resources, and practice of cognitive restructuring techniques with internalized stigma examples. Twenty-six participants, in 4 cohorts, received the 90-minute intervention in a multiple baseline design trial to establish preliminary feasibility and efficacy. Participants completed measures of internalizing symptoms, emotion regulation, social support, stress appraisal, and internalized stigma every 2 weeks for 5 time-points. Participants rated the intervention as successful, logical, and appropriate for SGM youth and young adults. Limited change was seen in outcome measures at follow-up time-points. Onset of the COVID-19 pandemic necessitated changes to the intervention delivery mode, and along with factors such as limited dosing, may explain lack of improvement on distal outcome measures. With further refinement, this brief preventive intervention can easily be delivered to SGM youth and young adults to provide skills and resources for coping with minority stress.

Advisor: Debra A. Hope