AFFIRM is an affirmative CBT-based group designed to help LGBTQ+ youth and adults manage stress. AFFIRM supports mental and sexual health, enhances coping skills and validates strengths of its participants.

AFFIRM is an eight session, manualized intervention. It is focused on reducing depression and improving coping and sexual self-efficacy for LGBTTQQ2SA* youth and adults by providing them opportunities to develop identity cognition (self-awareness, identifying risk), mood (recognizing the link between thoughts and feelings), and behaviour (identifying strengths and ways of coping), as well as equipping them with the tools to manage and influence those factors by themselves.

Last reviewed: 2023

Intended Outcomes:

  • Reduce depression
  • Enhance coping skills
  • Identify personal strengths

Continuum of Care:
Universal Prevention

Topic Areas:
Anxiety, Behavioral Health/Mental Health, Depression, Physical Health, Suicide

Adult (25+), Teen/Adolescent (13-18), Young Adult (19-24)

Geographic Locations:
Rural, Urban

Delivery Settings:

Cultural Considerations:
Limited research found involving diverse populations

LGBTQ+ (lesbian, gay, bisexual, transgender, queer and questioning, etc.) youth and young adults ages 12-21

A clinical degree such as Master of Social Work (MSW), Licensed Professional Counselor (LPC), Licensed Clinical Marriage and Family Therapist (LCMFT), etc.


Is Training Required?
Yes, see developer info

Who can provide the required training?
Please contact for more information on training

Program Costs (materials, training, etc.):
Yes, refer to program website

Program/Practice Website:

Relevant Published, Peer-Reviewed Research:

Craig, S. L., Austin, A., & Huang, Y. T. (2018). Being humorous and seeking diversion: Promoting healthy coping skills among LGBTQ+ youth. Journal of Gay & Lesbian Mental Health, 22(1), 20-35.

Craig, S. L., Leung, V. W., Pascoe, R., Pang, N., Iacono, G., Austin, A., & Dillon, F. (2021). AFFIRM Online: Utilising an affirmative cognitive–behavioural digital intervention to improve mental health, access, and engagement among LGBTQA+ youth and young adults. International journal of environmental research and public health, 18(4), 1541.

Craig, S. L., Eaton, A. D., Leung, V. W., Iacono, G., Pang, N., Dillon, F., … & Dobinson, C. (2021). Efficacy of affirmative cognitive behavioural group therapy for sexual and gender minority adolescents and young adults in community settings in Ontario, Canada. BMC psychology, 9(1), 94.

Additional Sources:

Unable to be Rated

WV Rating:
Unable to Be Rated
»WV Ratings Info

Rationale for Rating:

There were a total of 5 studies found. Two were pilot studies which were excluded initially. The other three were all conducted in the same area. Two were pre-post test studies. In one of those studies, the control group was given the pre-test prior to the pandemic. The included participants received the pre-test during the pandemic. The study concluded that the intervention was successful for the included participants; however, the control group had an increase in depression in the post-test. There is a of the validity of the findings due to the pandemic potentially causing further depressive symptoms that were not accounted for in the original timing of the pre-test. There are not enough studies to support this intervention at this time.

Contraindications or Concerns:
None identified

Other Registries/Ratings

The California Evidence-Based Clearinghouse for Child Welfare:
Promising Research Evidence

Blueprints for Healthy Youth Development:
Not On Registry

Clearinghouse for Military Family Readiness:
Not On Registry

Office of Juvenile Justice and Delinquency Prevention Model Programs Guide:
Not On Registry

Washington State Institute for Public Policy:
Not On Registry