ABFT for LGBTQ Suicidal Youth: Feasibility, Acceptability and Transportability

Suicidal thoughts and behaviors among LGBTQ+ youth are shaped not only by emotional distress, but also by the social environments in which young people live. Research has shown that LGBTQ+ youth face higher rates of suicidal thoughts and attempts compared to their peers, with much of this risk linked to experiences of stigma, discrimination, and rejection, often referred to as minority stress. These stressors can occur across multiple settings, including schools, healthcare systems, and, importantly, within families. At the same time, family support and acceptance have been shown to play a powerful protective role, reducing suicide risk and supporting overall well-being. Despite this, many LGBTQ+ youth encounter barriers to accessing affirming care in traditional healthcare settings and instead turn to community-based LGBTQ+ centers, where they may feel safer and more understood. Understanding how providers in these settings navigate suicide risk, and the complex role of family involvement, is an important step in strengthening support for this population.

With her AFSP grant, Dr. Jody Russon conducted a qualitative study exploring the perspectives of 18 providers working in LGBTQ+ community centers who support youth experiencing suicidal thoughts and behaviors. Through focus group interviews, providers described how they regularly encounter the impact of discrimination, family rejection, and barriers to affirming care in their work with youth. They also shared the challenges of engaging families in treatment, particularly when caregivers are not accepting, which can create tension between wanting to build family support and ensuring the safety of the young person. Providers emphasized the importance of assessing family readiness, using therapeutic education to increase understanding, and, when needed, expanding the definition of “family” to include supportive individuals outside of biological relatives. At the same time, they highlighted broader systemic challenges, including limited resources, long waitlists, and a lack of affirming services in mainstream care settings. Overall, the findings underscore the critical role of affirming providers and community-based supports, while pointing to the need for training, resources, and family-centered approaches that safely address the broader social factors shaping suicide risk among LGBTQ+ youth.

Citation: Smith, K. A., Srinivasan, S., Guenette, C., & Russon, J. M. (2026). LGBTQ+ Community Center Providers' Perceptions: Tensions and Solutions for Serving LGBTQ+ Youth With Suicidal Thoughts and Behaviors and Their Families. Journal of marital and family therapy, 52(2), e70120. https://doi.org/10.1111/jmft.70120