AFFIRM: Evidence-Based InterventionS for LGBTQ+ Individuals & their Families

The Center of Excellence on LGBTQ+ Behavioral Health Equity (CoE LGBTQ+ BHE) is offering Mental and Behavioral Health Organizations serving LGBTQ+ youth and their families the opportunity to become an Official AFFIRM Caregiver Site. This opportunity includes the 3-Day Virtual AFFIRM Caregiver Training and purveyor-led coaching sessions for all trained therapists at your site.

Through a competitive application process, agencies have the opportunity to bring this manualized, evidence-informed practice to their organization.

The 2022 application period for AFFIRM Caregiver is now closed. 


The AFFIRM practice models were developed in collaboration with LGBTQ+ youth and adult community partners utilizing an adapt and evaluate framework aimed at ensuring the AFFIRM interventions are rooted in the needs and experiences of LGBTQ+ clients. Learn more about the development of AFFIRM.

There are two AFFIRM interventions, one for LGBTQ+ youth and one for caregivers of LGBTQ+ youth.

AFFIRM Youth is an evidence-based, eight module, manualized coping skills training intervention focused on reducing mental health issues and behavioral risks experienced by LGBTQ+ populations. Developed specifically for LGBTQ+ youth, AFFIRM Youth has been found to be efficacious with this vulnerable population across a range of settings (e.g., schools, health care centers, behavioral health clinics) and recently with young and middle-age adult populations.

Behavioral healthcare providers trained in AFFIRM Youth learn to:

  • Affirm sexual and gender minority identities
  • Engage in case conceptualization and formulation that attends to the specific needs of LGBTQ+ clients
  • Enhance client ability to cope with anti-LGBTQ+ discrimination
  • Implement strategies aimed at helping clients modify unhelpful thoughts, create support networks, engage in healthy and affirming behaviors, and sustain hope

AFFIRM Caregiver is an evidence-informed, seven session, manualized intervention to enhance affirmative parenting practices that promote the safety and well-being of LGBTQ+ youth. AFFIRM Caregiver is designed to work with any caregiver of LGBTQ+ children and youth. This includes biological and adoptive parents, kinship/family members of origin, chosen family, foster/resource parents, and all other people who parent and support LGBTQ+ young people.

Behavioral healthcare providers trained in AFFIRM Caregiver learn to:

  • Educate caregivers about youths’ sexual orientations, gender identities, and expressions
  • Help caregivers understand the impact of anti-LGBTQ+ discrimination on youth and help them move from rejection to affirmation
  • Foster the development of affirmative parenting practices, including compassionate parenting
  • Flexibly deliver and implement an evidence-informed, manualized intervention to caregivers in their settings

To learn more about AFFIRM, visit or contact the CoE LGBTQ+ BHE at


See where around the world AFFIRM trainings have been delivered!

Site Highlights

When Oregon-based mental health nonprofit Options Counseling and Family Services received a grant to provide training for a few of its counselors, Jack Harden, a Salem-based marriage and family therapist registered associate for Options, jumped at the opportunity to learn more about therapy for queer and trans youth.

A queer and trans person, Harden has found it especially rewarding to help children and teenagers through AFFIRM, a nine-week social and emotional support group for LGBTQ+ identifying youth that is run by Options Counseling.

The Hugh Lane Wellness Foundation in Pittsburgh has launched AFFIRM, a virtual support group for LGBTQ+ youth designed to teach them how to love their true colors. “For me, [the term] ‘affirm’ is really important language because we need to move past ‘acceptance,’ ” said Sarah Rosso, executive director of the Hugh Lane Wellness Foundation. “ ‘Affirm’ is showing up wildly in support of people, affirming them for exactly as they are, who they are, across all of the intersections of their identities.”

“It helps them build identity affirmation, to find support and connect with other peers,” Rosso said. “It helps them develop resiliency and some positive coping strategies.”


AFFIRM Youth Infographic

Learn more about


AFFIRM Caregiver Infographic

Learn more about

AFFIRM Caregiver!

Finding an Affirmative Therapist

A tip sheet for youth

Affirmative Care Checklist

A tip sheet for therapists


Ashley Austin, Ph.D., LCSW (she/her)

Ashley Austin, PhD, LCSW is a Professor of Social Work at Barry University.  She is actively involved in conducting research devoted to promoting the health and well-being of transgender and gender diverse children, teens, and adults rooted. In addition, Dr. Austin is engaged in direct clinical practice, as well as training and clinical consultation aimed at advancing affirmative care for TGD populations. Her recent work has been focused on developing knowledge about experiences of gender dysphoria and gender euphoria to inform affirmative practice models. As co-developer and purveyor of the AFFIRM interventions, Dr. Austin is actively involved in research, training, and consulting associated with effective implementation of the AFFIRM interventions across a wide range of sites both nationally and internationally. 

Shelley Craig, Ph.D., R.S.W., LCSW (she/her)

Shelley L. Craig, PhD, LCSW is Professor of Social Work at the Factor-Inwentash Faculty of Social Work at the University of Toronto and Canada Research Chair in Sexual and Gender Minority Youth (SGMY). She has published extensively and generated research funding to develop research and practice that cultivates resilience in the lives of SGMY, particularly leveraging information and communication technologies and evidence-informed interventions.  She is the Principal Investigator of the International Partnership for Queer Youth Resilience (INQYR) and the international student training network (ISTN). Dr. Craig has been engaged in many community organizations including as Co-Chair of WorldPride, Vice-President of PFLAG National, and is grateful to be the recipient of multiple awards including the Ontario Association of Social Work (OASW) Inspirational Social Work Leader. As co-developer and purveyor of the AFFIRM interventions, Dr. Craig is actively involved in research, training, and consulting associated with effective implementation across a wide range of sites both nationally and internationally. 



Ashley Austin (she/her)

Shelley Craig (she/her)

AFFIRM Caregiver: Overview, Evidence, & Steps for Becoming a Site

The CoE LGBTQ+ BHE is offering free AFFIRM Caregiver training and purveyor-led coaching to agencies providing behavioral health services to parents and caregivers of LGBTQ+ youth. AFFIRM Caregiver is a group-based, compassionate parenting intervention designed to improve the knowledge and skills of caregivers, that in turn, improves the behavioral health and well-being of LGBTQ+ youth. Through this competitive application process, agencies have the opportunity to bring this manualized practice to their community. Watch this recorded session to learn how your organization can provide this evidence informed affirmative intervention to biological and foster parents, caregivers, kinship carers, and others that can support LGBTQ+ youth. The co-creators of AFFIRM Caregiver discuss the model and application process, and also provide answers during an open Q&A. 


Ashley Austin (she/her)

Shelley Craig (she/her)

AFFIRM Youth: Overview, Evidence & Steps for Becoming a Site

This webinar recording is aimed at practitioners interested in building knowledge and skills related to providing evidence based affirmative interventions to diverse LGBTQ+ youth. The first half of the webinar introduces attendees to AFFIRM Youth, an 8-session, manualized affirmative cognitive behavioral intervention for LGBTQ+ youth. Presenters provide an overview of theoretical and conceptual underpinnings of AFFIRM. In particular, attendees will be introduced to the key factors contributing to mental health disparities among LGBTQ+ youth, as well as critical sources of healing and resilience. Evidence of AFFIRM Youth’s effectiveness for improving mental health and coping skills among diverse LGBTQ+ Youth will be presented. Part II of the webinar offers detailed information regarding becoming an AFFIRM Youth site.

The UConn School of Social Work is approved by the Connecticut Department of Public Health to provide continuing education credits (CECs) for social workers. The School is accredited by the Council on Social Work Education. The University of Connecticut is accredited by the New England Association of Schools and Colleges, Inc. through its Commission on Institutions of Higher Education.


Craig, S. L., & Austin, A. (2017). The AFFIRM open pilot feasibility study: A brief affirmative cognitive behavioral coping skills group intervention for sexual and gender minority youth. Children and Youth Services Review. 64, 136-144. DOI: 10.1016/j.childyouth.2016.02.022

Craig, S. L., McInroy, L. B., Eaton, A. D., Iacono, G., Leung, V. W. Y., Austin, A., & Dobinson, C. (2019). Project Youth AFFIRM: Protocol for implementation of an affirmative coping skills intervention to improve the mental and sexual health of sexual and gender minority youth. JMIR Research Protocols, 8(6), e13462.

Austin, A., & Craig, S. L. (2019). Trans-affirmative cognitive behavioral therapy. In J. Pachankis & S. Safren (Eds.), Handbook of evidence-based mental health practice with LGBT clients (pp. 25–50). New York, NY: Springer.

Craig, S. L., Austin, A., & Alessi, E. (2019). Cognitive behavioral therapy for LGBT youth mental health. In J. Pachankis & S. Safren (Eds.), Handbook of evidence-based mental health practice with LGBT clients (pp. 25–50). New York, NY: Springer.

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

Austin, A., Craig, S. L., & Alessi, E. (2016). Affirmative Cognitive Behavior Therapy with Transgender and Gender Nonconforming Adults. Psychiatric Clinics of North America. DOI: 10.1016/j.psc.2016.10.003.

Austin, A. & Craig, S.L. (2015). Adapting empirically supported interventions for sexual and gender minority youth:  A stakeholder driven model. Journal of Evidence-Based Social Work. DOI:10.1080/15433714.2014.884958.

Austin, A. & Craig, S.L. (2015). Transgender* Affirmative Cognitive Behavioral Therapy: Clinical Considerations and Applications. Professional Psychology: Research and Practice. 46(1), 21-29

Craig, S. L., Austin, A., & Alessi, E. (2013). Gay affirmative cognitive behavioral therapy for sexual minority youth: A clinical adaptation. Clinical Social Work. 41, 3, 25-35. DOI:10.1007/s10615-012-0427-9.

Craig, S.L., Iacono, G., McInroy, L. et al. Demonstrating LGBTQ+ Affirmative Practice in Groups:: Developing Competence through Simulation-Based Learning. Clin Soc Work J 50, 297–307 (2022).

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