Support-seeking Behavior Research Articles

In Their Own Words: Patient Narratives of Breast Cancer Surgery and Reconstruction.

Breast cancer's global burden prompts a comprehensive understanding of patient experiences surrounding surgical interventions. Social media platforms serve as a new potential avenue for analysis, reflecting patients' coping mechanisms and support-seeking behaviors. This study's objective is to further understand patient experiences regarding breast cancer interventions via social media to improve physician-patient dialogue. A cross-sectional study was conducted of Instagram and TikTok posts surrounding breast cancer surgeries using procedure-related hashtags. Content was categorized to prevalent themes related to Breast-Q foci and was subsequently analyzed. Data from 1,028 individuals were analyzed. Posts encompassed double mastectomy (39%), single mastectomy (22%), and combineddeep inferior epigastric perforator flap, latissimus dorsi flap, and transverse rectus abdominis muscle flapreconstruction (39%). Frequently identified themes included 'Raising Awareness' (86.87%), 'Spreading Positivity' (53.11%), 'Resiliency' (31.03%), 'Online Support' (24.61%), 'Update of Appearance' (20.82%), 'Recovery/Rehab' (19.94%), and 'Scientific Explanation' (19.75%). Instagram posts more likely encompassed positivity (p < 0.001), resiliency (p = 0.001), and mental health (p = 0.011). TikTok posts more likely (p = 0.001) discussed scientific explanations, decision-making, and symptoms (p < 0.001). Preoperative posts more likely (p < 0.001) surrounded scientific explanations, decision-making, and fear. Postoperative posts more likely (p < 0.001) highlighted appearance updates, recovery/rehab, and positivity (p = 0.012). Experiences with mastectomy and reconstruction differed: recovery/rehab (p < 0.001), scientific explanations (p = 0.015), treatment process (p = 0.003), range of motion (p < 0.001), self-esteem (p = 0.017), and wound management (p = 0.008). Concerns of patients online reflect Breast-Q measures. Understanding these nuanced patient discussions can provide novel insights for providers. Tailoring interactions through these insights may facilitate enhanced support, discussions, and experiences throughout the treatment journey. Main Points Social media offers a unique insight into personal patient experiences Online breast surgery patient perspectives reflect Breast-Q measures Outlooks from shared online posts may facilitate physician-patient dialogue LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Experienced financial toxicity among long-term cancer survivors: results from a national cross-sectional survey.

Financial toxicity, the subjective distress caused by objective financial burden, significantly impacts cancer survivors. Yet, enduring effects on survivors remain unclear. Therefore, we investigated the experienced objective financial burden and subjective financial distress in long-term cancer survivors. A cross-sectional nationwide online survey of adult cancer survivors ≥ 5y after diagnosis were analyzed. Objective financial burden was measured via extra expenses and income loss, while subjective financial distress covered psychological well-being, coping and support-seeking behavior, and financial concerns. Groups were compared (i.e., having cancer vs. former patients) by t-tests and chi-squared tests. Financial toxicity was visualized with Sankey plots and sunburst diagrams. 4,675 respondents completed the survey, of whom 2,391 (51%) were ≥ 5y after their cancer diagnosis. Among them, 75% experienced income loss and/or extra expenses after diagnosis. One-third of the previously employed respondents relied on work disability benefits. Further, 'being unable to make ends meet' increased from 2% before diagnosis to 13% ≥ 5y after diagnosis (p < .001). Additionally, 58% reported negative psychological impacts of financial toxicity, and 47% worried about their financial future. Cancer survivors often face income loss and additional expenses, leading to ongoing financial difficulties that affect their psychological well-being. Despite this significant impact, there is a lack of guidance and support to help them manage these financial challenges. These findings highlight the need for healthcare professionals to recognize and address the financial challenges. This study underscores the widespread financial challenges cancer survivors encounter, emphasizing the need for ongoing financial support and comprehensive assessments of their physical and psychological well-being.

Expectant mothers' social media emotional support-seeking behavior

In developing countries, the use of digital media for health information by expectant mothers is a relatively new phenomenon, in contrast to developed countries. This study explores whether emotional support and satisfaction are linked and how they affect the use of social media for healthcare information. A non-experimental survey design was employed in this study. Expectant mothers were surveyed in five hospitals in Ghana's capital from May to August 2022 using a questionnaire. After reviewing and cleaning the data, 580 usable responses were obtained. The collected data were analyzed using SmartPLS 4 structural equation modeling. The findings of the study indicate that expectant mothers' decision to adopt digital media for health information is influenced by emotional support on social media (ESPSM) and satisfaction with social media (SATSM). Furthermore, satisfaction with social media partially mediated the effect between ESPSM and social media health information usage (SMHIU). These findings highlight the importance of emotional support and satisfaction with social media platforms in promoting digital health information usage. In particular, emotional support plays a crucial role for women, especially during pregnancy. These discoveries provide valuable insights for healthcare professionals on how best to assist expectant mothers.

Narrating the Sociocultural Experience and Management of Stigma Related to Military Caregiving

ABSTRACT Despite accelerating the recovery and rehabilitation of wounded veterans and saving the U.S. substantial sums in avoided long-term care costs, military caregivers (MCs) are an underserved community lacking resources and support. On top of managing a variety of emotional, physical, relational, and occupational challenges, MCs experience stigma. Indeed, caregiving can be a stigmatized task, especially for military-affiliated individuals who may be expected to adhere to cultural norms of personal sacrifice and resilience in the face of adversity. The current study uses narrative inquiry to better understand the unique experiences and characteristics of MCs providing care for veterans experiencing posttraumatic stress. Specifically, this study examined MCs’ narratives to uncover the sociocultural experience and management of stigma related to military caregiving. Interviews with 15 military caregivers of veterans experiencing PTS demonstrated that military caregivers experienced stigma for 1) staying in the relationship, 2) enabling the veteran, 3) mismanaging the condition, and 4) flaking on plans and relationships. In response to stigma, MCs often challenged stigma through strategies of denial or evasion of responsibility. This study contributes to communication scholarship by introducing co-stigma management and further interrogating processes related to stigma management communication. In addition, the results can inform Veteran Affairs (VA) healthcare, caregiver assistance programs, health practices, and support-seeking behaviors.

Investigating changes in student mental health and help-seeking behaviour after the introduction of new well-being support services at a UK university.

Growing numbers of students now seek mental health support from their higher education providers. In response, a number of universities have invested in non-clinical well-being services, but there have been few evaluations of these. This research addresses a critical gap in the existing literature. This study examined the impact of introducing non-clinical well-being advisers on student mental health and help-seeking behaviour at a large UK university. Survey data collected pre-post service introduction in 2018 (n = 5562) and 2019 (n = 2637) measured prevalence of depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), and low mental well-being (Warwick-Edinburgh Mental Wellbeing Scale), alongside student support-seeking behaviour. Logistic regression models investigated changes in outcome measures. Administrative data (2014-2020) were used to investigate corresponding trends in antidepressant prescribing at the onsite health service, student counselling referrals and course withdrawal rates. Adjusted models suggested reductions in students' levels of anxiety (odds ratio 0.86, 95% CI 0.77-0.96) and low well-being (odds ratio 0.84, 95% CI 0.75-0.94) in 2019, but not depression symptoms (odds ratio 1.05, 95% CI 0.93-1.17). Statistical evidence showed reduced student counselling referrals, with antidepressant prescribing and course withdrawal rates levelling off. Student perception of the availability and accessibility of university support improved. Our findings suggest a non-clinical well-being service model may improve student perception of support, influence overall levels of anxiety and low well-being, and reduce clinical need. The current study was only able to examine changes over the short term, and a longer follow-up is needed.

Interaction dynamics of social support expressions predict future support-seeking behaviors in online support groups

Maintaining the sustainability of online support groups (OSGs) presents a significant challenge. Integrating the literature on interaction dynamics and supportive communication, this study investigated how interaction dynamics in supportive communication foster long-term support-seeking behaviors that are crucial to sustaining continuous support exchanges in OSGs. Using a large-scale dataset of 48,868 posts and 468,243 comments over ten years from an OSG, this study examined how reciprocity and compensation of emotional and informational support, signaled by emotional expressions and analytical expressions, predicted a poster's future support-seeking behaviors in the OSG. Results showed that a poster's future support-seeking behaviors were positively associated with receiving (a) reciprocity of analytical expressions and (b) compensation of negative emotional expressions with positive emotional expressions in their past posts. However, reciprocity of negative emotional expressions was negatively associated with a poster's future support-seeking behaviors. This study emphasizes social support as an ongoing interactive process and its importance in motivating support-seeking behaviors and fostering a thriving OSG.

Unraveling the Cross-Cultural Differences in Online Expression of Social Anxiety in Online Support Communities.

Individuals suffering from social anxiety disorder (SAD) are increasingly turning to online support communities for self-disclosure and social support. Despite the extensive body of research on online mental health discourses, the cultural nuances within SAD-related discussions remain underexplored. In this study, we examine the cultural differences in online expression of social anxiety by analyzing individuals' self-disclosure and support-seeking behaviors in social media posts. Using two-week data (n = 1,681) from two SAD support communities on the Reddit and Douban groups, we used both qualitative thematic analysis and quantitative semantic analysis to discern prevalent themes and linguistic attributes characterizing these online expressions. Our findings not only uncover common themes such as sharing personal experiences and seeking mutual validations in both communities but also identify their divergences, as Western users primarily sought advice and information in posts, whereas Chinese users were more inclined toward networking. Cultural variations in language use were evident, particularly in individuals' affect and their expression of personal and social concerns. Western users were more likely to convey negative emotions and delve into personal matters related to SAD, whereas Chinese users tended to grapple more with workplace anxieties. This study contributes to the cultural understanding of online mental health discourses and offers insights for crafting culturally sensitive interventions and supports for people with SAD.

A Qualitative Forum Analysis of Fathers’ Stressors and Support Seeking Behaviour During the COVID-19 Pandemic

Fathers experienced high rates of mental health concerns during the COVID-19 pandemic. Social support is crucial to mitigate these problems; however, access to and quality of support were impacted by public health guidelines to increase physical distancing. Online forums offer an avenue for peer connection and support. Yet, minimal research has examined forum use during COVID-19. The objective of the current study was to examine the experiences and support needs of fathers during the pandemic through an exploratory qualitative content analysis of an online social support forum. Posts ( N = 299) and comments ( N = 2597) on Reddit’s sub-forum r/daddit (July and October 2020) were systematically analysed through a Framework Analytic Approach. Findings highlighted five main themes (with subthemes): forum use, family functioning, psychological and health factors, interpersonal functioning, and COVID-19. Findings underscore the critical need for mental health and parenting programs tailored to fathers and informing services to support father and family wellbeing.

Incivility experiences of racially minoritised hospital staff, consequences for them and implications for patient care: An international scoping review.

Workplace incivility is a pervasive complex problem within health care. Incivility manifests as subtle disrespectful behaviours, which seem inconsequential. However, evidence demonstrates that incivility can be harmful to targets and witnesses through negative emotions, poorer mental health, reduced job satisfaction, diminished performance and compromised patient care. It is unclear to what extent existing research critically explores how ethnicity, culture and racism influence how hospital staff experience incivility. This global scoping review systematically analysed existing research exploring the specific ways incivility manifests and impacts racially minoritised hospital workers. Of 2636 academic and 101 grey literature articles, 32 were included. Incivility experiences were categorised into four themes: (1) Cultural control, (2) Rejection of work contributions, (3) Disempowerment at work and (4) Managerial indifference. The included articles highlighted detrimental consequences, such as negative emotions, silencing, withdrawal and reduced support-seeking behaviours. Few studies presented evidence regarding the negative impacts of incivility on patient care. Racialisation and racial dynamics are a significant factor for hospital-based incivility. Currently we do not know the extent to which racialised incivility is associated directly or, perhaps either via burnout or disengagement, indirectly with poorer care. This knowledge can inform the creation of comprehensive, evidence-based interventions to address this important issue.

Insecure attachment and support-seeking during COVID-19: a sequential mixed methods investigation

ABSTRACT The COVID-19 pandemic led many couples to stay at home together with minimal contact with others. As social distancing measures reduced contact with outside households, many partners could seek support only from one another. In two studies using a sequential mixed methods design, we investigated support-seeking behaviors in romantic relationships during COVID-19. In the qualitative study, semi-structured interviews (n = 48) showed differences in how and why partners seek support with an initial consideration of the role of attachment. We identified the following themes: direct support-seeking, indirect support-seeking, (in)dependence, and gender dynamics. In the quantitative study (n = 588), high COVID-19 worry, high attachment anxiety, and low attachment avoidance were associated with more support-seeking. Interestingly, we also found that when COVID-19 worry was high, individuals high in attachment avoidance were more likely to report seeking support. The paper provides a unique insight into the impact of COVID-19 on support-seeking behaviors in romantic relationships.

Support Seeking Tactics Used by Family Caregivers of Relatives With Dementia: Influences on Network Support and Caregiving Burden

Social support for family members who care for a relative with dementia can mitigate caregiving burden. Yet, in that evidence points to these caretakers as often experiencing isolation and loneliness while providing dementia-related care, a need remains to better understand factors contributing to their adverse support experiences. Accordingly, this study applies sensitive interaction systems theory (SIST) to examine how caregivers’ direct versus indirect support-seeking behaviors relate to the quality of support responses they receive from a member of their social network. Associations between network support responses and caregiving burden are also investigated. Family caregivers ( n = 411) completed a Qualtrics survey. Results from path analysis indicated that family caregivers’ direct support seeking was related to supportive responses from a network member, while their indirect tactics to gain assistance predicted unsupportive reactions. Supportive and unsupportive network responses to family caregivers' support seeking were both related to greater caregiving burden. Additionally, indirect support seeking predicted greater caregiving burden, while this relationship was also partially mediated by unsupportive network responses. Findings highlight the utility of marriage and family counseling efforts to help family caregivers identify and practice strategies for communicating their varying dementia-care support needs to others while also managing unconstructive responses shared within their social network. Caregivers may additionally benefit from counseling to help them to develop coping skills beyond support seeking.

Social comparison and overall adjustment among freshmen in one public university

The freshmen in universities continue to face adjustment issues to new environments. Thus, transition to the university is characterized by expected independent decisions as compared to the previous secondary school teacher controlled learning environment.When the transition challenges are not well managed by the university administration, then it could lead to the emergence of psychopathology, as pre-existing mental health problems are exacerbated or new symptoms emerge in response to novel environmental stressors.The present study examined the relationship between social comparison and overall adjustment among the freshmen in one selected public university in Kenya. The study was informed by Social Comparison Theory (SCT) and Student Integration Theory.This study was anchored in the positivist research paradigm. The study was guided by the cross-sectional survey research design. The sample size comprised 213 freshmen in one public university in Western Kenya. The Social Comparison Scale and Adjustment Questionnaire were used to collect data. The validity results indicated that the Keiser-Meyer-Olkin (KMO) was 0.753. The Bartlett’s Test of Sphericity at 95% level of confidence was significant (p-value of .000 &lt; 0.05). The finding shows that there was a low negative (r = -.142, n =213, p&lt;.05) relationship between social comparison and overall adjustment among the first year university students. The study concludes that the social comparison regression model was adequate to predict overall adjustment among first year university students [F (1, 211) = 4.366, p&lt; .05)].The study recommends that the university counseling center should develop holistic counseling therapies, which would enhance coping skills, seeking support, and counseling seeking behaviours among first year students

Evaluation of the Situations of Coping With Mental Trauma and Trauma in Emergency Service Personnel Who Medically Intervened to Earthquake Affected People in the 2020 Izmir Earthquake.

This study aimed to evaluate the mental trauma and coping status of emergency health care workers who responded to the earthquake affected people in the October 2020 Izmir earthquake. This was a descriptive and cross-sectional study. State-Trait Anxiety Inventory (STAI), Posttraumatic Cognition Inventory, Strategies for Coping with Earthquake Stress Scale (SCESS), and Post-earthquake Trauma Level Determination Scale (PETLDS) were used. Independent t-test, analysis of variance, Tukey's test, and Pearson's correlation analysis were used for statistical analysis. Statistical significance was accepted as P ≤ 0.05. A total of 113 health-care professionals participated in the study. There is a positive and high degree of correlation between the religious coping sub-dimension of the SCESS and the PETLDS (P < 0.001). There was a moderate positive correlation between the religious coping sub-dimension of the SCESS and the state anxiety (P < 0.001) and trait anxiety (P < 0.001) subscales of the STAI. In our study, mental trauma and post-traumatic coping levels of health-care workers who were exposed to earthquakes differed according to age, gender, and educational status. We found that post-earthquake trauma levels were directly related to state and trait anxiety levels and religious coping levels. We found that, after the earthquake, social support seeking behavior, state and trait anxiety levels increased; negative cognitions about self, negative cognitions about the world, and self-blame increased.Practice implications: This study draws attention to the evaluation of emergency health workers who work at the forefront of disasters in terms of subsyndromal post-traumatic stress disorder (PTSD). It is recommended to make plans for psychologically protective and preventive interventions for health-care workers especially after disasters.

Public perception of bidirectional intimate partner violence

Bidirectional violence is the most common form of intimate partner violence (IPV) and may influence public reactions to it. Laypeople recruited from Amazon's MTurk (n = 2248) were randomly assigned a fictional IPV vignette manipulating relationship gender dyad, direction of violence, and severity of injury. Participants generally perceived lower offender risk, lower physical and psychological harm to victim, and higher victim responsibility when violence was bidirectional, often incrementally to other case factors. Increasing our understanding of how bidirectionality influences perceptions of IPV may help combat stereotypes about IPV, improve support-seeking behaviors from “non-typical” victims, and increase accuracy of case management decisions.

The Multifaceted Role of Oxytocinergic System and OXTR Gene.

The article explores the multifaceted role of the neuropeptide oxytocin in human behavior and its connection to the oxytocin receptor ( OXTR ) gene. Oxytocin, produced in specific brain nuclei, is implicated in emotional, social, and maternal behaviors, stress reduction, uterine contraction during childbirth, and lactation. The OXTR gene, located on chromosome 3, encodes oxytocin receptors found in various body parts, including critical brain regions associated with social behaviors. The article delves into studies on rodents, revealing correlations between OXTR gene expression and pair bonding in the prefrontal cortex and social behavior regulation in the amygdala. The discussion extends to the impact of oxytocin on social support-seeking behavior, focusing on a specific genetic variation, rs53576. The article explores how this genetic variation influences empathy, stress reactivity, and susceptibility to disorders such as autism and social anxiety. Furthermore, the article examines structural and functional changes in the brain associated with OXTR gene variations. It discusses the role of DNA methylation in influencing oxytocin receptor availability, affecting social perception and responsiveness to negative stimuli. The article also highlights the oxytocinergic system's involvement in disorders such as autism and social anxiety, emphasizing the interplay between genetics and environmental factors. The article also touches on the potential therapeutic use of exogenous oxytocin in mitigating symptoms associated with these disorders. In summary, the article underscores the intricate relationship between oxytocin, the OXTR gene, and diverse aspects of human behavior, providing insights into social bonding, perception, and the development of behavioral disorders.

The use of written guides to empower breast cancer survivors in their management of chronic pain: A realist evaluation

ObjectiveMany breast cancer survivors experience long-term complaints following treatment, such as pain, which are often not addressed in a sufficient way. To empower survivors in talking about their pain and related complaints and in searching for appropriate support when needed, we developed two written guides. With this study, we aimed to pilot test the guides and gain insight into the implementation process and influencing mechanisms through the perspective of a realist evaluation. MethodsNine survivors were interviewed at two time points (i.e., post-intervention and at three-month follow-up). The data were thematically analysed and categorized into a context-implementation-mechanisms-outcomes hypothesis. ResultsThe guides empowered the participants to discuss pain with medical specialists and initiate support-seeking behaviour through underlying mechanisms such as awareness, acknowledgment, hope, reduced isolation, and motivation. Nonetheless, mechanisms and outcomes differed according to a survivor’s unique context. ConclusionWritten guides can offer a feasible way to empower survivors in their management of chronic pain. However, a one-size-fits-all approach is not desirable and other strategies might be necessary. Practice implicationsIt is pivotal to engage survivors as well as professionals in adopting new interventions. As such, the role of nurses in introducing and endorsing the guides should be further explored.

Editorial

Dear Readers There is no doubt that 2023 has inflicted more war, hardships and frustrations upon our world than anyone could have predicted, but we are ready to embrace any and all things that 2024 has to offer. Here are some insights, hopes and dreams for the New Year and the upcoming Christmas: on behalf of the entire Editorial Office of the Archives in Psychiatry and Psychotherapy, I would like to wish you, Dear Readers, peace, creative thinking and health. May the Holiday Season be merry, prosperous and rich in inspirations for compelling future works. Meanwhile, this current issue of the APP abounds with interesting reads. We would like to open with “Social cognition and attachment profiles of women with fibromyalgia syndrome (FM): a case-control study” by Beycan Ayhan et al. from Turkyie. In this study, the authors aimed to examine social cognitive and attachment profiles of FM patients. FM patients may have no social cognition impairments, especially in lack of any psychiatric comorbidities. Moreover, they may suffer from the avoidant type of insecure attachment, which may further affect social support seeking behavior they display. The authors conclude that attachment-based interventions may be important in the treatment of the FM Syndrome.

Sexual Minority Youth Reporting SOGIE-Based Harassment to Adults at School: The Roles of Experienced Harassment, Outness, Safety, and Adult Support at School.

Despite a proliferation of bullying prevention programs in recent time, limited work has investigated support-seeking behaviors in response to elevated bullying levels among sexual minority youth (SMY). To address this gap, the current study examined how harassment targeting SOGIE (sexual orientation, gender identity, and gender expression), sexual identity outness, school safety, and perceptions of teacher/staff support were associated with SMY talking to an adult at school about harassment. A large contemporary national sample of SMY (N = 5538) between the ages 13-18 (Mage = 15.53, SD = 1.33) who experienced at least one form of SOGIE-based harassment in the past year was leveraged for analyses. Hierarchical multivariable logistic regressions revealed more frequent SOGIE-based harassment was associated with greater odds of reporting harassment to school personnel, particularly among SMY who felt safe at school. Findings highlight the need for school-based interventions to foster school safety among SMY who experience peer harassment to promote their reporting of this behavior.

Health-Related Stigma and Challenges Faced by Men Living with Celiac Disease: A Qualitative Analysis

BackgroundCeliac disease (CD) is an autoimmune condition managed by strict adherence to a gluten-free diet. Dietary choice has gendered connotations, and men with CD may face judgment from others when following a gluten-free diet. However, little is known about health-related stigma in men with CD. ObjectivesThe study aim was to explore the health-related stigma and challenges faced by men with CD, and the influence of CD on their lives. MethodsQualitative semistructured online interviews were conducted with men living with CD. ParticipantsTwenty adults (aged 18 years or older) identifying as men living in the United Kingdom, with self-reported CD, were recruited using social media and opportunistic sampling. Statistical analysesParticipants provided rich, detailed discussions about aspects of their experience of living with CD. Reflexive thematic analysis was used, with a critical-realist lens that enabled researchers to connect men’s experiences within wider sociocultural constructs such as masculinity and social identity. ResultsThree themes were identified: CD threatens social inclusion; others’ assumptions about CD and microaggressions have a psychological influence, and masculine norms, health-related stigma, and power dynamics influence men’s health behaviors and everyday experience. Health-related stigma was found to be interconnected with these men’s gendered social environment, suggesting thatmay be an important social and structural determinant of dietary, health-related, and health support-seeking behaviors in men diagnosed with CD. ConclusionsContrary to prior assumptions, health-related stigma influences men with CD of all ages, particularly in social settings. The study unveils the complex interplay of individual beliefs, social norms, and power dynamics, in particular with other men, that influence individual beliefs and emphasize the performative aspect of food consumption. Internalized stigma and microaggressions influence men’s well-being. To better support men with CD, health providers, charitable organizations, and the food industry should address the social influence of adherence to a gluten-free diet, in particular perceived threats to social status and inclusion, which may cause concern, influence food choice, and influence dietary adherence.

LGBTQ+ youth experiences of the COVID-19 pandemic as observed through gender-sexuality alliances

Many of the factors that put LGBTQ+ youth at risk for poor mental health outcomes before the COVID-19 pandemic were exacerbated by the period of home confinement during the pandemic. The following exploratory study investigated the experiences of LGBTQ+ youth during the pandemic as perceived by Gender-Sexuality Alliance (GSA) advisors. In October-November 2021, recruitment began for a qualitative survey shared via a closed Facebook group for GSA advisors in a Midwestern state, in addition to an email sent by a nonprofit supporting GSAs in that state. Advisors were asked to complete the survey in reference to their experience facilitating these school clubs from March 2020-March 2021, a period during the pandemic that saw the highest number of restrictions around home confinement along with schools moving to a virtual format. Findings included themes reflecting impacts of the level of caregiver acceptance on access to support, youth engaging in support-seeking behaviors, and enhancements and challenges of virtual meetings. Implications for social work intervention are shared, focusing on supporting caregivers on a path toward acceptance of their child and advocating for policies that transform the culture and the conversation from whether LGBTQ+ youth can exist as themselves in some spaces, to fully embracing their identity as valued members of society.