The Necessity for Affirmative Therapy Training: Initial Development and Validation of the Stillwell Affirmative Counseling Competency Scale

Document Type


Degree Name

Doctor of Philosophy (Ph.D)



Date of Award

Summer 2023


Sexual orientation and gender identity (SOGI) minorities continue to experience significant mental health disparities, making them two to four times more likely to present for counseling. Although Affirmative Therapy is the best practice per research findings, counselor education rarely incorporates this training, and counselors report feeling under-prepared to serve this population. There is no current measure to determine whether counselors increase their competency post-training for the few counselor education programs that train on Affirmative Therapy. Therefore, this study aims to create the Stillwell Affirmative Counseling Competency Scale (SACCS) to be utilized by Affirmative Therapy training programs that will measure a clinician’s competency based on the Society for Sexual Affectional, Intersex, and Gender Expansive Identities (SAIGE) Competencies. This study was conducted in multiple stages, utilizing a quantitative research method throughout the scale development. The steps followed Devillis and Thorpe’s scale development model: (A) creating a large pool of potential items based on the two competencies outlined by SAIGE, (B) item review by subject-matter experts to establish content validity and reduce the items in the scale, and (C) a pilot study of the SACCS and utilizing an exploratory factor analysis (EFA) to understand the underlying factor structure and assess for convergent and divergent validity.


Edith Gonzalez

Subject Categories

Counseling | Social and Behavioral Sciences