Online social work services (e.g., telemental health; telebehavioral health; virtual care; telehealth) present significant opportunities for clinical social workers to provide effective care to marginalized populations, such as LGBTQ+ youth. The COVID-19 pandemic has led to an increased focus on telehealth, and while there are excellent resources to guide ethics, standards, and legal decisions (NASW, n.d.), there is less guidance in the literature to specifically inform the adaptation of offline clinical skills to telehealth, particularly for LGBTQ+ youth. To address this gap, we present examples from our experience offering AFFIRM, an affirmative cognitive behavioral therapy (CBT) group intervention now being delivered through telehealth. Specifically, this paper will: (a) describe the key considerations for the delivery of CBT via telehealth to youth; (b) detail specific clinical skills and strategies to enable successful online implementation; (c) describe the adaptation approach through a case study of cognitive restructuring with a transgender youth; (d) and offer specific guidance to support clinicians to adapt their clinical skills to the virtual environment.

在线社会工作服务（例如，远程心理健康；远程行为健康；虚拟护理；远程健康）为临床社会工作者提供重要机会，为边缘化人群（例如 LGBTQ+ 青年）提供有效护理。COVID-19 大流行导致人们更加关注远程医疗，虽然有很好的资源来指导伦理、标准和法律决策（NASW，nd），但文献中很少有指导具体告知离线临床的适应远程医疗技能，特别是对于 LGBTQ+ 青年。为了解决这一差距，我们提供了我们提供 AFFIRM 的经验示例，这是一种现在通过远程医疗提供的肯定性认知行为疗法 (CBT) 团体干预。具体来说，本文将：(a) 描述通过远程医疗向青年提供 CBT 的主要考虑因素；(b) 详细说明实现在线成功实施的具体临床技能和策略；(c) 通过一个跨性别青年的认知重组案例研究来描述适应方法；(d) 并提供具体指导，以支持临床医生使他们的临床技能适应虚拟环境。