unifying science, education and service to transform lives module 4: an overview of treatment...

Unifying science, education and service to transform livesUnifying science, education and service to transform lives

Module 4:An Overview of Treatment Approaches, Modalities, and Issues of Accessibility in the Continuum of Care

A Provider’s Introduction to Substance Abuse for Lesbian,

Gay, Bisexual, and Transgender Individuals

First Edition

A Provider’s Introduction to Substance Abuse for LGBT Individuals Module 4 Treatment Approaches

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Understand special issues in working with LGBT clients

Understand levels of care and modalities

Know guidelines for insuring accessibility and LGBT–

affirmative treatment

PowerPoint Slide # 4-1

Learning Objectives


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Approaches, Levels and Continuum of Care, and Access to Treatment

Treatment-readiness approaches – Sexual orientation and gender identity issues– Coming out– Social stigma and discrimination– Health concerns, such as HIV/AIDS – Homophobia and heterosexism

Level of care – Residential vs outpatient – LGBT community based support services

Continuum of care LGBT specific versus mainstream



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LGBT Client Do's and Don'ts

• Staff Sensitivityo Knowledge, skills, and attitudes

• Assessment Practices andIssues

• Facilities and Modalitieso For example, room assignments and

shared bathrooms o Individual, group, and family

interventions • Discharge and Aftercare PowerPoint Slide # 4-3


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Defining Care

LGBT-tolerant Aware that LGBT people exist and use their services

LGBT-sensitive Aware of, knowledgeable about, and accepting of LGBT people

LGBT-affirmative Actively promote self-acceptance of an LGBT identity as a key part of recovery



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Special Assessment Questions

Level of comfort being LGBT person ? Stage of coming out ? Family/support/social network ? Health factors ? Milieu of use ? Drug use and sexual identity or sexual behavior

connections ? Partner/lover use ? Legal problems related to sexual behavior ? Gay bashing ? Same-gender domestic violence ? Out as LGBT in past treatment experiences ? Correlates of sober periods ? PowerPoint Slide # 4-5


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Modalities

Group counseling

Family counseling

Individual counseling



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Research based Interventions

PROP (Positive Reinforcement Opportunity Project– low-intensity contingency management intervention in

both outpatient and community settings– Preliminary efficacy at reducing methamphetamine

use (Shoptaw et al, 2006)

Gay Specific CBT Groups (Shoptaw, 2005)– Significantly reduced depressive symptoms in sample

of methamphetamine-dependant gay and bisexual men


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Case Example: RUTH

(a) What key recovery (a) What key recovery issues is Ruth facing?issues is Ruth facing?

(b) What issues is Ruth (b) What issues is Ruth facing that are facing that are particular to her identity particular to her identity as a lesbian?as a lesbian?

(c) What kind of What kind of interventions would you interventions would you suggest if you were her suggest if you were her counselor?counselor?



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References and Further Resources

SAMHSA's Substance Abuse Treatment Locator www.findtreatment.samhsa.gov SAMHSA National Helpline (for locating drug and alcohol abuse treatment programs)

– (800) 662-HELP (4357) (English and Espanol)– (900) 487-4889 (TDD)

National Runaway Switchboard (Youth)– It’s anonymous, confidential and free. 1-800-RUNAWAY.

AIDS Info800-874-25729:00 a.m.-7:00 p.m.Spanish-speaking operators available.www.aidsinfo.nih.gov

CDC National STD/AIDS Hotline 800-227-8922 English (STD)800-342-2437 English (AIDS)800-344-7432 (Spanish)800-243-7889 (TDD)English: 24 hours/7 days a week; Spanish: 8 a.m.-2 a.m., 7 days a week (eastern time); TTY: 10:00

a.m.-10:00 p.m., Monday- Friday (eastern time)www.ashastd.org/nah/index.html

Project Inform National HIV/AIDS Treatment Hotline800-822-74229:00 a.m.-5:00 p.m., Monday-Friday (Pacific time)10:00 a.m.-4:00 p.m., Saturday (Pacific time)Spanish-speaking operators available.www.projinf.org

Gay and Lesbian Medical Association http://glma.org/ – "Resources for Patients" to access the LGBT-friendly physician database, list of important things to discuss with your health care

provider, and information on hepatitis and depression.

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