Legal Issues for Programs Treating LGBT Clients Lesbian, gay, bisexual, and transgender (LGBT) individuals with substance abuse problems are doubly stigmatized. As substance abusers, they are viewed by many as weak in character and moral fiber. As lesbian, gay, bisexual, and transgender individuals, they are reviled by some as deviant and immoral. They may encounter…

Modalities Typical modalities for substance abuse treatment include individual, group, couples, and family counseling, but LGBT individuals can face other unique problems if they are treated by traditional programs through group, couples, or family modalities. The group modality may be difficult for LGBT individuals if heterosexism/homophobia is demonstrated by staff and other group members. Groups…

Clinical Issues With Substance-Abusing Lesbians Too little is written on the incidence, prevalence, and patterns of substance use among lesbians. Many formal studies have generalized from gay males to lesbians, whereas others have used unreliable sampling methods. In the literature that is available, certain risk factors are noted repeatedly, such as: • The reliance of…

LGBT youth have the same developmental tasks as their heterosexual peers, but they also face additional challenges in learning to manage a stigmatized identity. This extra burden puts LGBT youth at increased risk for substance abuse and unprotected sex and can intensify psychological distress and risk for suicide. Stigma, Identity, and Risk of Being Gay…

Personnel Policies and Procedures Inclusion of the following policies and procedures in agency operations will help ensure a nondiscriminatory environment for both clients and staff as well as equal representation of LGBT viewpoints in program and policy development. • Include sexual orientation and gender identity in your nondiscriminatory employment policy. • Develop and implement grievance…

LGBT Provider Networks With the advent of managed care panels, individual providers (e.g., physicians, nurse assistants, social workers, and psychologists) may join those panels to satisfy contractual specifications negotiated with private or public purchasers. In addition, many MCOs allow practicing groups to join. Thus, different specialty networks have formed, which then collectively apply to the…

Preventing Attrition During the assessment session, it is important to anticipate potential obstacles to successful treatment, especially factors that can lead to early attrition. The counselor should explore any instances in which the client previously dropped out of treatment and urge the client to discuss any thoughts of quitting treatment. Open discussion can resolve problems…

Session 1 Protocol The counselor welcomes the client and provides an overview of the session. In this session, the counselor uses MET techniques while reviewing the client’s PFR and helping the client prepare for change. Assess the Client’s Readiness To Proceed The counselor asks the client to express his or her thoughts and any major…

What Is Cognitive Behavioral Counseling? A CBT social learning model focuses on teaching interpersonal and self-management skills (CSAT 1999a). CBT is a skill-building rather than a deficit-oriented approach. Marijuana dependence is considered a learned behavior that developed in response to external (e.g., environmental, relational) and internal (e.g., feelings, thoughts) conditions. A CBT perspective suggests that…