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A Provider's Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals

A continuing education course for 7 ces

consisting of reading and taking a post-test on:

A Provider's Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals


Who Should Attend

The Center for Substance Abuse Treatment (CSAT) of the Substance Abuse and Mental Health Services Administration (SAMHSA) is pleased to present A Provider's Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals.
This publication was developed through a systematic and innovative process in which clinicians, researchers, program and administrative managers, policymakers, and other Federal, State, and independent experts were brought together for a series of intensive sessions. These individuals reviewed and discussed current administrative and clinical practices for treating substance-abusing lesbian, gay, bisexual, and transgender individuals and then wrote and edited the resulting document. The goal of this process was to improve and advance substance abuse treatment for a community of individuals whose health care needs are often ignored, denigrated, or denied.
This document seeks to inform administrators and clinicians about appropriate diagnosis and treatment approaches that will help ensure the development or enhancement of effective lesbian, gay, bisexual, and transgender (LGBT)-sensitive programs. Serving as both a reference tool and program guide, it provides statistical and demographic information, prevalence data, case examples and suggested interventions, treatment guidelines and approaches, and organizational policies and procedures.
This publication focuses on the two most important audiences for successful program development and implementation—clinicians and administrators. Section I provides an introduction for both audiences and includes information on sexual orientation, legal issues, and treatment approaches and modalities from a lesbian, gay, bisexual, and transgender standpoint. Section II is written for the practicing clinician. It offers further information on clinical issues of lesbian, gay, bisexual, and transgender clients; an introduction to strategies and methods for improving current services to LGBT individuals; and steps for starting LGBT-sensitive programs. Section III, developed for program administrators, provides an overview of the issues that need to be addressed when developing an LGBT program or when expanding current services for LGBT clients. It offers the data needed to build a strong foundation for a program, including an organizational mission and policies and procedures. It provides resources and strategies for working with managed care organizations and building alliances and cooperative arrangements to coordinate efforts on behalf of LGBT individuals so that members of the LGBT population can promote self-help programs within their own communities.
Besides increasing awareness of the need for LGBT-sensitive treatment services and helping all those involved in the treatment process become more aware of LGBT issues, this document also serves an important public health function. For example, the convergence of HIV, hepatitis, and substance abuse is a major concern that has not been adequately addressed in LGBT communities, especially
regarding the availability of vaccines for hepatitis A and hepatitis B. Educating LGBT people about these vaccines, the importance of vaccination, and strategies for preventing hepatitis C infection is a responsibility of all health care providers, not just substance abuse treatment professionals.
This publication is the result of the collaboration of many contributors, and CSAT gratefully acknowledges the dedication, time, talent, and hard work that the writers and reviewers have brought to this publication.


In this 7 unit course, Learning Objectives are:

1. Recognize various perspectives on LGBT culture and how cross-cultural issues affect substance abuse

2. Recognize the legal barriers facing LGBT individuals,

3. Identify the the level of care and treatment options that tend to work best for LGBT clients, and how programs can be made more accessible for these populations.

4. Identify how life experiences and heterosexism may shape substance abuse among the LGBT population.

5. Evaluate the potential interaction among substance abuse, recovery issues, and the coming out process.

6. Explore how family histories and personal relationships may affect substance abuse issues and the treatment process.

7. Identify specific issues relevant to lesbians, gay men, bisexuals, transgender individuals, and LGBT youth, and explore health issues that face these clients

8. Explore competency issues for counselors dealing with the LGBT population including countertransference.

is approved by the:

American Psychological Association to sponsor continuing education for psychologists - www.psychceu.com maintains responsibility for this program and its content.
Board of Registered Nursing (#13620)
California Board of Behavioral Science accepts our CE Provider Approvals through APA, NASW, and NBCC. Course meets the qualifications for hours of continuing education credit for LMFTs, LCSWs, LPCCs, and/or LEPs as required by the California Board of Behavioral Science
Florida Board of Clinical Social Work, Marriage and Family Therapy, Mental Health Counseling (BAP 753 )
NAADAC - The Association for Addiction Professionals (#575)
National Board for Certified Counselors - www.psychceu.com has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6055. Programs that do not qualify for NBCC credit are clearly identified. www.psychceu.com is solely responsible for all aspects of the programs. (ACEP #6055)
Texas State Board of Examiners of Professional Counselors (#1761)
The Texas Board of Social Work Examiners (#6246)

maintains responsibility for the program.



how it works

Due to the wonders of technology, the minute you submit your order over our secure line, it is encrypted, and processed safely and securely by Authorize.net, a secure web processor. Or, if you prefer, call us toll-free 888-777-3773.

You will immediately receive confirmation of your order, your password and how to access the course material. (Please do not block e-mails from classes@psychceu.com, orders@psychceu.com and info@psychceu.com)

If you ordered an online course, you can begin to take the course immediately.

You will receive instructions, via e-mail, on how to take your test online.

Contact us or call if you need technical support.

Your test will be graded online, so the moment you have passed, you may print out your certificate of completion.

That's it! You are done!




From the Clinician's Quick Guide (Bonus Material)

When assessing LGBT individuals with substance use problems, programs may need to incorporate more
inclusive language into their assessment instruments and retrain staff. Assessments include relationships
with family and friends, social interactions, work issues, level of self-esteem, understanding of self-identity,
and level of community support.
Family of Origin
• The biopsychosocial assessment includes taking a family history and reviewing family dynamics.
• Caution and sensitivity are needed when asking sensitive questions about members of the family
of origin because LGBT clients often have unresolved issues about their families of origin.
• The family of origin's response to the individual's coming out can have a lasting and—if negative and
unaccepting—devastating effect.
• LGBT clients need to process the messages, roles, images, and stereotypes about sexuality received
from their families of origin.
For more information, see A Provider's Introduction, pages 69–70.
Family of Choice and Relationships
Clients define who they consider members of their family of choice. Counselors need to—
• Include life partners and significant others in the client's treatment (with permission);
• Be aware of the problems of same-sex couples and the variety of relationships in the LGBT community;
• Know that one partner may be out while the other is closeted, which can create tension;
• Understand issues that LGBT parents face, including the fear of losing child custody; and
• Acknowledge their biases when working with LGBT clients.
For more information, see A Provider's Introduction, pages 71–72.
Special Assessment Questions for LGBT Clients
The following are examples of questions that counselors can include when assessing LGBT clients:
• How comfortable are you with being an LGBT person?
• Do you consider yourself out? What were your experiences coming out? What were the consequences?
• What is your support and social network? Describe current or past relationships and your relationship
with your family of origin.
• How often do you use substances? Do you use mainly when you are socializing?
Assessing the Special Needs of LGBT Individuals
• What is your drug of choice—the one you seek most? What does it seem to provide? Relaxation?
Freedom from guilt? Enhanced sexual behavior?
• Have you had social problems or lost relationships with partners, family members, or friends because of
substance use?
• Are you using or have you used injection drugs? If so, what drugs? Do you use amphetamines (speed,
crystal, crank)? Do you use amphetamines to enhance sexual intensity?
• Are there any health factors of concern (including HIV and hepatitis C)?
• Does your significant other (when applicable) believe there is a problem? Does he or she also have a
substance use problem?
• Have you had legal problems resulting from your use of alcohol and drugs, including arrest for driving
under the influence? Have you ever had legal problems related to sexual behavior?
• Have you ever been verbally attacked or assaulted because you were thought to be an LGBT person?
• Are you a victim of domestic violence? Was it by a person of the same sex?
• Have you had treatment for substance abuse? If so, was your sexual orientation or sexuality discussed?
• What is the longest time you have not used substances? What allowed that to happen?
For more information, see A Provider's Introduction, pages 55–56.
The following questions can help the counselor gather information about the client's family of origin and
assess unresolved issues that might interfere with clients' ability to maintain sobriety:
• What were the rules in your family system? Were all family members expected to behave or act in a certain way?
• Do you have any history of physical, emotional, or sexual trauma?
• What were your family's expectations about careers, relationships, appearance, status, or environment?
• Was sex ever discussed?
When addressing sexual orientation and gender issues, counselors can begin by reviewing with clients how
differences were perceived in the family:
• Was anyone else in the family acknowledged to be or thought of as being an LGBT individual? How did
the family treat that person?
• Are you out to your family? If so, what type of response did you receive?
For more information, see A Provider's Introduction, page 70.



Treatment Improvement Protocols (TIPs)

Treatment Improvement Protocols (TIPs) are developed by the Center for Substance Abuse
Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration
(SAMHSA) within the U.S. Department of Health and Human Services (HHS). Each TIP
involves the development of topic-specific best-practice guidelines for the prevention and treatment
of substance use and mental disorders. TIPs draw on the experience and knowledge of
clinical, research, and administrative experts of various forms of treatment and prevention. TIPs
are distributed to facilities and individuals across the country. Published TIPs can be accessed via
the Internet at http://www.kap.samhsa.gov.
Although each consensus-based TIP strives to include an evidence base for the practices it
recommends, SAMHSA recognizes that behavioral health is continually evolving, and research
frequently lags behind the innovations pioneered in the field. A major goal of each TIP is
to convey “front-line” information quickly but responsibly. If research supports a particular
approach, citations are provided.



APA Ethics

We do adhere to the American Psychological Association's Ethical Principles of Psychologists. Our courses are carefully screened by the Planning Committee to adhere to APA standards. We also require authors who compose Internet courses specifically for us follow APA ethical standards.

Many of our courses contain case material, and may use the methods of qualitative research and analysis, in-depth interviews and ethnographic studies. The psychotherapeutic techniques depicted may include play therapy, sandplay therapy, dream analysis, drawing analysis, client and therapist self-report, etc. The materials presented may be considered non-traditional and may be controversial, and may not have widespread endorsement within the profession. www.psychceu.com maintains responsibility for the program and its content.

All material included in this course is either in the public domain, or used with express permission.

Cost of the 7 unit course is $88

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