Lesbian, gay, and bisexual individuals who are also racial/ethnic minorities (LGBT-POC) are a multiply marginalized population subject to microaggressions associated with both racism and heterosexism. To date, research on this population has been hampered by the lack of a measurement tool to assess the unique experiences associated with the intersection of these oppressions. To address this gap in the literature, we conducted a three-phase, mixed method empirical study to assess microaggressions among LGBT-POC. The LGBT People of Color Microaggressions Scale is an 18-item self-report scale assessing the unique types of microaggressions experienced by ethnic minority LGBT adults. The measure includes three subscales: (a) Racism in LGBT communities, (b) Heterosexism in Racial/Ethnic Minority Communities, and (c) Racism in Dating and Close Relationships, that are theoretically consistent with prior literature on racial/ethnic minority LGBTs and have strong psychometric properties including internal consistency and construct validity in terms of correlations with measures of psychological distress and LGBT-identity variables. Men scored higher on the LGBT-PCMS than women, lesbians and gay men scored higher than bisexual women and men, and Asian Americans scored higher than African Americans and Latina/os.

A brief motivational intervention with 117 homeless adolescents was evaluated using a randomized design and 3-month follow-up. The intervention was designed to raise youths' concerns about their substance use, support harm reduction, and encourage greater service utilization at a collaborating agency. The study was designed to strengthen initial promising results of an earlier study (P. L. Peterson, J. S. Baer, E. A. Wells, J. A. Ginzler, & S. B. Garrett, 2006). Several modifications in the clinical protocol were included to enhance engagement with the intervention. Analyses revealed no significant benefits for intervention participants when homeless youths' substance use rates were compared with those of control participants. Service utilization during the intervention period increased for those receiving the intervention but returned to baseline levels at follow-up. Participants reported overall reductions in substance use over time. Differences between sampling methods for the current and previous study are discussed, as are the limitations of brief interventions with this population. Future research needs to elucidate mechanisms of change and service engagement for highly vulnerable youth.

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Few empirical studies are available to guide best practices for transferring evidenced-based treatments to community substance abuse providers. To maximize the learning and maintenance of new clinical skills, this study tested a context-tailored training model (CTT) which used standardized patient actors in role-plays tailored to agency clinical context, repetitive cycles of practice and feedback, and enhanced organizational support. This study reports the results of a randomized pilot evaluation of CTT for motivational interviewing (MI). Investigators randomly assigned community substance abuse treatment agencies to receive either CTT or a standard two-day MI workshop. The study also evaluated the effects of counselor-level and organizational-level variables on the learning of MI. No between-condition differences were observed on the acquisition and maintenance of MI skills, despite reported higher satisfaction with the more costly context tailored model. Analyses revealed that those counselors with more formal education and less endorsement of a disease model of addiction made the greatest gains in MI skills, irrespective of training condition. Similarly, agencies whose individual counselors viewed their organization as being more open to change and less supportive of autonomy showed greater average staff gains in MI skills, again, irrespective of training method. Post-training activities within agencies that supported the ongoing learning and implementation of MI mediated the effects of organizational openness to change. This pilot study suggests that tailored training methods may not produce better outcomes than traditional workshops for the acquisition of evidence-based practice and that efforts to enhance dissemination should be focused on characteristics of learners and ongoing organizational support of learning.

Factors associated with the well-being of lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth were qualitatively examined to better understand how these factors are experienced from the youths’ perspectives. Largely recruited from LGBTQ youth groups, 68 youth participated in focus groups (n = 63) or individual interviews (n = 5). The sample included 50% male, 47% female, and 3% transgender participants. Researchers used a consensual methods approach to identify negative and positive factors across 8 domains. Negative factors were associated with families, schools, religious institutions, and community or neighborhood; positive factors were associated with the youth's own identity development, peer networks, and involvement in the LGBTQ community. These findings suggest a pervasiveness of negative experiences in multiple contexts, and the importance of fostering a positive LGBTQ identity and supportive peer/community networks. Efforts should work towards reducing and eliminating the prejudicial sentiments often present in the institutions and situations that LGBTQ youth encounter.

The notion that client language about change is related to actual behavioral change is central to the practice of motivational interviewing (MI), but has not been examined in adolescent clients. In this study homeless adolescents who used alcohol or illicit substances but were not seeking treatment (n = 54) were recorded during brief motivational interventions. Adolescent language during sessions was coded based on MI concepts, and ratings were tested as predictors of rates of substance use over time. Types of adolescent speech included global ratings of engagement and affect, as well as counts of commitment to change, statements about reasons for change, and statements about desire or ability to change. Results of multivariate linear regression indicate that statements about desire or ability against change, although infrequent (M = 0.61 per 5 minutes), were strongly and negatively predictive of changes in substance use rates (days of abstinence over the prior month) at both 1-and 3-months post baseline assessment (p < .001). In contrast, statements about reasons for change were associated with greater reductions in days substance use at 1-month assessment (p < .05). Commitment language was not associated with outcomes. Results suggest that specific aspects of adolescent speech in brief interventions may be important in the prediction of change in substance use. Future studies are needed to test the observed relationships in larger samples and other clinical contexts, and assess if youth language about change mediates effects of clinical interventions.Motivational interviewing (MI;Miller & Rollnick, 2002) is a popular, empirically-based counseling method for a range of health-related problems. Defined as a "client-centered, directive method for facilitating intrinsic motivation to change by exploring and resolving ambivalence," (Rollnick & Miller, 1995), MI emphasizes formation of collaborative therapeutic relationships with clients through which client language about change may be strategically elicited and reinforced. "Change language" is defined as client expressions of problems with the current state, benefits of change, and hope and optimism about future change (Miller & Rollnick, 2002). In articulating a theory for MI, Miller and colleagues have stated that "1) The practice of MI should elicit increased levels of change and decreased levels of resistance from clients, 2) The extent to which clients verbalize arguments against change (resistance) during MI will be inversely related to the degree of subsequent behavior change, and 3) The extent to which clients verbalize change talk (arguments for change) during MI will be directly related to the degree of subsequent behavior change" Hettema, Steele, & Miller, 2005, p. 106).

Objective Prior research has established that lesbian, gay, and bisexual (LGB) people experience higher rates of childhood abuse compared to heterosexuals. However, there has been little research on the mental health impact of these experiences, or how race/ethnicity might influence prevalence and mental health impact of childhood abuse in this population. The study’s objective was to examine the relationships between race/ethnicity and childhood abuse and their effect on mental health indicators in a national sample of LGB adults. Method Participants were recruited via the internet using snowball and targeted sampling methods. 669 LGB adults, 21% of whom were people of color, participated in an online survey. Participants completed the Childhood Trauma Questionnaire-Short Form, the Center for Epidemiologic Studies Depression Scale, the Patient Health Questionnaire Generalized Anxiety Disorder Scale, the PTSD Checklist-Civilian Version, and the Perceived Stress Scale Short-Form. Results Latina/o and Asian American participants reported the highest levels of physical abuse (p < .01), and Latina/o and African American participants reported the highest levels of sexual abuse (p < .01). Childhood emotional abuse was the strongest predictor of current psychopathology symptoms for all participants (ps < .01). Relative to White participants, emotional abuse showed a stronger relationship with current PTSD and anxiety symptoms for African American participants (ps < .01), and physical abuse showed a stronger relationship with current PTSD and anxiety symptoms for Latina/o participants (ps < .05). Conclusions Findings suggest that race/ethnicity may be an important factor when examining childhood abuse and mental health correlates among LGB populations.

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