Providing culturally competent care to LGBT residents is an important area of concern in the current practice of long-term care (LTC) staff and providers. Existing literature shows thatLGBT residents are likely to face discrimination and suboptimal care in LTC facilities due to homophobia, transphobia, and heteronormative/cisnormative policies. This grounded theory study assessed the LGBT cultural competency that exists among staff working in LTC facilities, and provides a framework for understanding how their knowledge, skills, and attitudes with respect to LGBT residents are connected to their ability to care for those populations. The core category identified in this study was "staff sensitivity to minority sexual orientation and gender identity (SOGI) of residents." Main categories reflected the ways that competency, awareness, knowledge, experience with LGBT people, attitudes toward LGBT people, and current training needs reflect staff sensitivity to resident SOGI. Recommendations are made for training LTC staff to be sensitive to the particular needs of sexual and gender minorities in their facilities.

Affirmative therapy is a type of psychotherapy used to validate and advocate for the needs of sexual and gender minority clients. Therapists use verbal and nonverbal means to demonstrate an affirming stance toward lesbian, gay, bisexual, and transgender (LGBT) clients. Although this therapeutic approach can be used with LGBT individuals across the lifespan, the case presented in this paper highlights the benefit of using this approach with older LGBT individuals. Discussion of the unique challenges faced by older LGBT people will be followed with an illustrative case that shows ways that affirmative therapy can help individuals achieve greater self-actualization. The case formulation and conclusion will highlight specific ways that therapists can convey an affirmative stance and help clients feel welcome and accepted in the therapeutic setting. Recommendations for environmental cues, intake questions, and treatment skills will be offered at the conclusion.

ATTITUDES OF HETEROSEXUAL ASSISTED LIVING RESIDENTS TOWARD GAY AND LESBIAN PEERSSexual minorities in post-retirement care facilities fear discrimination and suboptimal care due to homophobia and heteronormative policies. This qualitative study explored the attitudes of 13 heterosexual assisted facility residents toward gay and lesbian peers in their facility. Although most participants reported that they were comfortable talking about homosexuality, the feelings, beliefs, and behaviors toward gay and lesbian residents that they described ranged from favorable, to ambivalent, to unfavorable.Results seemed to indicate that heterosexual residents still view sexual minorities as -others‖ who are unlikely to inhabit the same spaces they do. Recommendations for further research are provided in order to ameliorate the conditions of aged care facilities for all residents, including sexual minorities.iii

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Older adults who identify as lesbian, gay, or bisexual (LGB) or as transgender and gender nonconforming (TGNC) have often been considered an "invisible minority." Historically, research and clinical literature on aging has not typically acknowledged diversity in sexual orientation and gender identity. In turn, LGBT-related written work has not classically considered the experiences of LGBT adults in later life. Although recent years have brought about some progress, the older-adult LGBT population continues to be veiled throughout the literature, with neither clear identification or inclusion in aging publications nor direct recognition of their presence represented in the literature focusing on LGBT people.This increasingly growing group, however, can no longer be concealed, as current demographics project a significant growth in numbers for this population in coming decades. When looking at the most recent population-based Gallup survey of LGBT individuals, 3.4% of Americans overall identified as 10

It is widely understood that sexual minorities are at increased risk of substance use and dependence, and any clinical intervention must thoroughly assess these behaviors. In addition to the widely accepted role that prejudice, stigma, and discrimination may play in substance use, it is also imperative to understand the role(s) that normative antecedents play. Boyle, LaBrie, and Omoto provide a scoping review that illuminates what (little) is known regarding norms-focused research with lesbian, gay, bisexual (LGB) populations. Clinically, it is relevant to keep in mind that when addressing alcohol, tobacco, and other drug (ATOD) use with LGB clients, they may overestimate ATOD use among their peers, and this perceived norm of ATOD use may directly impact their own use. In addition, given that actual ATOD use norms are low when looking at the LGB population as a whole, psychoeducation is crucial in addressing these misperceptions that may be directly or indirectly contributing to current use patterns with LGB clients, particularly if their main reference points are nightlife settings, social media sites, and dating or hookup apps. A brief intervention such as personalized normative feedback may also be utilized to correct misperceptions, again with an eye toward decreasing problematic ATOD use with sexual minority clients. This research does not negate the role that sexual minority stress may also play in disproportionate substance use in LGB populations, but it adds to our understanding of the multilayered dynamic forces that must be addressed with respect to substance abuse treatment efforts.Rimes, Argyriou, Goldsmith, and Tsokos examined mediating variables between sexual minority status and depressive symptoms

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