Lesbian, Gay, and Bisexual Clients' Experiences in Treatment for Addiction

Abstract

This study examined the extent to which lesbian, gay, and bisexual clients perceived their addiction counselors and treatment programs to be sensitive to issues related to sexual orientation. The experiences they considered most successful were reported as more affirmative than experiences they considered least successful; however, in neither situation were counselors or treatment programs consistently affirmative.

Inviting the Significant Other of LGBT Clients into Substance Abuse Treatment Programs: Frequency and Impact

“…It is therefore not surprising that there have been so few studies regarding inviting the partners or significant others of LGBT clients into treatment. A number of studies have indicated that LGBT individuals may have more difficult treatment experiences and/or poorer outcomes in substance abuse treatment than do heterosexual clients (Chaiken 1995;Cullen 2004;MacEwan 1994;Matthews and Selvidge 2005;Senreich 2009a). Clinically focused authors have suggested that LGBT clients may feel less supported by staff and clients while in treatment than do heterosexual clients and feel a lack of connection to the treatment program (Cheng 2003;Drabble and Underhill 2002;Finnegan and McNally 2002;Hicks 2000;Kominars and Kominars 1996;Neisen 1997;SAMHSA 2001).…”

Differences in Outcomes, Completion Rates, and Perceptions of Treatment Between White, Black, and Hispanic LGBT Clients in Substance Abuse Programs

“…Part of the reason for this is that only a limited number of empirical studies have been performed concerning the outcomes, completion rates, and/or experiences of LGBT clients in substance abuse treatment, with the vast majority of them having utilized small samples with mostly white participants (Chaiken, 1995;Cochran, 2004;Crosby, Stall, Paul, & Barrett, 2000;Cullen, 2004;Cwiak, 2004;Driscol, 1982;MacEwan, 1994;Matthews & Selvidge, 2005;Paul, Barrett, Crosby, & Stall, 1996).…”

The Effects of Honesty and Openness About Sexual Orientation on Gay and Bisexual Clients in Substance Abuse Programs

“…Gay/bisexual clients often enter substance abuse treatment with a lifetime of experience determining when it is safe or not safe to reveal their sexual orientation to others. If they perceive that the treatment environment is not sensitive to their needs or even dangerous for a gay/bisexual individual to be honest and open about their sexual orientation, then it may be difficult for them to do the necessary exploration of their personal issues in order to recover from their substance misuse (Barbara, 2002;Cabaj, 1995;Cheng, 2003, Drabble & Underhill, 2002, Hicks, 2000Matthews & Selvidge, 2005;Neisen, 1997; Substance Abuse and Mental Health Services Administration [SAMHSA], 2001;Warn, 1997). Counselors in substance abuse programs are often poorly trained in the specific issues of working with gay/bisexual clients and may have homophobic attitudes (Anderson, 1996;Cabaj, 2000;Cheng, 2003;Neisen, 1997;Rathbone-McCuan & Stokke, 1997).…”

“…The first focuses on the use of substances by gay/ bisexual individuals as often connected to social and sexual aspects of their lives. In such instances, this connection needs to be dealt with as an important component of strategies for becoming clean and sober, as well as in regard to relapse prevention (Barbara, 2002;Beatty et al, 1999;Cabaj, 1997;Hicks, 2000;Matthews & Selvidge, 2005;Warn, 1997;Weinberg, 1994). For gay/bisexual men in particular, the use of substances may be strongly associated with promiscuous sexual activities, both as a way to decrease the stress of finding and becoming quickly involved with sexual partners and as a way to enhance the sensations of the sexual encounter (Cabaj, 2000;Green, 2003;Hicks, 2000;Kurtz, 2005;Loue, 2002;SAMHSA, 2001;Senreich & Vairo, 2004;Warn, 1997).…”

“…Trying to discuss such issues in individual and group therapy settings in environments that are insensitive or even hostile to the needs of gay/ bisexual clients may be nearly impossible. Second, numerous authors have suggested that substance use among gay/bisexual individuals may be a strategy to cope both with the stresses of societal discrimination against them, and more significantly as a way to quell "internalized homophobia," that is, the feelings of shame they have adopted as a result of societal negativity expressed toward the gay/bisexual population Downloaded by [Michigan State University] at 11:27 26 December 2014 (Anderson, 1996;Beatty et al, 1999, Cabaj, 2000Kus & Latcovich, 1995;Kus & Smith, 1995;Loue, 2003;Matthews & Selvidge, 2005;Drabble & Underhill, 2002;Neisen, 1997;Rathbone-McCuan & Stokke, 1997;Warn, 1997). If the substance abuse treatment environment duplicates societal homophobic attitudes, then clients' internalized homophobia may be reinforced, rather than ameliorated.…”