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Module 4: An Overview of Treatment Approaches, Modalities, and Issues of Accessibility in the Continuum of Care

Module 4: An Overview of Treatment Approaches, Modalities, and Issues of Accessibility in the Continuum of Care. A Provider’s Introduction to Substance Abuse for Lesbian, Gay, Bisexual, and Transgender Individuals First Edition. Learning Objectives.

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Module 4: An Overview of Treatment Approaches, Modalities, and Issues of Accessibility in the Continuum of Care

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  1. Module 4:An Overview of Treatment Approaches, Modalities, and Issues of Accessibility in the Continuum of Care A Provider’s Introduction to Substance Abuse for Lesbian, Gay, Bisexual, and Transgender Individuals First Edition

  2. Learning Objectives • Understand special issues in working with LGBT clients • Understand levels of care and modalities • Know guidelines for insuring accessibility and LGBT– affirmative treatment PowerPoint Slide # 4-1 A Provider’s Introduction to Substance Abuse for LGBT Individuals Module 4 Treatment Approaches

  3. Approaches, Levels and Continuum of Care, and Access to Treatment • Treatment-readiness approaches • Sexual orientation and gender identity issues • Coming out • Social stigma and discrimination • Health concerns, such as HIV/AIDS • Homophobia and heterosexism • Level of care • Residential vs outpatient • LGBT community based support services • Continuum of care LGBT specific versus mainstream PowerPoint Slide # 4-2 A Provider’s Introduction to Substance Abuse for LGBT Individuals Module 4 Treatment Approaches

  4. LGBT ClientDo'sandDon'ts • Staff Sensitivity • Knowledge, skills, and attitudes • Assessment Practices and Issues • Facilities and Modalities • For example, room assignments and shared bathrooms • Individual, group, and family interventions • Discharge and Aftercare PowerPoint Slide # 4-3 A Provider’s Introduction to Substance Abuse for LGBT Individuals Module 4 Treatment Approaches

  5. Defining Care LGBT Affirmative • LGBT-tolerant Aware that LGBT people exist and use their services • LGBT-sensitive Aware of, knowledgeable about, and accepting of LGBT people • LGBT-affirmative Actively promote self-acceptance of an LGBT identity as a key part of recovery PowerPoint Slide # 4-4 A Provider’s Introduction to Substance Abuse for LGBT Individuals Module 4 Treatment Approaches

  6. Special Assessment Questions • Level of comfort being LGBT person ? • Stage of coming out ? • Family/support/social network ? • Health factors ? • Milieu of use ? • Drug use and sexual identity or sexual behavior connections ? • Partner/lover use ? • Legal problems related to sexual behavior ? • Gay bashing ? • Same-gender domestic violence ? • Out as LGBT in past treatment experiences ? • Correlates of sober periods ? PowerPoint Slide # 4-5 A Provider’s Introduction to Substance Abuse for LGBT Individuals Module 4 Treatment Approaches

  7. Modalities • Group counseling • Family counseling • Individual counseling PowerPoint Slide # 4-6 A Provider’s Introduction to Substance Abuse for LGBT Individuals Module 4 Treatment Approaches

  8. Research based Interventions • PROP (Positive Reinforcement Opportunity Project • low-intensity contingency management intervention in both outpatient and community settings • Preliminary efficacy at reducing methamphetamine use (Shoptaw et al, 2006) • Gay Specific CBT Groups (Shoptaw, 2005) • Significantly reduced depressive symptoms in sample of methamphetamine-dependant gay and bisexual men A Provider’s Introduction to Substance Abuse for LGBT Individuals Module 4 Treatment Approaches

  9. Case Example: RUTH (a) What key recovery issues is Ruth facing? (b) What issues is Ruth facing that are particular to her identity as a lesbian? (c) What kind of interventions would you suggest if you were her counselor? PowerPoint Slide # 4-7 A Provider’s Introduction to Substance Abuse for LGBT Individuals Module 4 Treatment Approaches

  10. References and Further Resources • SAMHSA's Substance Abuse Treatment Locatorwww.findtreatment.samhsa.gov • SAMHSA National Helpline (for locating drug and alcohol abuse treatment programs) • (800) 662-HELP (4357) (English and Espanol) • (900) 487-4889 (TDD) • National Runaway Switchboard (Youth) • It’s anonymous, confidential and free. 1-800-RUNAWAY. • AIDS Info 800-874-2572 9:00 a.m.-7:00 p.m. Spanish-speaking operators available.www.aidsinfo.nih.gov • CDC National STD/AIDS Hotline 800-227-8922 English (STD) 800-342-2437 English (AIDS) 800-344-7432 (Spanish) 800-243-7889 (TDD) English: 24 hours/7 days a week; Spanish: 8 a.m.-2 a.m., 7 days a week (eastern time); TTY: 10:00 a.m.-10:00 p.m., Monday- Friday (eastern time)www.ashastd.org/nah/index.html • Project Inform National HIV/AIDS Treatment Hotline 800-822-7422 9:00 a.m.-5:00 p.m., Monday-Friday (Pacific time) 10:00 a.m.-4:00 p.m., Saturday (Pacific time) Spanish-speaking operators available.www.projinf.org • Gay and Lesbian Medical Association http://glma.org/ • "Resources for Patients" to access the LGBT-friendly physician database, list of important things to discuss with your health care provider, and information on hepatitis and depression. A Provider’s Introduction to Substance Abuse for LGBT Individuals Module 4 Treatment Approaches

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