Transcript SESSION # 4: OVERVIEW OF TREATMENT APPROACHES, MODALITIES

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
Unifying science, education and services to transform lives.
Learning Objectives
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Understand special issues in
working with LGBT clients
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Understand levels of care and
modalities
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Know guidelines for insuring
accessibility and LGBT–
affirmative treatment
A Provider’s Introduction to Substance Abuse for LGBT Individuals
PowerPoint Slide # 4-1
Module 4 Treatment Approaches
Unifying science, education and services to transform lives.
Approaches, Levels and
Continuum of Care, and Access to
Treatment
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Treatment-readiness approaches
– Sexual orientation and gender identity issues
– Coming out
– Social stigma and discrimination
– Health concerns, such as HIV/AIDS
– Homophobia and heterosexism
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Level of care
– Residential vs outpatient
– LGBT community based support services
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Continuum of care
LGBT specific versus mainstream
A Provider’s Introduction to Substance Abuse for LGBT Individuals
PowerPoint Slide # 4-2
Module 4 Treatment Approaches
Unifying science, education and services to transform lives.
LGBT Client Do's and Don'ts
• Staff Sensitivity
o Knowledge, skills, and attitudes
• Assessment Practices and
Issues
• Facilities and Modalities
o For example, room assignments and
shared bathrooms
o Individual, group, and family
interventions
• Discharge and Aftercare
A Provider’s Introduction to Substance Abuse for LGBT Individuals
PowerPoint Slide # 4-3
Module 4 Treatment Approaches
Unifying science, education and services to transform lives.
Defining
Care
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LGBT-tolerant
Aware that LGBT people exist and use their services
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LGBT-sensitive
Aware of, knowledgeable about, and accepting of LGBT
people
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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
Unifying science, education and services to transform lives.
Special Assessment Questions
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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
Unifying science, education and services to transform lives.
Modalities
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Group counseling
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Family counseling
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Individual counseling
PowerPoint Slide # 4-6
A Provider’s Introduction to Substance Abuse for LGBT Individuals
Module 4 Treatment Approaches
Unifying science, education and services to transform lives.
Research based Interventions
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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)
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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
Unifying science, education and services to transform lives.
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
Unifying science, education and services to transform lives.
References and
Further Resources
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SAMHSA's Substance Abuse Treatment Locator www.findtreatment.samhsa.gov
SAMHSA National Helpline (for locating drug and alcohol abuse treatment programs)
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National Runaway Switchboard (Youth)
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(800) 662-HELP (4357) (English and Espanol)
(900) 487-4889 (TDD)
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/
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"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