This article was first published in Prevention Pipeline, a publication of the Substance Abuse & Mental Health Services Administration

Drabble, Laurie A

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San Jose State University

Training providers: Working with lesbian clients.

SJSU ScholarWorks

San Jose State UniversitySJSU ScholarWorksFaculty Publications Social Work9-1-1999Training providers: Working with lesbian clients.Laurie A. DrabbleSan Jose State University, laurie.drabble@sjsu.eduFollow this and additional works at: https://scholarworks.sjsu.edu/social_work_pubPart of the Social Work CommonsThis Article is brought to you for free and open access by the Social Work at SJSU ScholarWorks. It has been accepted for inclusion in FacultyPublications by an authorized administrator of SJSU ScholarWorks. For more information, please contact scholarworks@sjsu.edu.Recommended CitationLaurie A. Drabble. "Training providers: Working with lesbian clients." Prevention Pipeline (1999): 12-13.Training Providers By Laurie Drabble Editors note: This article is basedon iJ!formationpresentedbyLaurie Drabble in herposter session at SAMHSA s 2nd National Conftrence on WOmen. Drabble is a consultant basedin northern California. She is theformer executive director ofthe California WOmen s Commission on AlcoholandDrugAbuse. She can be reachedby e-mailat LADrabble@aol. com populations of women and girls in prevention, treatment, and health settings. The presentation focused on resources for advancing services to lesbians by training providers. Specifically, the session pro­vided an overview of a training curriculum that is used by Progres­sive Research and Training for Action (PRTA) for enhancing substance r----------------------------------------------- abuse preven-Sensitivity training is a critical component for tion and ensuring quality treatment and prevention treatmentservices for Lesbian, Gay, Bisexual, and services to Transgender People A!esbian enters a treatment program and is told that he is welcome but that she should keep her sexuality to herself and avoid mentioning her partner to other program participants. An­other young lesbian at risk for alcohol and drug problems doesn't feel safe or welcome to participate in a local mentoring program for girls because she is fearful of being rejected from the program staff or potential mentor. At the same time, she is forced by her family to seek counseling to "fix the problem" of her attraction to other girls. Such obstacles do much more harm than good in helping lesbians at risk for substance abuse. CSAP's Prevention Primer (1994) expresses the problem well: "Efforts that are not affirming of gay, lesbian, and bisexual persons are not only nonproductive, they may increase problems." A poster session presentation at the recent SAMHSA 2nd National Conference on Women underscored the importance of integrating sexual orientation into overall efforts to address the needs of diverse 12 Prevention Pipeline lesbian, gay, bisexual, and transgender (LGBT) communities throughout California. The session also highlighted other resource documents and training materials for enhancing access to health and substance abuse services for lesbians. Alcohol and Drug Problems Recent studies suggest that lesbians drink more, and more often, than heterosexual women, but the increase is at moderate, not heavy, levels of drinking. These studies also suggest that there is less of a "gap" in drinking behav­iors between lesbians and gay men than is apparent between women and men in the heterosexual population. Use of tobacco and other illicit drugs (particularly for marijuana and cocaine) appears to be higher among lesbian than heterosexual women. For example, Elisabeth Gruskin, a researcher at Kaiser Permanente Medical Center in Oakland, CA, examined data from a survey ofKaiser members and found that younger lesbians and bisexuals were more likely to drink alcohol and smoke than their heterosexual counterparts. She points out that these behaviors represent important health risks for lesbians. Future research is needed to examine theories posited by researchers and practitioners to explain higher reports of alcohol­related problems and higher overall consumption of alcohol and other drugs among lesbians, gay men, and bisexuals. Internalized ho­mophobia, stresses related to the coming out process, and external homophobia (including lack of awareness on behalf of treatment agencies) have all been cited as possible contributors to alcohol problems. Researchers T.L. Hughes and Sharon Wilsnack suggest that lesbians might be disproportion­ately affected by certain risk factors that correlate to alcohol consump­tion among women in general (Journal ofOrthopsychiatry, 1997). These include problems related to underemployment, job discrimina­tion, stresses related to multiple roles and family conflict, tenden­cies to engage in drinking behaviors that parallel significant others, and reduction of factors thought to protect heterosexual women (for example, traditional roles and childbearing). Explanations of substance abuse and other problems among lesbian and gay youth vary, as do explana­tions ofproblems in adults. For example, one study found that many lesbian and gay youth have experienced verbal and physical abuse from family members and peers (Journal ofConsulting and Clinical Psychology, Vol. 62, No. 2, 1994). Other studies have found that lesbian, gay, and bisexual youth are often neglected by schools; social service or health agencies serving high-risk youth; and by lesbian, gay, bisexual, and transgender (LGBT) civil rights and service organizations. Sensitivity Training "Training is one critical compo­nent of an overall strategy for ensuring quality services for lesbians," says Brenda Underhill, author of Creating f/isibility: Providing Lesbian-Sensitive and Lesbian-Specific Alcoholism Recovery Services. "Training increases the sensitivity and skills of individual providers and can open the door to organizational changes that can create a more welcoming environment." Some of the organizational and systems strategies for which Underhill advocates include hiring openly lesbian staff, institutionaliz­ing training on sexuality and diversity issues, and creating or confirming agency policies regard­ing freedom from discrimination or harassment based on sexual orientation, gender, and cultural background. She also suggests a review of all operational procedures such as initial phone contact, service activities and communica­tions materials to ensure that "heterosexual bias" (an assumption that participants are heterosexual) have been eliminated. Nancy Ferreyra, director of Progressive Research and Training for Action (PRTA) in Oakland, CA, says that "people who have partici­pated in our trainings report being better prepared to work with lesbian, gay, bisexual, and transgender clients and better prepared to link with existing resources." She points to the importance of these issues by citing results of a survey of 397 training recipients. The survey included an open­ended question inviting respondents to identify the three top unmet needs in their community. The two top issues identified were the need for increased LGBT -specific alcohol and drug services and a need for increased professional awareness and training. Key components of the training to enhance services for LGBT communities address issues of sexuality, substance abuse in LGBT communities, counseling skills, organizational issues, and ways to access resources. Participants are given an opportunity to gain information, learn new skills, ask questions, and examine their own assumptions and practice through presentations, experiential exer­cises, and facilitated discussion. PRTA also provides specialized technical assistance and training, including in-service trainings for women's treatment organizations on creating lesbian-sensitive services. Recently, PRTA has begun provid­ing training and assistance to LGBT organizations interested in develop­ing specialized prevention initia­tives in their local communities, including environmental prevention of alcohol problems and alternative activities for LGBT youth. Resources available from PRTA include: • 	 Opportunity and f/isibility: Providing Culturally Competent Treatment, Prevention and Recovery Services for Lesbian, Gay, Bisexual, and Transgender People. (This is a curriculum for a 1-day training developed under contract with the Califor­nia Department of Alcohol and Drug Programs.) • 	 Creating f/isibility: Providing Lesbian-Sensitive andLesbian­Specific Alcoholism Recovery Services. (This is a training curriculum project of the Alcoholism Center for Women, Los Angeles, CA by Brenda L. Underhill, MS, CAC.) • 	 Ethical Funding for Lesbian, Gay, Bisexual, Transgender and HIVIA.IDS Community-Based O~ganizations: Practical Guidelines When Constdering Alcohol, Tobacco, andPharma­ceutical fonding. (This preven­tion resource was developed by Laurie Drabble, MSW, MPH.) • 	 LGBTSubstance Abuse Re­source List. For further information contact: Progressive Research and Training for Action, 440 Grand Ave, Suite 401, Oakland, CA 94610. Tel: 510­465-0547; Fax: 510-465-0505; TDD: 510-465-2888. September/October 1999 13 

Drabble, Laurie

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Training providers: Working with lesbian clients.

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