New Book an Insightful Guide to the Challenges Faced by LGBT Alcohol and Substance Abuse Patients and Counselors

When it comes to treating LGBT substance abuse know this: LGBT persons know they are the same but different from their straight counterparts.

While treatment and intervention for alcoholism and drug addiction in lesbian, gay, bisexual and trans patients often mirrors that offered to the general population, these services often do not train staff adequately about the complexity of the experiences, emotions and challenges faced by LGBT patients. Many times they sadly run the risk of being ineffective, counterproductive or even detrimental to recovery.

In “Fundamentals of LGBT Substance Use Disorders,” the new book released by Harrington Park Press (and distributed by Columbia University Press), the well-known and widely published clinician Michael Shelton sums up what is known about the prevalence of LGBT substance abuse and treatment, and emphasizes the importance of affirmative therapy practices — counseling that supports and embraces client sexual identity.

Michael Shelton’s “Fundamentals of LGBT Substance Use Disorders” continues the work begun by Dana G. Finnegan and Emily B. McNally, the married lesbian professional counseling couple widely considered pioneering heroes of LGBT substance abuse research and counseling. The Harrington Park Press book updates and modernizes an older out-of-print classic work by Finnegan and McNally, and includes a Foreword by both of them.

The book looks at not only how lesbians, gay men, bisexuals, and transgender individuals differ in their susceptibility to substance abuse, but stresses that treatment programs must consider many additional factors, including race, ethnicity, age, family relations, and place of residence in order to succeed.

The book is the first new comprehensive resource for LGBT substance abuse counselors to be released since a government-funded guide was released by SAMHSA (Substance Abuse and Mental Health Services Administration) sixteen years ago, in 2001.

In addition, there have been significant LGBT cultural victories since the publication of the earlier LGBT substance use disorder resources and, as well as more social and political tensions.

“Fundamentals of LGBT Substance Use Disorders” is an introduction, textbook, and handbook for LGBT-focused and general substance use disorder counselors. It synthesizes and summarizes optimum care guidelines, current terminology and sobering facts about substance abuse, most strikingly regarding those who identify as bisexual, who have the highest rates of alcoholism and substance abuse.

The following are a few key terms and facts from the book:

What to Look for in Effective LGBT Substance Abuse Treatment

LGBT people face barriers entering treatment, and challenges while in a treatment setting. These range from prejudicial and discriminatory treatment from staff and peers to “therapeutic neutrality.” This means being prescribed the same treatment regardless of sexual orientation or gender identity.

Below is a short list of key requirements LGBT people should look for when seeking effective substance abuse treatment.

  • LGBT-specific programs are available.
  • Treatment embraces “affirmative therapy” (see below).
  • Facility operates as a safe place for LGBT patients. Just one bad experience with a staff member or even a random person working in the same building is enough to destroy a clinic’s effectiveness and reputation in the LGBT community.
  • LGBT employees on staff: A clinic or program with no LGBT employees is a red flag and may not bode well for LGBT patient success.

Three Terms You Need to Know When Seeking LGBT Counseling

- Affirmative Therapy

-Trauma-Informed Care

-Cultural Competency

  • Affirmative Therapy recognizes, embraces and supports an individual’s self-identity, and operates on the principle that sexual orientation and gender identity are not the problems for LGBT persons, but societal heterosexism is.
  • Trauma-Informed Care takes into account the more-than-normal distress and suffering from upbringing or discrimination that may have led or encouraged LGBT persons to abuse substances or alcohol and then to seek treatment.
  • Cultural Competency means the treatment staff must have a special understanding and respect for LGBT cultural differences and experiences. They should provide an inclusive, safe (non-hostile) environment that may not exist in a program that is based on therapeutic neutrality (treating LGBT patients and non-LGBT patients in the same fashion).

“It’s Not Me, It’s You”: Heterosexism and 7 More Terms You May Have Heard but Not Considered Particularly Important

  • Minority Stress: Stress caused by just being a member of a minority group, mostly a result of everything on this list. Of course, every LGBT person belongs to more than one minority group.
  • Microaggressions: These are brief and commonplace verbal and behavioral indignities made towards LGBT people (and other minorities). They can be more damaging than overt expressions of bigotry precisely because they are small, and therefore often ignored or downplayed.

Microaggressions lead the victim to feel self-doubt rather than justifiable anger, and isolated rather than supported.

There are three types of microaggressions: Microassaults (verbal attacks that can include slurs, bullying, and hate speech); Microinsults (rudeness and insensitivity that demean a person’s heritage or identity; an example is “forgetting” to use a trans person’s preferred name or gender pronoun); Microinvalidations, which are interactions that exclude, negate, or nullify a person’s thoughts or feelings. An example might be a straight person stating or implying that minority stress does not exist, offering the platitude: “We are all human beings.”

  • Social Stigma: Extreme disapproval of a person or group based on stereotypes to segregate them from the larger society.
  • Stigma Consciousness: The chronic expectation/fear of being stereotyped by others.
  • Stereotype Threat: The fear of being seen through the perspective of a negative stereotype or of doing something that would inadvertently confirm that stereotype. The MTV short film “American Male” is a good, though exaggerated, example.
  • Heteronormativity: The belief that hetero is not only bettero, but is the only normal sexual orientation.
  • Heterosexism: The “enforcement” of heteronormativity in a clinic or group setting. Heterosexism hurts just as much as other negative “isms: — racism, sexism — but is the expression of heteronormativity (“only heterosexuals are normal”) through discrimination.
  • Implicit Bias: Even if someone feels he or she is not biased, he or she actually is. Examples are assuming a Latina works as a maid, that the black man wearing a hoodie is a thug, or that all gay men are diseased or effeminate.

Five Not-So-Fun Facts about LGBT Substance Abuse

  • Bisexuals make up the largest single population in the LGBT community, have the most practical troubles, and are most susceptible to substance use disorder issues. Yet they remain the least researched and least understood. In more than one study, the odds of substance misuse for bisexual youth were 340% higher than for heterosexual youth.
  • Two-thirds of LGBT people experience at least one of three forms of discrimination based on sexual orientation, gender identity and race. Substance abuse is four times greater among those who experience all three types of discrimination, than those who experience none.
  • LGBT men and women demonstrate a smaller decline (or none at all) in substance use as they age, in contrast to heterosexuals, who typically reduce or end their substance use as they get older.
  • Baby Boomers represent the fastest-growing group in need of substance abuse care.
  • Most gay men and lesbians do not have a substance use issue, although their risk is elevated in comparison to that of heterosexuals. •

Author and publisher details on the following page.

Fundamentals of LGBT Substance Use Disorders
 Michael Shelton
 November 8, 2016
 Harrington Park Press
 Distributed by Columbia University Press
 ISBN: 9781939594112 paper
 Available at Amazon, Amazon UK, Harrington Park Press

Download 300dpi cover image.

 Michael Shelton has previously served as a board member for NALGAP (National Association of Lesbian, Gay, Bisexual, Transgender Addiction Professionals and Their Allies). Among his previous books are Gay Men and Substance Abuse: A Basic Guide for Addicts and Those Who Care for Them, which was awarded Best LGBT Book of the Year by the Independent Book Publishers Association, and Family Pride: What LGBT Families Should Know About Navigating Home, School, and Safety in Their Neighborhoods.

 Harrington Park Press is a specialized academic/scholarly book publisher devoted to emerging approaches to LGBTQ diversity, equality, and inclusivity. Harrington Park Press is distributed internationally by Columbia University Press.