Lgbt - Naadac

Lgbt - Naadac

SPECIALIZING IN LGBTQ TREATMENT Presented at NAADAC, 2014 Seattle, WA MONICA OCONNELL, MA, L M F T, L A D C , B E H A V I O R A L H E A LT H S U P E R V I S O R A T P R I D E I N S T I T U T E I N M I N N E S O TA A BIT ABOUT PRIDE INSTITUTE

WHO WE ARE For over 28 years, PRIDE Institute has *exclusively* helped the LGBTQ population through substance abuse and mental health treatment programs. Located just 10 miles from the Minneapolis city center, PRIDE takes a holistic approach in serving the LGBTQ population, offering Dual Diagnosis licensure, 24-hour nursing care in a serene, retreat-like setting with a nationally recognized clinical staff.

In addition, we are a renowned teaching facility with an average of 8 interns on staff at all times Monica OConnell MA, LMFT, LADC Mental Health Supervisor, PRIDE Institute EMDR trained therapist & consultant in training A BIT ABOUT PRIDE INSTITUTE

Our treatment program is preferable to one-size-fitsall, mainstream programs that do not understand or address issues specific to LGBT

individuals. Contact PRIDE Institute at 1-800-547-7433 www.pride-institute.com OFFERING TRAUMA-INFORMED CARE

Specializing in Crystal Meth and Sexual Compulsivity programming Body Image Sexual Health program HIV/AIDS Programming 3 day Family immersive weekend PRIDE Sober Support Program.

OBJECTIVES Understanding LGBTQ inclusive identification and terminology Discuss impact of trauma (e.g., internalized homophobia, micro-aggressions, bullying) on LGBTQ clients and their resulting chemical use. Identify best practices to serve the LGBTQ community, including specialized and exclusive

services. JUST THE FACTS 30-40% of the LGBT Community is addicted, in contrast to 10 percent of the population at large 46% of lesbian and gay men in treatment have had homophobic therapist 34% felt their sexuality was seen as irrelevant 7% had therapist who made openly negative

comments about their sexuality LGBTQ Definitions: Lesbian, Gay, Bisexual, Trans*, Queer Understanding Clients:

gender sexuality expression

DEFINING TRANSGENDER Transgender is an umbrella term for people whose gender identity differs from what is typically associated with the sex they were assigned at birth Being transgender is not dependent on medical procedures or the taking of hormones

TERMINOLOGY 1.Assigned Sex at Birth: a person's sex is determined by a number of factors not simply genetics - and one's biology does not "trump" one's gender identity. People are born babies - they are not "born a man" or "born a woman. 2.Transgender: people whose gender identity, expression or behavior is different from those typically associated with their assigned sex at birth. 3.Cisgender: A term used by some to describe people who are not transgender. "Cis-" is a Latin prefix meaning "on the same side as," and is therefore an antonym of "trans-."

4.Gender Non-conforming: individuals whose gender expression is different from societal expectations related to gender. PRONOUNS Trans Woman: trans individual that identifies as a woman Trans Man: trans individual that identifies as a man Genderqueer: used by some individuals who identify as neither entirely male nor entirely female Two Spirit: People who display characteristics of both male

and female genders. Sometimes referred to as a third gender the male-female gender. The term is derived from the traditions of some Native North American cultures. LGBTQ, TRAUMA & ADDICTION High incidence of trauma in LGBTQ community Increased rates of trauma for LGBTQ individuals who use chemicals.

Trauma and addiction memories LGBTQ-SPECIFIC TRAUMA IMPRINTS Heterosexism Bullying Attachment injuries related to identity within the LGTBQ community Homophobia Transphobia

Internalized Homonegativity CHEMICAL USE STARTING AS A SOLUTION Clients describe use memories and earliest use periods to include reasons such as: Then I could fit in. I was so isolated and this helped me feel

numb. It was the first time I felt like I was attractive and could really be free to be myself. PRIMARY GOAL OF TREATMENT IS TO CREATE CLIENT SAFETY Trauma-informed Care Addressing Internalized Homonegativity Creating an environment of inclusion through LGBTQinformed & specialized care

Mental Health Shame Body image Healthy relationship models TREATMENT INTERVENTIONS Creating community through LGBTQ exclusive environment and addressing: Sexual Health

Trauma Mental Health Shame Body image Healthy relationship models SEXUAL HEALTH And the necessity of

Re-introducing intimacy definitions Sex Positive experiences & conversations Emphasis on re-defining sexual health TRAUMA Helping clients understand trauma Big T trauma; little t trauma; community violence and trauma Trauma occurrence during

developmental tasks Coming out stories Family response to identification in the community MENTAL HEALTH Understanding the impact of mental health on the LGBTQ community and chemical health

Examining mental health diagnosis and the LGBTQ community Early diagnosis vs. coming out stories Chemical use induced symptoms vs mental health Complex trauma vs. Axis II diagnosis BODY IMAGE

Impact of culture on body image Understanding body/gender dysphoria Use of chemicals in reference to body image HEALTHY RELATIONSHIPS Defining Self within relationships Allowing Clients to define Family & Relationships

LGBTQ CONSIDERATIONS Inclusive lodging (bedrooms, gender neutral bathroom facilities) Informed paperwork and assessment questions Addressing family of origin & family of choice

EXCLUSIVE & INCLUSIVE TREATMENT MODELS Priority placed on meeting the clients specific needs. Creating safety in client groups and relationships. Easier in exclusive environments In an inclusive environment, institution needs to address heterosexual

privilege and its presence in groups EXCLUSIVE & INCLUSIVE TREATMENT MODELS LGBTQ-informed Staff Starting at intake Specific LGBTQ training Trans* specific education

WHAT IS HETEROSEXISM System of attitudes, bias, and discrimination in favor of opposite-sex sexuality and relationships. Where being heterosexual is the norm. What is Heterosexual Privilege? Can you give examples of Heterosexual Privilege?

EXAMPLE OF HETEROSEXISM Assuming everyone is heterosexual. Discrimination against lesbians, gays and bisexuals. Assuming heterosexual norms apply to all people, relationships and situations.

PRIVILEGE White Privilege Male Privilege Female Privilege Straight Privilege Other Privilege lists: http://www.amptoons.com/blog/archives/2006/09/26/a-list-of-privilege-lists/ BODY IMAGE

Understanding Body/Gender Dysphoria in the Trans* community Use of drugs & alcohol in reference to body image Understanding the culture of body image and how it relates to LGBT individuals GRIEF AND LOSS

Rejection of family/friends Sexual abuse/violence

Unspeakable deaths Loss of Relationships Loss of self Death of significant people/pets Loss of community Loss due to sobriety ANXIETY AND DEPRESSION LGB individuals have higher rates of co-occurring

disorders than heterosexual individuals 62% of Transgender people have experienced depression 41% of Trans* people have attempted suicide in comparison to 1.6% of the general population Understanding the brain chemistry as well as the environmental struggles of anxiety & depression SHAME

Shame corrodes the very part of us that believes we are capable of change. -Brene Brown Understanding how shame keeps us isolated and addicted SEXUAL HEALTH Importance of talking about sex in treatment Struggles with/and understanding Intimacy

Sexual Compulsion Sexual Anorexia Setting specific goals with regards to sex and relationships with a sex-positive approach TRAUMA Fear of violence Sexual violence/abuse

Bullying Physical violence/abuse Emotional abuse Domestic violence/abuse

Effects of Invisibility Institutionalized Harassment RESOURCES TransMontana by Roberta Zenker Second Son by Ryan Sallans My Gender Workbook by Kate Bornstein

A Queer and Pleasant Danger by Kate Bornstein Transgender History by Susan Stryker Running on a Mind Rewired by Nate Cannon Trans (Documentary) Just Gender (Documentary) QUESTIONS? REFERENCES

www.itspronouncedmetrosexual.com www.avp.org www.fenway.org www.nalgap.org www.runningrewired.com www.transmontanathebook.com

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