Director of LGBTQ-Integrative Program M.A., Certified Sexuality Counselor, Certified Alcohol and Drug Counselor, and Licensed Professional Counselor Certified by the American Association of Sexuality Educators, Counselors and Therapists (AASECT) Adjunct at Hazelden Graduate School of Addiction Studies My role is 50% clinical and 50% outreach

LGBTQ Language Research Findings on LGBTQ Overview of LGBTQ-Integrative Treatment Model Preliminary Outcomes LGBTQ Services Outside of HSB

Health and Human Services uses LGBT as the agreed upon acronym in the United States. They don’t use GLBT, GBLT, LBGT, GLBTQ, LGBTQ, etc. LGBT stands for Lesbian, Gay, Bisexual, and Transgender.

Q represents the “continuums” Questioning clients represent a significant portion of those engaging in our program

How many people identify as LGBT? 3.4 percent of the U.S. adult population - more than 8 million people. (2012 Gallup report)

How many struggle with substance abuse? As much as percent of the LGBTQ community may struggle with substance use disorders (Substance Abuse and Mental Health Services Administration) - Compared with 10 percent of the population as a whole.

Data that informs our program

Hazelden’s Butler Center for Research study Statistical analysis of two samples of patients in adult residential treatment at Hazelden. Findings published in Research Update Article published in the current edition of Journal of Gay & Lesbian Social Services

Mean or average: LGBTQnon-LGBTQp = Number of detoxifications Number of inpatient CD episodes LGBTQ Research Findings

92% of LGBTQ clients have a co-occurring disorder Nearly twice as likely to report physical and emotional abuse Three times as likely to have a history of sexual abuse (48%) More likely to have polysubstance diagnoses LGBTQ Research Findings

Percent of patients with LGBTQnon-LGBTQp = Axis I disorder Depressive disorder Anxiety disorder Emotional abuse Physical abuse Sexual abuse Major Issues

Introducing the new model

Integrative – intending to unify separate things

Model suggests that LGBTQ and non-LGBTQ shared treatment experience is a critical asset… –If affirming policy and sexual health education are understood by staff and visible in the milieu

Hazelden’s Springbrook campus has been offering specialized services for LGBTQ-identifying clients for three years. LGBTQ Program Director role began in 2014 Formal program launch last month Program Background

Treatment Modalities

HSB’s LGBTQ-Integrative Treatment Bridging LGBT-Sensitive and LGBT-Affirming models, offering unmatched sensitivity for those early in the stages of “coming out” and in identity and relational conflict. Program equitably accommodates heterosexual and LGBTQ clients. LGBTQ groups with focus on dynamics of an integrated treatment environment. Sexual Health Education for entire community LGBTQ staff visible throughout multidisciplinary team. “Gay-affirmative straight clinicians.” Homophobia and heterosexism directly addressed through process work in community and ongoing policy change. Trauma and co-occurring disorders addressed as primary recovery concerns. Certified sexuality professional(s). Emphasis on Sexual Health Model over Sex Addiction Model. Treatment components reinforce the commonality all addicts share. Treatment components are client specific.

LGBTQ-specific groups Interventions across the multidisciplinary team Sexuality counseling Variety of curriculum Program Structure

Affirming policy backed by senior leadership Sexual health as a milieu intervention Strong regional LGBTQ bridging Specialized referral network Program Structure

Proven to reduce relapse and increase program completion Creates common ground, shared language Gets beyond “LGBTQ” to universal sex/drug linked relapse risks Connects recovery principles to LGBTQ / non-LGBTQ Gets information to closeted/questioning clients Weekly Sexual Health in Recovery Group

Sexual health bridges the gap between sensitive and affirming models LGBTQ or Sexual Health?

Ongoing research of LGBTQ population and development of evidence based practices Leading the system in implementation of sexual health curriculum Addressing higher incidence of trauma through integration with our trauma program Regular all-staff training in both LGBTQ and sexual health in recovery

LGBTQ-friendly policy, emphasizing non- discriminatory treatment of transgender clients Family and spiritual care staff with strong LGBTQ competency Certified Sexuality Counselor on staff Integration with LGBTQ community, from Twelve- Step meeting engagement to volunteer and sober community opportunities

Measuring program impact

Average Days in Treatment

More likely to Engage in Extended Care

Suggests Higher Abstinence Rates at 6/12 months

Living A Double Life Attempted Murder Drinking Ipecac, Receiving Electroshock “Trauma Re-enactment/Avoidance” “Sex Addiction” Case Examples

Extending our reach to LGBTQ patients

Throughout our system we emphasize the need for individualized treatment for all of our clients. In this way, the LGBTQ population receives treatment addressing their needs at all of our facilities.

Beaverton—LGBTQ outpatient services rolling out presently Center City—continues to develop its strong LGBTQ support for clients Betty Ford Center—currently developing LGBTQ- Integrative programming St Paul, Chicago, Plymouth, Naples, Chelsea and our other sites-continue to explore how to best meet LGBTQ clients needs

Access to Research Update on LGBTQ Links to podcast and video about LGBTQ program Overview of services across system Client/family/referent oriented Future training, including online offerings

A Provider's Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals (2001, SAMHSA/CSAT) BKD392: Cass, V.C., Homosexual identity formation: A theoretical model. Journal of Homosexuality 4(3): Coleman, E., Assessment of sexual orientation. Journal of Homosexuality 14:1-2 Coleman, E., 1981/1982. Developmental stages of the coming out process. Journal of Homosexuality 7(2/3):31-43 Kort, J. (2008). Gay affirmative therapy for the straight clinician: The essential guide. New York, NY: W. W. Norton & Company, Inc Ratner, E.F., T. Kosten, A. McLellan, April Treatment outcome of PRDI Institute patients: First wave-Patients admitted from September 1988 through February In: A.T. McLellan, (ed.) Outcome Report. Eden Prairie, MN: PRIDE Institute

Buster Ross LGBTQ Program Director