Ashley Austin

Effective Family-Based Interventions for Adolescents With Substance Use Problems: A Systematic Review

Objective: This article is a systematic review identifying effective family-based interventions for adolescent substance use problems. Method: A substantive review of each intervention is conducted using guidelines for effective treatment for substance use problems. Additionally, a methodological review of each study is done using criteria for empirically validated treatments. Results: Treatment components of five interventions—Brief Strategic Family Therapy (BSFT), Family Behavior Therapy, Functional Family Therapy, Multidimensional Family Therapy (MDFT), and Multisystemic Treatment—were consistent with a majority of guidelines for effective treatment. Notable exceptions include no aftercare and poor treatment retention. MDFT and BSFT met criteria of probably efficacious treatment, whereas the other interventions represented promising treatments. Moreover, MDFT demonstrated clinically significant changes in substance use and large effect sizes at posttreatment and follow-up. Conclusion: To increase provision of effective adolescent substance abuse treatment, social workers should use these research findings to guide implementation.

Promoting Self-Efficacy and Self-Esteem for Multiethnic Sexual Minority Youth: An Evidence-Informed Intervention

ABSTRACT Sexual minority youth face multiple challenges, yet research regarding evidence-informed practice strategies for this population is limited. This study describes the pilot efforts of Strengths First, the first strengths-based intervention created specifically to promote self-esteem and self-efficacy among multiethnic sexual minority youth. A pretest–posttest design was used to gather preliminary data from program participants (n = 162) about the potential effectiveness of the program during a 2-year period that ranged from the inception of the program in June 2008 to September 2010. Significant increases in self-esteem and self-efficacy were found. Implications for social service research and practice are discussed.

Treatment Attrition Among Racial and Ethnic Minority Youth

This study examined the predictors of treatment attrition among racial and ethnic minority adolescents from South Florida participating in treatment for substance use problems (N= 453). The influences of individual, social, cultural, and treatment factors on treatment attrition were explored within 3 racial and ethnic subgroups of adolescents. Multivariate logit analyses were conducted within each racial and ethnic subgroup. Specific factors differentially predicted attrition within each racial and ethnic subgroup and African American youth were more than twice as likely as their Hispanic counterparts to leave treatment prematurely. Findings underscore the importance of identifying and understanding unique treatment needs of racial and ethnic minority youth with substance use problems.

The Impact of Social Connectedness and Internalized Transphobic Stigma on Self-Esteem Among Transgender and Gender Non-Conforming Adults

ABSTRACT The transgender and gender non-conforming (TGNC) community continues to represent a notably marginalized population exposed to pervasive discrimination, microaggressions, and victimization. Congruent with the minority stress model, TGNC individuals persistently experience barriers to wellbeing in contemporary society; however, research uncovering resilience-based pathways to health among this population is sparse. This study aimed to explore the impact and interaction between internalized transphobic stigma and a potential buffer against minority stress—social connectedness—on the self-esteem of TGNC identified adults. Data were collected from 65 TGNC identified adults during a national transgender conference. Multiple regression analysis reveals that self-esteem is negatively impacted by internalized transphobia and positively impacted by social connectedness. Social connectedness did not significantly moderate the relationship between internalized transphobia and self-esteem. Micro and macro interventions aimed at increasing social connectedness and decreasing internalized transphobic stigma may be paramount for enhancing resiliency and wellbeing in the TGNC community.

Toward Transgender Affirmative Social Work Education

ABSTRACT Social work has professional and academic standards consistent with transgender affirmative education and practice. Nevertheless, a growing body of research suggests that transgender issues are largely absent from social work education, resulting in practitioners who are uninformed or biased against transgender issues. The present study expands the literature through a mixed methods study exploring perceptions of transgender issues in social work education from the perspectives of transgender social work students (n = 97). Quantitative and qualitative analyses reveal barriers to transgender affirmative social work education including (1) transphobic microaggressions within classroom and field settings, (2) the absence of transgender specific education and expertise, and (3) the general lack of visibility of transgender issues. Recommendations for transgender affirmative social work education are provided.

Support, Discrimination, and Alcohol Use Among Racially/Ethnically Diverse Sexual Minority Youths

Rates of alcohol use for sexual minority youths are nearly twice that of their heterosexual peers, yet specific risk and protective factors associated with alcohol use among sexual minority youths remain unclear. Structural equation modeling is used to examine relations among alcohol use, peer and family support, and discrimination among 207 diverse sexual minority youths. Discrimination had no relationship to alcohol use; however, it was negatively associated with peer and family support. Peer support was associated with greater alcohol use among bisexual youths. This study adds to our understanding of the roles of discrimination, social support, and alcohol use among diverse sexual minority youths.

Affirmative Cognitive Behavior Therapy with Transgender and Gender Nonconforming Adults

Although there is growing awareness in contemporary society regarding transgender and gender nonconforming (TGNC) identities, transgender people continue to be highly marginalized and subject to transphobic discrimination and victimization. As a result, authentically expressing and navigating a TGNC identity can be difficult. Psychiatrists and other mental health professionals can play a key role in supporting TGNC client health and well-being through the use of trans-affirmative approaches. Trans-affirmative practice recognizes all experiences of gender as equally healthy and valuable This article focuses on transgender affirmative cognitive behavior therapy.

Homophobia within schools of social work: The critical need for affirming classroom settings and effective preparation for service with the LGBTQ community

Abstract Social work programs must effectively meet the needs of their diverse lesbian, gay, bisexual, transgender, and queer (LGBTQ) student populations as well as effectively train all students to work with minority groups including the LGBTQ community. While many undergraduate and graduate social work programs provide open, supportive, and affirming experiences for LGBTQ students, there remain ongoing challenges related to hostility, stigma, heterosexism, and homophobia within classroom settings across programs in the US and Canada. This study examines classroom experiences of homophobia among 1,018 social work students. Qualitative data associated with three optional open-ended questions were analyzed utilizing grounded theory. Main qualitative findings identified several major themes associated with social work student experiences of homophobia in the classroom including: (1) Coming out; (2) Faculty inaction; (3) Implicit and explicit content; (4) Direct language and actions; and (5) Religious rationalizations and non-affirming positions. Conclusions and recommendations for social work education are discussed that center around creating safe and affirming classroom settings; the vital role of out faculty, students, and allies; impactful integration of diversity content within curricula, policies, and accreditation standards; ongoing training and mentorship; understanding the role of power and oppression; and a call to action among social work educators and the profession.

Fighting for survival: The experiences of lesbian, gay, bisexual, transgender, and questioning students in religious colleges and universities

ABSTRACT Little is known about the experiences of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) students attending religious colleges and universities. This study used grounded theory to analyze the narratives (N = 271) of LGBTQ former and current students. The central theme described by LGBTQ students was a fight for survival with five subthemes: (a) institutionalized homo/transphobia (strict school policies, enforcement of heterosexuality and gender conformity through discipline, conversion therapy); (b) a culture of fear (fear of exposure, homophobic panic and code words, seeking cover); (c) marginalization and isolation; (d) struggle (suffering and suicide, reconciling faith and LGBTQ identity); and (e) coping and resilience (surviving through critical thinking and strategic activism). Implications for practice are provided.

Minority Stress and HERoic Coping Among Ethnoracial Sexual Minority Girls: Intersections of Resilience

This study used a focus group methodology to explore the experiences of stress and coping among 40 Hispanic, Caribbean Black, Haitian, and African American cisgender sexual minority girls living in the southeastern United States. An analysis of the data using grounded theory strategies revealed that participants were part of a cultural context in which few boundaries existed between family, religion, and culture, and that they tended to believe that they were betraying family and culture because of their sexual minority identities. Participants described (a) real or perceived transgressions of gender expectations and roles, (b) violating religious doctrine, and (c) emotional exclusion and taunting by family members. In the same context, the theme of HERoic Coping described participants’ resilience that manifested as (a) serving as the family educator, (b) being “out” in the open with family, and (c) creating safety. This study found that the negotiation of complex family, religious, and community environments is critical to understanding resilience in ethnoracial sexual minority girls.