Edward J. Alessi

Lesbian, Gay, Bisexual and Transgender Youth Talk about Experiencing and Coping with School Violence: A Qualitative Study

This qualitative study used five focus groups of lesbian, gay, bisexual, and transgender (LGBT) youth attending public high schools to examine their experiences with school violence. Core themes focused on lack of community and empowerment leading to youth being without a sense of human agency in school. Negative attention themes were indicative of the vulnerability that the youth felt at school. As principal means of coping, the LGBT youth escaped and avoided stressors by distancing themselves from school. From emergent themes of LGBT youths experiences of school violence, recommendations to make schools safe and supportive learning environments for them are provided. These included the need for policies and rules, peer education, planned educational activities, and in-service training for school personnel about LGBT youth to create inclusive school communities.

Human Trafficking Is More Than Sex Trafficking and Prostitution Implications for Social Work

The human trafficking discussion has focused primarily on women and children who are trafficked for sexual exploitation. However, as social workers confront the issue, they require an understanding of the problem that also acknowledges individuals who are forced to work in other areas. This article critically examines the current discourse on human trafficking because the sole focus on women and children diverts attention from the study of trafficking within the context of globalization and the exploitation of labor. It analyzes the term human trafficking, particularly how it became linked to antiprostitution campaigns, and suggests guidelines for a framework that is grounded in social work values.

A Framework for Incorporating Minority Stress Theory into Treatment with Sexual Minority Clients

Empirical research has consistently demonstrated the negative mental health consequences of minority stress among lesbian, gay, and bisexual (LGB) populations; however, there is little understanding of how minority stress should be addressed in the actual clinical situation. This article discusses how to incorporate minority stress theory into clinical practice with LGB clients. A proposed framework begins with a two-part clinical assessment. The first part, based on Meyers (2003) minority stress model, examines the effects of prejudice events, stigma, internalized homophobia, and sexual orientation concealment. The second part, grounded in Hatzenbuelhers (2009) work, examines the clients coping/emotional regulation, social/interpersonal, and cognitive processes, which can be elevated by minority stress. Following the assessment process, the framework suggests using a LGB-affirmative treatment approach. To demonstrate the clinical utility of the framework it will be applied to the treatment of a client identifying as lesbian.

Cognitive behavioral therapy: a meta-analysis of race and substance use outcomes.

Cognitive behavioral therapy (CBT) is an effective intervention for reducing substance use. However, because CBT trials have included predominantly White samples caution must be used when generalizing these effects to Blacks and Hispanics. This meta-analysis compared the impact of CBT in reducing substance use between studies with a predominantly non-Hispanic White sample (hereafter NHW studies) and studies with a predominantly Black and/or Hispanic sample (hereafter BH studies). From 322 manuscripts identified in the literature, 16 met criteria for inclusion. Effect sizes between CBT and comparison group at posttest had similar effects on substance abuse across NHW and BH studies. However, when comparing pre-posttest effect sizes from groups receiving CBT between NHW and BH studies, CBTs impact was significantly stronger in NHW studies. T-test comparisons indicated reduced retention/engagement in BH studies, albeit failing to reach statistical significance. Results highlight the need for further research testing CBTs impact on substance use among Blacks and Hispanics.

Stressful Events, Avoidance Coping, and Unprotected Anal Sex Among Gay and Bisexual Men

This study examined associations among stressful life events, avoidance coping, and unprotected anal sex (UAS) in a convenience sample of 297 men obtained through the Internet and who either reported having sex with men or self-identified as gay or bisexual. Participants completed an Internet-hosted self-administered questionnaire that included measures of victimization experiences and other stressful life events, and avoidance coping. More than half of the sample reported engaging in UAS during the previous 6 months. Victimization predicted UAS regardless of partner type; victimization, HIV-positive serostatus, and avoidance coping predicted UAS with nonprimary partners. The findings provide evidence that American gay and bisexual men may experience a variety of stressful life events, including a surprising amount of victimization, and that at least some episodes of UAS may be associated with attempts to cope with distress associated with such events.

'The darkest times of my life': Recollections of child abuse among forced migrants persecuted because of their sexual orientation and gender identity.

Numerous studies demonstrate that lesbian, gay, bisexual, and transgender (LGBT) children and youth are likely to experience abuse by peers, parents, and other adults and that these experiences correlate with a host of mental health problems. However, there is little understanding of the experiences of LGBT children and youth living in countries where social and legal protections for sexual and gender minorities are limited or nonexistent. This qualitative study used thematic analysis to explore the child and adolescent abuse experiences and their impact on the pre-migration mental health of LGBT forced migrants. We analyzed 26 interviews with individuals who obtained refugee or asylee status in the United States or Canada on the basis of sexual orientation or gender identity. Participants originated from countries in Asia, Africa, the Caribbean, Eastern Europe, Latin America, and the Middle East. Analysis revealed the following themes: abuse by parents and caregivers, abuse by peers and school personnel, having nowhere to turn, and dealing with psychological distress. Findings indicate that participants experienced severe verbal, physical, and sexual abuse throughout childhood and adolescence and that this abuse occurred at home, in school, and in the community. Furthermore, there were no resources or sources of protection available to them. Participants linked their abuse to subjective experiences of depression, anxiety, and traumatic stress, as well as suicidal ideation and suicide attempts. We conclude with implications for refugee adjudication practices, mental health care, and international policy.

Determinants of Lesbian and Gay Affirmative Practice Among Heterosexual Therapists

The current study tested a conceptual model based on social-cognitive theory (Bandura, 1986), highlighting the influence of attitudes toward sexual minority individuals, training hours, affirmative counseling self-efficacy, and beliefs about affirmative practice on therapist engagement in lesbian and gay affirmative practice. We recruited via the Internet 443 heterosexual psychologists (n = 270), clinical social workers (n = 110), and marriage and family therapists (n = 63) residing in various parts of the United States. The majority of participants identified as female (70%) and White (88%). A path analysis indicated that beliefs and affirmative counseling self-efficacy mediated associations between attitudes and therapist engagement in affirmative practice. Furthermore, self-efficacy mediated the relation between training hours and engagement in affirmative practice. Results suggest that more affirmative attitudes are linked with higher levels of affirmative counseling self-efficacy and more positive beliefs, which in turn positively influences therapist engagement in affirmative practice. Additionally, more hours of training influence affirmative counseling self-efficacy, which in turn correlates with higher levels of therapist engagement in affirmative practice. The discussion includes implications for affirmative practice training.

Victimization in a Nationwide Sample of Gay and Bisexual Men

Research indicates a high level of bias-related victimization among gay and bisexual men, but the total amount of victimization experienced by this population, including sexual orientation bias-related, other bias-related, and non-bias-related victimization, has hardly been examined. The relationship between coping and non-sexual orientation bias-related victimization among these populations has also received little research attention. This study examines total victimization during the previous 6 months and dispositional coping in a nationwide nonprobability sample of 297 self-identified gay and bisexual men. Results showed a high incidence of total victimization, with 72% of participants reporting a victimization occurrence. Emotion-oriented coping was positively correlated with victimization. The results indicate that many gay and bisexual men live in stressful environments which may contribute to negative health and mental health outcomes among them.

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.

A Qualitative Exploration of the Premigration Victimization Experiences of Sexual and Gender Minority Refugees and Asylees in the United States and Canada

Progress in analyzing and interpreting the concepts of sexual orientation and gender identity in the context of refugee law has contributed to a rise in individuals seeking asylum in such countries as the United States and Canada. However, few studies have examined the victimization experiences of sexual- and gender-identity forced migrants prior to their arrival in North America. This qualitative study used thematic analysis to explore the premigration adult victimization experiences of 26 lesbian, gay, and transgender individuals who obtained refugee, asylee, or withholding-of-removal status in the United States or Canada based on persecution for their sexual orientation and/or gender identity. Participants originated from countries in Asia, Africa, the Caribbean, Eastern Europe, Latin America, and the Middle East. Analysis revealed the following themes: living on the edge, adopting concealment strategies, routine victimization, and protectors as perpetrators. Participants described living in a constant state of hypervigilance, and they adopted numerous strategies to protect themselves from victimization. Despite the use of such strategies, participants experienced victimization by community members and state actors, leaving them no choice but to flee to ensure their safety and well-being. Findings are discussed using the ecological framework outlined by the World Health Organization (WHO). The discussion concludes with implications for international policy and clinical practice.