Evan Senreich

Are Specialized LGBT Program Components Helpful for Gay and Bisexual Men in Substance Abuse Treatment

In the New York metropolitan area, a convenience sample of 187 men previously treated in substance abuse programs between 2000 and 2006 completed questionnaires regarding their reported outcomes, completion rates, and perceptions of treatment. The sample included 81 gay and bisexual (“gay/bisexual”) men in “traditional” programs (with no specialized groups for gay/bisexual clients), 51 gay/bisexual men in “LGBT specialized treatment” (programs with specialized groups for gay/bisexual clients), and 55 heterosexual men. In bivariate and multivariate analyses, heterosexual men and gay/bisexual men in LGBT specialized treatment had more favorable results than did gay/bisexual men in traditional programs, suggesting the effectiveness of LGBT program components.

The Effects of Honesty and Openness About Sexual Orientation on Gay and Bisexual Clients in Substance Abuse Programs

A convenience sample of 183 gay, lesbian, and bisexual participants who were previously treated in substance abuse programs, completed surveys that included questions regarding their honesty and openness about their sexual orientation with counselors and clients in their programs, as well as in their personal lives. It was found that levels of honesty and openness in treatment positively correlated with reported program completion, satisfaction with treatment, feelings of therapeutic support, and feelings of connection to the program. However, there were no correlations between honesty and openness and reported abstinence from substances at the end of treatment and at the time of survey completion.

A Gestalt Approach to Social Work Practice

Although there is a body of literature that applies Gestalt therapy techniques to clinical practice, little has been written about the use of Gestalt therapy theory as a comprehensive framework for social work practice as a whole. Gestalt therapy theory unifies social works ecological and strength perspectives and is highly consonant with the core values of the profession. Four major theoretical aspects of Gestalt therapy that are highly applicable to social work practice are described: field theory, “I-Thou” relationship, creative adjustment, and the phenomenological perspective. Case examples are provided to demonstrate a Gestalt approach to social work practice.

Demographic, Background, and Treatment Factors That Affect Gay and Bisexual Clients in Substance Abuse Programs

In New York City, a convenience sample of 180 gay/bisexual former clients of substance abuse programs completed surveys that included questions regarding their demographic, background, and treatment factors. Multivariate analysis was utilized to determine which factors predicted differences in reported abstinence rates after treatment, reasons for leaving treatment, and perceptions of treatment. Specialized lesbian, gay, bisexual, and transgender programs and groups, individual counseling, and frequent 12-step program attendance appeared to be beneficial for gay/bisexual clients in substance abuse treatment. Furthermore, gay/bisexual men reported lower abstinence levels after treatment than did gay/bisexual women, and bisexual clients appeared to have more treatment difficulties than did gay/bisexual clients.

Self-Identified Heterosexual Clients in Substance Abuse Treatment With a History of Same-Gender Sexual Contact

There is virtually no literature concerning the experiences of self-identified heterosexual clients in substance abuse treatment who have a history of same-gender sexual contact (HSGS). In a U.S. urban inpatient program in 2009–2010, 99 HSGS clients were compared to 681 other heterosexual and 86 lesbian, gay, and bisexual clients regarding background factors, program completion rates, and feelings about treatment. Male HSGS participants had lower completion rates than other male heterosexual participants. Qualitative data indicated that most male HSGS participants experienced difficult emotions regarding same-gender sexual encounters, particularly those involving trading sex for money or drugs. Implications for treatment are discussed.

When White Clients Are in the Minority in a Substance Use Disorders (SUDS) Treatment Program: An Exploratory Study

There has been virtually no research regarding the experiences of White clients in substance use disorders (SUDS) treatment programs where they are in the minority racially. In a U.S. city, at a 28-day inpatient program where White individuals represented 12% of the client population, 68 White clients responded to open-ended questions regarding how their racial identity affected their treatment experiences. Nearly one half of the White participants reported no difficulties regarding being part of a small racial minority group in treatment. However, one third of the White participants expressed significant negative reactions about being in the racial minority in treatment. They expressed feeling ostracized and not accepted, being exposed to racist attitudes and comments, and experiencing a sense of alienation.

Shining the Light on Intersectionality: The Complexities of Similarity and Difference in the Therapeutic Process from the Perspectives of Black and Hispanic Social Workers

ABSTRACT Few studies have examined the experiences of non-White social workers in racially concordant and discordant therapeutic relationships. The relationship is often complex, with many factors intersecting. Three focus groups with 18 Black and Hispanic social workers and social work students were conducted to explore their perspectives on how racial similarities and differences affect the worker–client relationship. Qualitative data analysis revealed five themes: intersections of diverse characteristics, language discordance and concordance, similarity and difference affecting client engagement, assumptions and expectations based on racial/ethnic background, and use of social work skills and self when encountering difference. Implications for ethnocultural countertransference are highlighted.

The Perceptions of White Clients in a Substance Abuse Program in Which They Are in the Minority

ABSTRACT Background: There is a large body of literature regarding the need for culturally-informed practice with non-white populations in substance abuse treatment. Virtually nothing, however, has been written regarding the needs of white clients when they represent a small minority in treatment programs. Objectives: The primary purpose of this study is to compare perceptions of treatment and completion rates between white and nonwhite clients in a substance abuse treatment program where white clients represent a small minority. Methods: In New York City in 2009/2010, at a short-term inpatient program where white clients represented 12% of the population, 611 clients completed surveys that included scales measuring satisfaction, therapeutic alliance, social cohesion, and connection to the program. White and non-white clients were compared regarding results of these scales as well as program completion rates. Furthermore, demographic/background characteristics of the white and nonwhite clients obtained from the surveys were compared. Results: White clients reported lower levels of connection to the treatment program than non-white clients at levels that were statistically significant. However, there were no statistically significant differences between them for the other scales and program completion rates. Although white clients reported greater frequency and number of substances used, they were far less likely to have had felony convictions. Conclusions: Although differences were not extreme, there was evidence that greater sensitivity to the needs of white clients in programs in which they are in the minority is needed. Furthermore, this study demonstrates racial disparities in criminal justice involvement between white and non-white substance users.

A postgraduation follow-up of social work students trained in “SBIRT”: Rates of usage and perceptions of effectiveness

ABSTRACT Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based modality that can help social workers work with substance-using clients as part of an integrated health care approach. This study reports the findings of a post-graduation one-year follow-up survey of 193 master’s and bachelor’s social work students trained in SBIRT in practice courses at a Northeast urban college. Forty-three percent of the trainees who were practicing social work after graduation were using SBIRT. A content analysis of participants’ comments found that the vast majority found SBIRT to be a valuable practice modality, with barriers to utilization of SBIRT identified.

Attitudes of West African Immigrants in the United States toward Substance Misuse: Exploring Culturally Informed Prevention and Treatment Strategies

There is a lack of literature exploring substance misuse issues of the West African-born population in the United States. Thirty-four participants born in West Africa participated in one of three focus groups in a U.S. city to discuss their attitudes toward alcohol and drug use. Based on a qualitative analysis of the discussions, stigmatization of substance abusers and negative attitudes toward U.S. substance abuse treatment were identified as barriers to service utilization for West African immigrants. Community cohesion, importance of family, and a strong sense of spirituality were identified as essential resources to inform substance misuse prevention and treatment strategies.