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Substance Abuse Treatment and LGBT Issues

An Overview for Providers Treating LGBT Clients

1. Studies generally state that gay men and lesbians have greater substance abuse problems than non-LGBT men and women.

A. True

B. False


2. Which of the following were found to have higher rates of alcohol use?

A. MSM compared to heterosexual males

B. Heterosexual males compared to MSM

C. Lesbians compared to heterosexual women

D. Heterosexual women compared to lesbians


3. There is compelling evidence that HIV and hepatitis C infections are linked with the use of:

A. Alcohol

B. Methamphetamine

C. Sedatives

D. Tranquilizers


4. Which of the following is an interdependent state of acting out prejudice?

A. Verbal attacks

B. Discrimination

C. Violence

D. All of the above


5. Which of the following is a key concept in understanding issues facing gay men, lesbians, and bisexuals in substance abuse treatment?

A. Internalized homophobia

B. Antigay bias

C. Homophobia

D. Heterosexism


6. A skilled substance abuse treatment counselor should be attentive to the negative effects that prejudice produces when working with LGBT clients.

A. True

B. False


7. Which of the following is true?

A. The gene has been identified on the X chromosome that influences homosexual orientation.

B. The gene has been identified on the Y chromosome that influences homosexual orientation.

C. There has been reported a linkage on the X chromosome that may influence homosexual orientation.

D. There has been reported a linkage on the Y chromosome that may influence homosexual orientation.


8. It has been found that Lesbians are more likely to have:

A. Lesbian sisters

B. Gay brothers

C. Both (A) and (B)

D. None of the above


9. It is helpful for providers to know that the clinical issues facing bisexuals often are problems resulting from:

A. Women’s sexual orientation being more changeable than men’s.

B. The difficulty of acknowledging and acting on a sexual orientation that is not accepted by the heterosexual majority but also not accepted by many gay men and lesbians.

C. People not becoming fully aware of their orientation for years.

D. Their sexual orientation seeming to change when, in fact, they are just becoming conscious of their true orientation.


10. Treatment providers need to consider an LGBT client’s _____ when providing care.

A. Partner

B. Family of origin

C. Family of choice

D. All of the above


Cultural Issues in Working With LGBT Individuals

11. A culturally competent model of treatment:

A. Acknowledges the client’s cultural strengths, values, and experiences.

B. Encourages behavioral and attitudinal change.

C. Both (A) and (B).

D. None of the above.


12. For _____ individuals, entering into a mainstream treatment program is usually a frighteningly foreign experience that calls for sensitivity by treatment staff.

A. Traditional

B. Culturally immersed

C. Assimilated

D. Bicultural or multicultural


13. In _____ culture, silence is highly valued - a difficulty for counselors who are trained to assess commitment by verbal expression.

A. Asian

B. American Indian

C. Latino

D. All of the above


14. It is of utmost importance for counselors to be aware of how their own cultural _____ influence their practice and how they affect their behavior toward coworkers and clients.

A. Values

B. Biases

C. Attitudes

D. All of the above


15. For some LGBT people, the term _____ overemphasizes sexuality and seems to indicate that the sex act is more important to homosexuals than it is to heterosexuals.

A. Queer

B. Dyke

C. Homosexual

D. Trans


16. Due to its experience of discrimination, the LGBT community is always tolerant of diversity.

A. True

B. False


17. Traditionally, _____ were taught to celebrate the differences and to see all their members as sacred beings fashioned by the creator.

A. American Indians and Alaska Natives

B. African Americans

C. Hispanic Americans / Latinos

D. Asian / Pacific Islanders


18. Becoming reconnected with family is seen as necessary for health in native tradition.

A. True

B. False


19. Practitioners need to be aware of their _____ when communicating with American Indians and Alaska Natives.

A. Language

B. Nonverbal behavior

C. Both (A) and (B)

D. None of the above


20. Many African-American individuals, particularly women, call themselves bisexual instead of gay.

A. True

B. False


21. Substance abuse treatment counselors need to refrain from using which term if they are working with African-Americans?

A. Gay

B. Queer

C. Homosexual

D. Dyke


22. The use of storytelling and African proverbs can enhance insight into treatment.

A. True

B. False


23. For which of the following is cohesiveness of the group an important value and because of this shame is a frequently used social constraint to control or deter expressions of homosexual behavior?

A. American Indians and Alaska Natives

B. African Americans

C. Hispanic Americans / Latinos

D. Asian / Pacific Islanders


24. It is necessary to remember that for most Hispanic Americans the learning process is based on the process rather than in the context.

A. True

B. False


Legal Issues for Programs Treating LGBT Clients

25. The confidentiality regulations for communications apply in all of the following situations, except for:

A. If the person seeking the information already has that information.

B. If the person seeking the information has other ways of getting it.

C. If the person seeking the information comes armed with a subpoena or search warrant.

D. The confidentiality regulations for communications apply for all of the above.


26. The confidentiality regulations permit disclosure without the client’s consent during medical emergencies, when reporting child abuse, and during communications among program staff.

A. True

B. False


27. The client may revoke consent at any time, and the consent form must include a statement to this effect.

A. True

B. False


28. If a program has already made a disclosure prior to the client revocation, acting in reliance on the client’s signed consent, it is required to try to retrieve the information it has already disclosed.

A. True

B. False


29. The program can disclose a minor’s information, without the minor’s consent, as long as they have the parent’s signature.

A. True

B. False


30. As part of the recovery process, and because there are laws protecting alcoholics and former drug abusers from discrimination, substance abuse treatment programs should encourage clients to acknowledge to others that they have abused alcohol and drugs.

A. True

B. False


31. If a program refers a client to a vocational rehabilitation training program or a _____ and he or she is rejected because of a history of drug abuse or HIV positivity, there is legal recourse.

A. Doctor

B. Dentist

C. Lawyer

D. Homeless shelter


32. The Americans with Disabilities Act specifically excludes which of the following from the definition of “disability”?

A. Pedophilia

B. Transvestism

C. Exhibitionism

D. All of the above


Overview of Treatment Approaches, Modalities, and Issues of Accessibility in the Continuum of Care

33. Substance abuse treatment for LGBT individuals is the same as that for other individuals and primarily focuses on stopping the substance abuse that interferes with the well-being of the client.

A. True

B. False


34. Providers need to understand that a part of substance abuse recovery for many LGBT individuals is:

A. Accepting themselves as gay, lesbian, bisexual, or transgender.

B. Finding a way to feel comfortable in society.

C. Both (A) and (B).

D. None of the above.


35. Abuse of which of the following is nearly epidemic in gay men in some parts of the United States and often results in strong cravings and frequent relapses and may require extensive and highly focused treatment?

A. Methamphetamine

B. Alcohol

C. Sedatives

D. Tranquilizers


36. An LGBT person’s sexual orientation / gender identity causes his or her alcohol and drug use.

A. True

B. False


37. Which of the following should be considered when developing the treatment plans of LGBT people with substance abuse problems?

A. The impact on the client of anti-LGBT bias.

B. Internalized homophobia.

C. Both (A) and (B).

D. None of the above.


38. Which of the following programs are aware of, knowledgeable about, and accepting of LGBT people?

A. LGBT-tolerant programs

B. LGBT-sensitive programs

C. LGBT-affirmative programs

D. All of the above


39. Data shows that there is a very successful treatment rate when acknowledging one’s sexual orientation is considered a key factor in recovery.

A. True

B. False


40. When LGBT- or gender-specific groups are held, therapists should regularly direct attention to:

A. Safe-sex practices.

B. Sexual feeling about same-sex individuals.

C. Experiences with same-sex individuals.

D. All of the above.


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