Oakland University Counseling Conference


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Oakland University Counseling Conference

  1. 1. Welcome <ul><li>Providing Culturally Competent Care to Lesbian, Gay, Bisexual, and Transgender Individuals </li></ul><ul><li>Knoll Larkin MPH </li></ul><ul><li>Mautner Project-”Removing the Barriers” </li></ul><ul><li>Funded by the Centers for Disease Control and Prevention </li></ul><ul><li>Affirmations—”The Community Center for Lesbian, Gay, Bisexual, Transgender People and their Allies” </li></ul>T0
  2. 2. Sexual Orientations <ul><li>Lesbian: A women who is emotionally, romantically, spiritually attracted to women. </li></ul><ul><li>Gay: A man who is emotionally, romantically, and spiritually attracted to men. </li></ul><ul><li>Bisexual/bi-attractional: Attraction to members of either sex </li></ul>T4:1
  3. 3. Sexual Orientations <ul><li>Same Gender Loving: A term used in communities of color to describe women who partner with women or men who partner with men. </li></ul><ul><li>Queer: a more inclusive term used to describe folks who don’t fit “neatly” into the LGB categories. </li></ul>
  4. 4. Identity vs. Behavior <ul><li>Who we say and feel ourselves to be might be different than what we actually do. </li></ul><ul><ul><li>Identity- the “label” one applies to oneself and one’s community of affiliation </li></ul></ul><ul><ul><li>Behavior- the specific activities a person engages in. </li></ul></ul>T 4:3
  5. 5. Levels of Identity <ul><li>Involved in gay, lesbian, bisexual politics or culture </li></ul><ul><li>“ Closeted and isolated from valuable support resources” </li></ul><ul><li>Sexual orientation may be only a minor part of personal identity </li></ul>T4:4
  6. 6. Gender Identity <ul><li>May be: </li></ul><ul><ul><li>Feminine / Femme </li></ul></ul><ul><ul><li>Androgynous </li></ul></ul><ul><ul><li>Masculine / Butch </li></ul></ul><ul><ul><li>Transgender </li></ul></ul><ul><li>Gender identity refers to ones own sense of gender </li></ul><ul><li>Gender identity is distinct from sexual orientation. </li></ul>T4:5
  7. 7. Gender Identity (cont.) <ul><li>Transgender: </li></ul><ul><ul><li>Gender expression incongruent with expectations of biological/assigned sex. </li></ul></ul><ul><ul><li>MTF (male to female) / FTM (female to male) </li></ul></ul>T4:6
  8. 8. Using Language: Summary <ul><li>One way to demonstrate inclusiveness in a healthcare setting is through use of language. </li></ul><ul><li>Use terms preferred by your clients. These may be different for each person, regionally or generationally based. </li></ul>T4:7
  9. 9. Common language: Summary (cont.) <ul><li>Preferred vs. Other Terms </li></ul><ul><ul><ul><li>Lesbian, Gay, Bisexual Homosexual </li></ul></ul></ul><ul><ul><ul><li>Partner Lover/Roommate </li></ul></ul></ul><ul><ul><ul><li>Sexual orientation Sexual preference </li></ul></ul></ul><ul><ul><ul><li>Crossdresser Transvestite </li></ul></ul></ul><ul><ul><ul><li>Transgender Transsexual </li></ul></ul></ul><ul><ul><ul><li>Intersex Hermaphrodite </li></ul></ul></ul><ul><li>WHEN IN DOUBT… ASK! </li></ul><ul><li>Words/Phrases Often Used “Within” the Community </li></ul><ul><li>Dyke, Queer, Family, In the Life </li></ul>T4:8
  10. 10. Negative effects of heterosexism and Transphobia <ul><li>Self-blame for the victimization one has suffered </li></ul><ul><li>Negative self concept </li></ul><ul><li>Anger directed inward resulting in destructive patterns </li></ul><ul><li>A victim mentality or feelings of hopelessness or despair, interfering with leading a fulfilling life </li></ul><ul><li>NOT A RESULT OF ONES SEXUALITY! </li></ul>
  11. 11. Life Cycle Issues For LGBT Individuals <ul><li>LGBT youth face additional stressors </li></ul><ul><li>(conformity, and coming out) </li></ul><ul><li>LGBT young adults (social life revolving around bars and substance use settings) </li></ul><ul><li>Coupling </li></ul><ul><li>Parenting </li></ul><ul><li>Treatment Providers need to consider an LGBT client’s partner, children, family of origin and family of choice when providing care! </li></ul>
  12. 12. LGBT Clients May Be Coping With: <ul><li>Coming out </li></ul><ul><li>Societal stigmas </li></ul><ul><li>HIV/AIDS </li></ul><ul><li>Discrimination </li></ul><ul><li>Homophobic family members, employers, and work colleagues </li></ul>
  13. 13. Coming Out: <ul><li>Refers to the experiences of some, but not all, LGBT people as they work through and accept a stigmatized identity. </li></ul><ul><li>Transforming a negative self identity into a positive one </li></ul><ul><li>Important for those trying to recover: Feeling positive and hopeful about themselves is at the heart of recovering from addition </li></ul>
  14. 14. What the coming out process means for counselors? <ul><li>Because many programs and counseling approaches value authenticity, discussing the process of coming out is crucial. </li></ul><ul><li>Counselors who accept and validate client’s feelings, attractions, experiences, and identities can play an important role in success. </li></ul>
  15. 15. Coming Out (cont) <ul><li>There is no correct way to come out </li></ul><ul><li>Some people may decide they do not want to take on a LGBT identity and may choose not to disclose their feelings and experiences to anyone. </li></ul>
  16. 16. Cass Model of Identity Development <ul><li>Stage 1: Identity Confusion </li></ul><ul><li>Stage 2: Identity Comparison </li></ul><ul><li>Stage 3: Identity Tolerance </li></ul><ul><li>Stage 4: Identity Acceptance </li></ul><ul><li>Stage 5: Identity Pride </li></ul><ul><li>Stage 6: Identity Synthesis </li></ul>
  17. 17. Barriers to receiving care: <ul><li>Marginalization and labeling of sexual orientation or gender identity as deviant or pathological in medical or psychiatric communities. </li></ul><ul><li>Anticipated, perceived, or actual discrimination </li></ul><ul><li>Fear of mistreatment </li></ul><ul><li>Lack of research about use patterns, treatment needs, etc. </li></ul><ul><li>Provider lack of information </li></ul><ul><li>Fear of being outed will result in loss of job, custody, housing, or social supports. </li></ul><ul><li>Exclusion of partner and family of choice from health care settings </li></ul><ul><li>Lack of insurance coverage under partner’s policy </li></ul><ul><li>Low self-esteem or belief that sexual orientation or gender identity is wrong. </li></ul>
  18. 18. Solutions: <ul><li>Before the patient encounter </li></ul><ul><ul><li>Marketing materials, brochures, ways services are introduced. Are they representative of the diversity of the populations within the service area? Will LGBT people feel like the advertised facility is a comfortable place for them? How is this communicated? What is the current reputation in LGBT community? Is there a need to address past negative experiences? </li></ul></ul>
  19. 19. Creating an Affirming Environment: <ul><li>Display health info, magazines, posters, and other decorations that reflect the faces and interests of clients served. Staff should also be representative of clients served. Consider posting a written non-discrimination policy that includes sexual orientation and gender identity. </li></ul>
  20. 20. Inclusive Paperwork <ul><li>Getting beyond “Married, Single, Divorced” Consider “partnered, significant relationship, significant other” </li></ul><ul><li>-Are you involved in a significant relationship? </li></ul><ul><li>-Is there someone you would like involved in your care? </li></ul><ul><li>-With whom do you live? </li></ul>
  21. 21. Culturally Competent Approach: <ul><li>Is client centered </li></ul><ul><li>Uses client’s own language </li></ul><ul><li>Non-judgmental </li></ul><ul><li>No assumptions </li></ul><ul><li>Open ended questions </li></ul><ul><li>Begins with less threatening questions </li></ul><ul><li>It’s okay to not know! </li></ul>
  22. 22. Culturally Competent Approach: <ul><li>Is client centered </li></ul><ul><li>Uses client’s own language </li></ul><ul><li>Non-judgmental </li></ul><ul><li>No assumptions </li></ul><ul><li>Open ended questions </li></ul><ul><li>Begins with less threatening questions </li></ul><ul><li>It’s okay to not know! </li></ul>
  23. 23. Affirmations LGBT Community Center <ul><li>Knoll Larkin </li></ul><ul><li>[email_address] </li></ul><ul><li>248-398-7105 </li></ul><ul><li>www.goaffirmations.org </li></ul>