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An assessment tool was designed to assist service providers in identifying lesbian, gay and bisexual (LGB) clients who present for assistance related to substance use concerns. Items were designed to facilitate self-disclosure of the individual's sexual orientation and identify concerns of LGB clients that will be relevant to treatment planning for substance use concerns. Therapists in general assessment and LGB-specialized services of a large treatment agency were trained to use the tool. This paper presents client and therapist comments made during the pilot study regarding the use and value of the assessment tool.

Substance abuse treatment for lesbian, gay and bisexual (LGB) individuals cannot center solely on substance abuse, but must also address the social and psychological aspects of being LGB. This study uses qualitative methods to examine service providers' knowledge and clinical impressions of issues commonly experienced by LGB people with substance use problems. Focus groups and individual interviews were conducted with clinicians experienced in counselling LGB clients. The data were analyzed using NUD*IST qualitative software to derive salient themes presented by the service providers. Eight major themes were identified: openness and disclosure of sexual orientation in substance use treatment; the “coming out” process; societal homophobia; internalized homophobia; family and support systems; bars and social life; body image; and the impact of HIV and AIDS. Examples for each of the major themes are provided.

Openness about one's sexual orientation in the health care context contributes to lesbians satisfaction with care and to continued use of health services. We undertook a qualitative study to examine lesbians experiences in the health care environment and explain why openness about sexual orientation may be resisted by lesbians. Data were derived from four focus groups conducted with lesbians who discussed their expectations and preferences for their health care, as well as their met and unmet health care needs. Transcripts of the focus groups were analyzed using NUD∗IST qualitative software to derive salient themes presented by the women. Five major themes were identified: anxiety and concern related to self-disclosure, non-disclosure of sexual orientation, seeking out gay-positive physicians, frustration with assumptions of heterosexuality, and treatment of lesbian partners. Examples for each of the major themes are provided. Data from this study suggest ways health care providers can alleviate ...

Is a relationship breakup harder on certain people? To address this question, the present study investigated the relationship of individuals’ attachment styles to various reported aspects of a relationship's dissolution: initiation of the breakup, emotional reactions to the breakup, reasons for the breakup, and experiences and perceptions following the breakup. One hundred nineteen undergraduates completed an extensive questionnaire concerning a past romantic relationship that had broken up. Feeney, Noller, and Hanrahan's (1994) Attachment Style Questionnaire (ASQ) provided continous measures for five attachment styles or “attitudes”: confidence, discomfort with closeness, need for approval, preoccupation with relationships, and relationships as secondary. Principal-components analyses served to derive criterion indexes from the breakup questionnarie measures, which were individually regressed on the five ASQ scales. As predicted form attachment theory, respondents scoring high on preoccupation w...