Therapist correlates of attitudes toward sexual minority individuals, affirmative counseling self-efficacy, and beliefs about affirmative practice

Neuropsychological assessment with lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals: Practice, education, and training survey

Objective: We sought to describe the LGBTQ + related education, training, and clinical practice of independently licensed neuropsychologists in the United States and to identify factors that predict affirmative neuropsychological practices. We hypothesized that LGBTQ + identity, female gender, more recent training, and extent of LGBTQ + education/training would predict use of LGBTQ + practice guidelines. Method: A workgroup of clinical psychologists with experience in LGBTQ + psychology and neuropsychology developed a survey to identify personal and professional factors that predict affirmative neuropsychological testing practices. The survey was distributed through professional organizations and listservs between August and September 2021 with 118 responses meeting inclusionary criteria. Results: The majority of participants identified as heterosexual (70.3%) and cisgender (97.5%), and most (48-63%) received LGBTQ + training post-licensure. Between 19% and 32% of participants reported never completing LGBTQ + specific education. Consistent with our hypotheses, factors predicting affirmative clinical practice behaviors were LGBTQ + education/training, and personal background (sexual minority status, female/feminine gender, and years since degree). Other significant factors included prior experience with LGBTQ + patients and primary patient population (child vs. adult). Qualitative responses indicated varying values, attitudes, and knowledge regarding collection of LGBTQ + information and modification of clinical practice. Conclusions: Neuropsychologists underutilize affirming practices as evidenced by low rates of querying pronouns, knowing whether LGBTQ + health information is available at their institutions, and adjusting evaluation and feedback approaches. We provide specific training and education recommendations to increase knowledge and skills and to address beliefs about LGBTQ + health that can serve to promote affirmative neuropsychological practice.

Homonegativity, binegativity, and transnegativity among substance use treatment practitioners in the United States

Lesbian, gay, bisexual, and transgender (LGBT) people have an elevated risk for substance use disorder relative to heterosexual and cisgender people. Scholars have predominantly explained this disparity as resulting from LGBT people's chronic exposure to interpersonal and structural stigma and discrimination. Despite their front-line role in serving LGBT people with substance use disorder, investigations of homonegativity, binegativity, and transnegativity among substance use treatment practitioners have been limited. An online survey of 225 practitioners examined levels of homonegativity, binegativity, and transnegativity and their demographic and socio-political correlates. Levels of homonegativity were lower than those of binegativity and transnegativity. Educational attainment, connectedness to LGBT people, and having a liberal political identity were associated with lower homonegativity, binegativity and transnegativity, while religiosity was associated with higher scores in all categories. Addressing substance use treatment practitioners' stigma toward LGBT people, particularly bisexual and transgender people, should be prioritized. Substance use treatment organizations are recommended to examine how their policies and practices may perpetuate structural stigma toward LGBT people.

Including the issue of receiving payment for sex in intervention for substance use disorder: Professionals' intentions and interventions

BACKGROUND

Studies have shown that a high percentage of individuals with substance use disorder (SUD) are involved in receiving payment for sex (RPS). The stigma associated with RPS may lead to non-disclosure of RPS in drug treatment services thus preventing fully benefitting from SUD treatment. Research on RPS in the context of SUD interventions is scarce. The current study examined the extent to which social workers believe they should attend to the issue of RPS as part of the treatment of addictions and the extent of their self-reported work with RPS, as associated with comfort in discussing sexual issues in treatment (CDSIT), professional self-efficacy, attitudes towards people who engage in RPS, and attitudes towards social justice.

METHOD

A sample of 171 social workers who had worked with individuals with SUD in addiction treatment centers completed an online questionnaire. The main analyses were only conducted on participants who completed the full questionnaire (n = 124).

RESULTS

Most social workers believe in the importance of addressing RPS issues in treatment of individuals with SUD, but mostly did not translate their beliefs into practice. Attitudes toward social justice and toward people who engage in RPS, and the interaction between self-efficacy and CDSIT were associated with the belief in the importance of addressing RPS in treatment. The main factor that contributed to the self-reported work with RPS was CDSIT.

CONCLUSION

Policy-makers should promote specific training for professionals in the addiction field to address the issue of RPS when working with individuals with SUD, and increase levels of CDSIT.

A Moderation Analysis of Perfectionism, Cultural Sensitivity, and Counselors-In-Training Attitudes Toward Non-Dominant Sexual Identities

The purpose of this study was to explore the moderating effect of maladaptive perfectionism on the relationship between cultural sensitivity and counselors-in-training attitudes toward non-dominant sexual identities. A total of 209 counseling graduate students participated in the study. Results showed that cultural sensitivity predicted attitudes toward individuals who identify with a non-dominant sexual identity after controlling for age. Also, a regression analysis demonstrated that maladaptive perfectionism is a moderator in the relationship between cultural sensitivity and attitudes toward individuals who identify with a non-dominant sexual identity among counselors-in-trainings. Implications in the counseling and education field and suggestions for future research are discussed.

Training healthcare professionals in LGBTI cultural competencies: Exploratory findings from the Health4LGBTI pilot project

OBJECTIVES

Lesbian, gay, bisexual, trans and intersex (LGBTI) people experience health inequalities and barriers to accessing healthcare at a greater rate than the general population. This paper aims to present the Health4LGBTI training course for healthcare workers and the results of its pilot implementation.

METHODS

Funded by the European Parliament, the training course was developed by a multidisciplinary team including LGBTI organisations as part of the Health4LGBTI Project. 110 healthcare professionals from diverse medical fields attended the pilot training in six European Member States. Knowledge and attitudes were compared on the basis of a pre-post evaluation design utilising an ad hoc questionnaire.

RESULTS

Knowledge scores increased after the training, irrespective of age and sexual orientation of participants. Attitudes scores generally improved, particularly in terms of inclusivity and a greater acknowledgement of LGBTI health needs and self-competence.

CONCLUSION

The Health4LGBTI training course is both feasible and effective in training healthcare professionals and support staff to improve cultural competence and thereby promoting inclusive healthcare practice.

PRACTICE IMPLICATIONS

The Health4LGBTI training course can be implemented in different healthcare contexts. Piloting of the course provided an opportunity for healthcare professionals and for support staff to improve their knowledge of, and attitudes towards, LGBTI people.