Awareness of clients' sexual orientation and gender identity is very relevant
in effective treatment and counselling. However, many clients are
not open about their sexual orientation or gender identity in mainstream
treatment facilities - they may be uncomfortable, feeling anxious or
afraid of negative responses or homophobic/biphobic/transphobic attitudes
of staff and other clients. Lesbian, gay, bisexual, transgendered, transsexual, two-spirit,
intersex, and queer (LGBTTTIQ) people have specific life factors that
relate to substance use and/or mental health problems. These factors
include "coming out," gender transition, societal oppression, loss of
family support, isolation, and the predominance of bars in LGBTTTIQ
communities.
This manual is a revision of Asking the Right Questions: Talking about
Sexual Orientation and Gender Identity during Assessment for Drug and
Alcohol Concerns; it has been revised to include mental health issues,
updated resources and an expanded glossary.
Why is This Manual Important?
Many clients are not open about their sexual orientation or gender identity
in mainstream treatment/counselling facilities. They may feel uncomfortable
or anxious, fearing negative responses or prejudiced attitudes
from staff and other clients. Many clinicians are understanding of sexual orientation and gender
identity issues. However, these clinicians may lack a repertoire of appropriate
questions to ask about sexual orientation or gender identity, or
they may be unaware of why such questions are necessary for clients of
substance use and/or mental health services.
Findings From Two Phases Of The ARQ Project - General Conclusions
Several factors contribute to client self-disclosure:
- feelings of safety
- non-judgmental and non-heterosexist/genderist attitudes of staff and
other clients
- advertising of a service in LGBTTTIQ publications and communities
- LGBTTTIQ-positive stickers and posters
- use of non-biased, inclusive language
- confidentiality
- staff who are knowledgeable of LGBTTTIQ-specific issues.
The following factors enhance the experience of services for LGBTTTIQ
people:
- availability of specialized programs/services
- composition of treatment/counselling groups based on sexual orientation
and gender identity
- anti-discrimination policies
- LGBTTTIQ-positive materials in waiting areas
- access to LGBTTTIQ-positive therapists/counsellors.
What's in the Manual?
To provide effective addiction and mental health services,
therapists/counsellors need to be aware of these life factors in
clients. Asking the Right Questions 2 seeks to help service providers create
an environment where all clients feel comfortable talking about their
sexual orientation and gender identity.
This manual includes:
- the ARQ2 guide to be used with a standard substance use, mental
health, or other service assessment (pages 6–7)
- background information to help therapists, counsellors, nurses, doctors,
and other clinicians use the ARQ2 guide (pages 8–37)
- answers to common questions from counsellors (pages 38–47)
- a list of resources for counsellors (pages 48–54)
- a glossary of concepts, used throughout this manual, to help therapists/
counsellors familiarize themselves with terms that may be used by
LGBTTTIQ clients and communities
There are two parts to the ARQ2 guide.
Part A is a one-page assessment form to be completed by the client, in
the presence of the therapist/counsellor, during the initial assessment
interview or early in the counselling process. It is used to identify clients'
sexual orientation and gender identity and to ask about related concerns.
Part B is a set of eight open-ended interview items to be asked by the therapist/counsellor during assessment or early in the counselling/treatment
process. It is used to identify LGBTTTIQ clients' concerns that will be relevant
to treatment/case planning.
Download ARQ2: Asking the right questions 2 - Talking With Clients about Sexual Orientation And Gender Identity in Mental Health, Counselling and Addiction Settings in PDF format.
