Megan E . Gandy

This study introduces a new instrument designed to assess affirmative clinical practices with sexual and gender minority (SGM) clients, the Lesbian, Gay, Bisexual, and Transgender Competency Assessment Tool (LGBT-CAT). The LGBT-CAT has two unique qualities: Its design enables adaptation to measure practice competencies with gay, lesbian, bisexual and/or transgender clients, the latter of which has no existing measures regarding practice competencies, and it uses a qualitative collection method. Participants respond to 12 open-ended prompts; responses are then quantified by one or more raters based on a scoring rubric. In this cross-sectional study, practicing social workers (N=357) were surveyed using the LGBT-CAT as well as measures of affirmative practices with SGM clients, knowledge, beliefs, self-efficacy skills, attitudes, and behaviors. The LGBT-CAT demonstrated good reliability, poor criterion validity, and adequate construct validity. These results support the potential integration of the LGBT-CAT into research on practice with SGM clients.

In 2015, marriage equality in the United States was a big win for the gay and lesbian movement. Marriage equality as a primary focus of the movement, however, was not without its critiques, particularly as an issue affecting mostly white, gay, economically secure individuals. Given the history of the movement, it is essential to ask what is next. Young queer and trans people represent the next generation of potential activists and advocates for queer and trans liberation, yet little empirical attention has been paid to their goals for the movement and motivations to be actively involved, particularly among young adults in rural, conservative states. Therefore, this study sought to understand the social, economic, and environmental issues deemed important by queer and trans young adults (aged 18–29), as well as their motivations to get involved in activism efforts. Data came from a mixed-methods program evaluation, which presents a picture of the issues and motivations that led study participants (n = 65) toward activism in one conservative, highly rural, Southwestern state in the United States. The findings of this study are discussed in light of theoretical and empirical literature and then implications for the queer and trans movement, activists, and organizers are offered.

Sexual and gender minority (SGM) youth are disproportionately represented in behavioral health treatment settings, and face disparities in outcomes when compared to their non-SGM peers. These youth need workers who are culturally competent in addressing their specific needs. This paper presents a scale to measure the SGM-related cultural competence of direct care workers. The scale, named the Queer Youth Cultural Competency scale (QYCC), fills a gap in the measurement literature and enables social workers to more robustly address the cultural competency of service providers as it relates to lesbian, gay, bisexual, transgender, queer, and questioning youth receiving behavioral health treatment.

Direct-care workers can provide an array of service types to children, adolescents, and their families in behavioral health treatment. They may also work in a variety of settings (e.g., group homes, inpatient units/hospitals, residential treatment, treatment foster care, day treatment, in-home treatment, etc.). Direct-care workers typically are involved in the supervision of youth and in the implementation of a treatment plan developed by the youth’s treatment team. For youth who are lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) and are receiving behavioral health services, such workers form a critical part of their therapeutic experience. However, little is known about these workers’ competencies related to working with LGBTQ youth. This study begins to fill that gap by developing and testing a measure that assessed LGBTQ cultural competencies related to behavioral health practice with youth and a measure that was relevant to the roles and responsibilities of direct-care (e.g., paraprofessional, front-line) workers.

In order for direct-care workers to use LGBTQ cultural competency in their practice, more understanding is needed about their current level of LGBTQ-related cultural competency. The LGBTQ Youth Cultural Competency scale (abbreviated as LGBTQY-CC) provides a means to measure those competencies. An exploratory factor analysis found that the new scale consists of one primary factor which represents knowledge, attitudes, skill, and awareness of LGBTQ cultural competency. Cronbach’s alpha, correlations with other measures for concurrent validity, and correlation with a measure of social desirability all resulted in evidence that the LGBTQY-CC has good validity.

Analyses examined how the new measure was related to constructs associated with training and competency in direct-care workers. Multiple regression analyses showed that higher levels of LGBTQ cultural competency (as measured by the LGBTQY-CC) were significantly related to age (younger), political ideology (more liberal), more social contact with LGBTQ individuals, and degree of religious belief about LGBTQ being a sin. A model including these factors explained 60% of the variance in LGBTQY-CC scores.

The LGBTQY-CC was created with the long-term goal of creating training interventions for direct-care workers to improve their practice with LGBTQ youth. The measure could be used to assess training participants’ knowledge, attitudes, skills, and awareness and to evaluate the effectiveness of varying types and styles of training programs. Federal and state regulatory bodies have begun to require service providers to identify how they will address disparities faced by LGBTQ individuals, so service providers need to demonstrate how they are improving access to and quality of care for LGBTQ individuals. Therefore, the LGBTQY-CC may provide a means to gather data on efforts made by service providers to improve their behavioral health workforce’s capacity to serve LGBTQ youth.

Despite trends in society towards more inclusive and affirming environments for lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) persons, youth who identify as LGBTQ remain a vulnerable population. This paper reviews two recent books that address intervention in the lives of LGBTQ youth for the purpose of decreasing vulnerabilities to risk factors that contribute to unwanted mental health outcomes such as suicide, and increasing youth resiliency in the face of those vulnerabilities: Queer Youth Suicide, Culture and Identity: Unliveable Lives? by Rob Cover (2012), and Safe Spaces: Making Schools and Communities Welcoming to LGBT Youth by Annemarie Vaccaro, Gerri August, and Megan S. Kennedy (2012). This review begins by providing a description of the content and style of each book, then moves into comparing and contrasting the books’ strengths and weaknesses and their respective approaches to addressing interventions with LGBTQ youth. The review concludes with implications for an audience of youth work practitioners, researchers, educators, and policy-makers.

This study examined trends in general hospital discharges and dispositions involving episodes of severe mental illness (SMI) with and without co-occurring substance use disorders. We analyzed data from the National Hospital Discharge Survey from 1979 through 2008. Discharges involving SMI and co-occurring substance use disorders (COD) were associated with shorter lengths of stay and had a greater likelihood of being discharged routinely or home and reduced likelihood of being transferred to a short- or long-term facility. Although COD discharges had a greater odds of leaving against medical advice than SMI discharges, this effect was not significant over time. A greater understanding of hospital discharge planning practices is needed to ensure that patients are linked to appropriate aftercare services.

This study examined mental health service providers’ attitudes
toward LGBTQ youth in an agency setting (n = 100) using the
Homonegativity Scale, the Personal Comfort Assessment Tool, and the Gay Affirmative Practice Scale. The results of this study indicate that job category is associated with mental health agency employees’ attitudes toward LGBTQ youth. Most notably, respondents from the Management/Supervisory category reported less homonegative attitudes toward LGBTQ youth than respondents from the Administrative/Clerical/Support job category. A post hoc regression analysis revealed that homonegative attitudes predict gay affirmative practice for this sample. Implications for policy and practice are explored.
DOI:10.1080/0886571X.2013.813344

Cisgender is an identity term that refers to a person whose gender identity matches the sex that was assigned to that person at birth. The term, which serves to distinguish transgender identity from nontransgender, originated in the transgender rights movement and was borrowed from the biochemical sciences. Cisgender privilege is implied in the use of the term. Some activists and scholars critique the use of the term because of its implications for furthering a binary understanding of normative gender identity development (e.g., transgender or cisgender) rather than a fluid and wide-ranging scope of gender identity. Human services workers should become familiar with sources of privilege and oppression that the term cisgender represents and their implications for practice.

“Two-spirit” is a term that Native Americans use to self-identify as gay or lesbian, transgender, or as an alternate to binary gender roles (male and female). It is a contemporary term but has roots in Native American precolonial History. Identity development is suggested to evolve over a relatively linear cycle of stages; however, some argue for an indigenous way of understanding identity that does not conform to the linear and standardized approaches to knowledge that are embraced By the dominant Western culture in the Americas. Human service workers should be aware of the many health disparities faced By this population and should approach working with these individuals in a culturally competent manner.

Research on lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth has predominantly operated within a risk framework, highlighting the risks youth face in their homes, schools, and communities and how these risks are associated with disparate mental health outcomes. This research has been important in establishing the challenges faced by LGBTQ+ youth and the need for interventions to reduce stigma and victimization and promote well-being. However, a predominant focus on risk fails to account for the strengths and resilience of LGBTQ+ youth and positions them as “at-risk” rather than as resilient. This chapter describes a study aiming to redress this gap in the literature by assessing the types of strengths LGBTQ+ young adults identify with and the association between their identified strengths and mental health.

In 2015, marriage equality in the United States was a big win for the gay and lesbian movement. Marriage equality as a primary focus of the movement, however, was not without its critiques, particularly as an issue affecting mostly white, gay, economically secure individuals. Given the history of the movement, it is essential to ask what is next. Young queer and trans people represent the next generation of potential activists and advocates for queer and trans liberation, yet little empirical attention has been paid to their goals for the movement and motivations to be actively involved, particularly among young adults in rural, conservative states. Therefore, this study sought to understand the social, economic, and environmental issues deemed important by queer and trans young adults (aged 18–29), as well as their motivations to get involved in activism efforts. Data came from a mixed-methods program evaluation, which presents a picture of the issues and motivations that led study...

Abstract The social media site (SMS) Facebook can provide social workers with a method to engage in informal peer support. Scholars to date have mainly focused on SMSs such as Facebook as they pertain to clinical interactions with clients, maintaining professionalism especially among social work students, using them for professional or organizational promotion, and using them as an educational tool. Informal peer groups have been found to be an effective tool to combat burnout in high-stress professions such as social work. The use of a SMS such as Facebook for informal peer support could provide additional benefits to social workers beyond what they would experience from offline contact. This article fills a gap in the literature by describing how a group of practicing social workers use a private Facebook group for peer support, informal consultation, emotional support, and personal social connection. Given the continual high rates of job stress and burnout, social workers should consider new and innovative ways to use SMSs such as Facebook to enhance their self-care efforts.

This exploratory study recruited a purposive sample of twelve clinical staff from a Program of Assertive Community Treatment (PACT) team in central Virginia to understand the perceptions and experiences related to assertive engagement. The researchers coded the transcribed data initially as twenty-three sub-themes and further refined the data into four overarching themes: characteristics of assertive engagement, PACT engagement strategies and engagement strategies for difficult to engage clients. Further analysis emphasized that PACT team members emphasized the importance of the therapeutic relationship for engagement, which proves challenging for hard-to-engage clients.

This study examined trends in general hospital discharges and dispositions involving episodes of severe mental illness (SMI) with and without co-occurring substance use disorders. We analyzed data from the National Hospital Discharge Survey from 1979 through 2008. Discharges involving SMI and co-occurring substance use disorders (COD) were associated with shorter lengths of stay and had a greater likelihood of being discharged routinely or home and reduced likelihood of being transferred to a short- or long-term facility. Although COD discharges had a greater odds of leaving against medical advice than SMI discharges, this effect was not significant over time. A greater understanding of hospital discharge planning practices is needed to ensure that patients are linked to appropriate aftercare services.

Research indicates that rural transgender and gender diverse (TGD) populations have a greater need for health services when compared with their urban counterparts, face unique barriers to accessing services, and have health disparities that are less researched than urban TGD populations. Therefore, the primary aim of this mixed-methods study (n = 24) was to increase research on the health care needs of TGD people in a rural Appalachian American context. This study was guided by a community-engaged model utilizing a community advisory board of TGD people and supportive parents of TGD children. Quantitative results indicate that travel burden is high, affirming provider availability is low, and the impacts on the health and mental health of TGD people in this sample are notable. Qualitative results provide recommendations for providers and health care systems to better serve this population. Integrated mixed-methods results further illustrate ways that rural TGD people and families ad...

Research on lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth has predominantly operated within a risk framework, highlighting the risks youth face in their homes, schools, and communities and how these risks are associated with disparate mental health outcomes. This research has been important in establishing the challenges faced by LGBTQ+ youth and the need for interventions to reduce stigma and victimization and promote well-being. However, a predominant focus on risk fails to account for the strengths and resilience of LGBTQ+ youth and positions them as “at-risk” rather than as resilient. This chapter describes a study aiming to redress this gap in the literature by assessing the types of strengths LGBTQ+ young adults identify with and the association between their identified strengths and mental health. First, we provide a summary and critique of the literature on LGBTQ+ youth risks and strengths.