Brenda McGarrity

TheResearch
Proposal
LGBTQ
Communi
ty and
Recovery
of
Substanc
es

Abstract
The study is trying to determine if having a specific substance abuse
treatment for queer individuals increases positive experience in treatment as
well as if it increases chances for long term sobriety. The independent
variable in this study is substance abuse treatment. The dependent variable
is the experiences in treatment and long term recovery outcomes. There is
also a control comparison group which would be the heterosexual group that
goes through the regular religiously affiliated treatment center program. The
methods used included having multiple specifically chosen demographic
groups take different forms of treatment. To learn about peoples experiences
and to learn about sobriety outcomes the study used surveys to obtain the
information. The value of the expected outcomes would be finding more
effective routes for substance abuse treatment for queer individuals.
Introduction and review of the literature
The questions this study is trying to answer are: does having a
substance abuse treatment specifically for queer individuals significantly
increase positive experiences in treatment? Does it increase chances of long
term sobriety for queer individuals? The hypothesis of this study is the more
intently the substance abuse treatment addresses an individuals identity
specifically the needs of queer identified individuals the more positive they
will likely feel about their treatment experience. It is also hypothesized that
the more intently the treatment also tends to the specific needs of queer
individuals the greater likelihood that they will participate in long term
recovery. The independent variable in this study is substance abuse
treatment. The dependent variable is the experiences in treatment and long
term recovery outcomes. There is also a control comparison group which
would be the heterosexual group that goes through the regular religiously
affiliated treatment center program.

For most people facing addiction to substances, trying to get clean is

hard. Seeking recovery can be a path of struggle from going into inpatient
treatment, to outpatient treatment and even finding the right support groups
to continue your life in recovery. This can be further complicated if the courts
are involved, if youre working class, or impoverished. Its complicated even
more if there are cultural or religious barriers. To take these scenarios into an
even bigger challenge, what if you werent placed in groups where you felt
you belonged, what if you were bullied or didnt feel safe in the spaces where
you are in theory supposed to feel the most support in your recovery?
The scenarios above are just a few of the things some LGBTQ
people face while seeking recovery. The LGBTQ community is a particularly
vulnerable group when within an already vulnerable population of people,
people facing addiction to substances. Both groups face a lot of
stigmatization from the larger society. Most of the studies that have been
done on these intersecting identities have been done in urban settings of big
cities. Most of the research has been done on what, and how much people in
the LGBTQ community use. Some research has been done on why they use,
while less research has been done on the experiences they had in treatment
and within long term recovery options. This study has been based off of and
around the missing information of 5 different literature pieces.
One of the literature pieces found talked about substance abuse
among gay men, lesbians, & bisexuals of each sex. The article did not
investigate substance abuse among gender non-conforming folks, trans
identified folks or others in the queer community. Although this article
brought up that there are some LGBTQ specific recovery options out there, it
also addressed that there is only a handful of inpatient treatment centers
specifically for LGBTQ folks and how many outpatient facilities lack a LGBTQ
group option. This articles sample was a convince sample so all participants
in this sample participated in a 12 step program or knew someone who
attended a 12 step program in a large urban queer community area. The

study found that folks in the sample who were treated in a specialized LGBT
substance abuse program or group were more likely to report being
abstinent later in life and reported higher levels of both therapeutic support
and connection and lower levels of leaving treatment. The study actually
found that the specialized treatment was the only factor that was a
significant predictor of the persons current abstinence. The study also found
that being bisexual was a negative predictor of abstinence at the end of
treatment. This indicated to the author that it may be due to encountering
more difficulties in treatment than gay individuals. This also implies that
bisexual individuals have different needs than gay individuals, even though
the two groups are viewed as a unified group with no specialized services for
bisexual individuals (Senreich , 2009). Due to the lack of acknowledgment of
trans or gender non-conforming folks or others in within the queer
community it could be assumed that these individuals would potentially
encounter more barriers than even bisexual individuals in treatment. This
would need to be researched more for those populations and their
experiences. This contributed to my study because I wanted to represent
different identities within the queer community and see if the identities had
different results in response to the different forms of treatment options.
An article thats focus was on influences, treatment and
prevention for addiction in LGBT communities brought up the historical
factors that can potentially lead to substance abuse in this population. The
article also talked about unique cultural features that could also contribute to
substance abuse which in turn would need culturally sensitive treatment. It
also addressed social and interpersonal stressors on LBGT folks that can lead
to substance abuse and the importance of overcoming discrimination inside
and outside the walls of treatment programs. This author also commented on
the lack of literature on transgender folks, but also failed to mention other
folks in the queer community that are not talked about such as gender nonconforming or A sexual or pan sexual etc. This author also talked about the

need of research looking at intersectionality of gender and ethnic minorities

to develop a greater understanding of how to serve these folks. The main
point of this article was that their needs to be more attention on strength
based models, resiliency, and prevention for those in the LGBT population
facing substance abuse (Brubaker , 2012). This article contributed to my
study because it once again highlighted a lack of representation of specific
queer identities. It also contributed ideas about what kinds of things would
need to be addressed in treatment such as oppression. This study helped me
develop many of my survey questions.
Another article was looking at what kind of drugs specific groups in the
LGBT community tend to use. This article also looked at possible reasons for
folks to be abusing substances. One of the main points gained from this
article is that among the LGBT group there are different sub-groups, the subgroupings proving to be meaningful to inform treatment approaches for
individuals. The study done seemed to find that sub-groups tended to use
certain drugs (at least in this sample), which has the potential to help
professionals better examine and address individuals needs for treatment
based on drug of choice as well as the individuals identity (Cochran, 2007).
This article contributed once again to the idea that so many within the queer
community need specifically geared treatment options that address their
identity. This article also contributed in wanting to see the differences of
needs across the various identities. In regards to my study it was to see if
increased specificity of treatment affected those in the queer community
across the board or if there would be a variance.
Another article talked about specifically gay men and substance abuse
and the things that affect these individuals that can lead to substance abuse.
This article also talked about options for treatment. For example, the article
talked about how a harm-reduction model might work well for this
population. The article also talked about different things counselors might
want to work on with individuals in this population, such as internalized

homophobia or internalized negative societal attitudes if it applies to the

individual. The article focused a lot on the challenges that specifically the
gay male identified population face in the US and what the author thought to
be effective ways of serving these individuals. It also touched on relapse and
triggers and how different drugs effect this population. The article ended
talking about the importance of continuing this kind of research and the need
for the topic to have more clinical attention (Drew, 2012). The importance of
this research and the need for clinical attention should not just be aimed at
gay identified males but on the whole queer community. Its important for
professionals to look all the factors that affect these different sub-groups
within the queer community seeking recovery, so that they can be served
better and have a greater chance of being in long term recovery. This article
contributed to my study in terms of wanting to include measures or potential
limitations if relapse occurred or if the participants dropped out of treatment.
This article made me address in my study the potential of someone dropping
out of treatment and then not being found or refusing to continue to
participate.
The last article used talked about resiliency in getting sober and
sustaining sobriety among older lesbians with alcoholism. The study
interviewed a small sample of older white lesbian woman who were
educated, middle class individuals who came from urban settings and had a
year of sobriety. What came from the study was a greater understanding of
the importance of having culturally sensitive treatment provisions for
individuals. This article also touched on many things that were brought up in
other articles like the difficulties and challenges in attaining and sustaining
sobriety. This author really stressed the importance of support systems in
attaining and maintaining sobriety as well as those supports being
knowledgeable and sensitive to the individuals gender identity and
substance use. This would mean that support systems would have to
educate themselves on gender identity and the experiences of those

identities. It would also mean that support systems would need to educate
themselves on substance effects and effective treatments for these
substances (Rowen, 2014). This article laid the foundation in my study to be
about various levels of support. I wanted to test how various kinds of
treatment support affected the queer community. I wanted to measure
likelihood of better treatment experiences in relation to treatment geared
specifically to an individuals gender identity. This article also showed the
importance of allowing an individual to be their own voice in reporting how
treatment is going/effecting them.
Method or study design
With all the information gathered from above the following study design was
created.
Sample selection
Each group would consist of 12 participants. So there would be a total
of 60 participants. The various treatment options would be paid for by the
research study for the participants involvement in the study. The study
would be advertised to treatment facilities and to social service agencies
around the US to gain participants. Participants would not have to have all
the same start dates; this will allow all participants to start as soon as they
are able to avoid them changing their mind in starting their recovery
process.
Participant demographics
The participant demographics would consist of a heterosexual group
that would be a quota sample of Minneapolis, Minnesota. Minneapolis was
chosen because it is one of the few locations of a queer specific substance
abuse treatment center. The other 4 group demographics would consist of 2
gay identified men, 2 lesbian identified women, 2 Trans men, 2 Trans women,
2 gender non-conforming, and 2 other queer identified folks.

Instruments used or developed

Surveys would be used to collect data on participants experiences as well as
track their sobriety with the various treatments. Surveys would be self-assed.
Survey questions will include but are not limited to: how accessible was
treatment for you? Would you have gotten treatment if it wasnt paid for by
the study? What has been your treatment experience? How safe had you felt
in treatment? How open have you been in treatment? Have you thought
about leaving or left? Did gender Identity ever come up? If so what was that
experience like? How do you feel about the treatment center staff,
counselors, or curriculum? What was your experience with your peers like?
The studies budget would include the cost of surveys, survey mailing,
and traveling cost of participants, Treatment costs for participants and pay
for data and survey collectors, and publishing/editing costs. The breakdown
of costs:
Surveys: 60 participants x 4 copies of surveys = 240 surveys
240 Surveys x print cost of $4.19 = $1005.60
Survey administration costs: $15 x 3 hrs = $45 x 60 participants = $2,160 x
4 surveys = $10,800
Traveling costs: 48 queer participants x $2,000 air fair = $96,000 + ($40 cab
fair x 48 queer participants = $1,920) = $97,920
Total Expected Costs: $109,725.60
Type of study designed
The study would consist of 4 groups of folks who identify in the queer
community. There would be a 5th comparison group that would be made up of
heterosexual counterparts. Each group would enter a form of substance
abuse treatment. One group would go to the Pride Institute (a LGBT
substance abuse treatment center); the second group would go to a

treatment center with a LGBT support group available. The third group would
go to a regular religiously affiliated treatment center with a LGBT support
group option. The fourth group would go to a regular religiously affiliated
treatment center without any LGBT option. The 5th group which consists of
heterosexuals who would go to a regular religiously affiliated treatment
center.
The participants will take their first survey half way through their
treatment experience and again at the end of treatment. The participants
will take 2 more surveys 3 months and 6 months after completing treatment
to have a better understanding of the sustainability of participants recovery.
The reason the 3rd & 4th queer group and the heterosexual group are
in religiously affiliated treatment programs is because they are the most
common forms of treatment available in the US. Religiously based substance
abuse treatment largely stems from historical contexts of religious treatment
centers and AA/12 steps being written by two religious straight, white,
middle class men.
Prediction of study outcome
The expected outcome would be that queer individuals would have
better treatment outcomes and experiences if they went to an exclusively
queer inpatient treatment center. If the expected outcome does occur and
this study supports the hypothesis it would hopefully lead to exclusively
queer treatment centers becoming more accessible. One of the ways queer
treatment centers could become more accessible would be if more queer
treatment centers were created. Another way would be if transportation to
these treatment centers was covered. Another accessibility issue that would
need to be addressed is insurance and if they will help cover specialized
treatment centers.
Discussion of the significance of expected results

The results of the study would be applied to the human service field of
substance abuse and addiction. If human service professionals want every
person to have an equal chance to having a successful recovery we would
need to offer the most effectively known treatment. It would be unethical to
ignore the results of the study and not give queer individuals adequate
access to substance abuse treatment specific to their needs if it was found
that specific LGBT treatment showed a significant difference in outcomes.
This study would contribute a lot in terms of available data. The data
currently available in various library data bases in fairly limited. We are
currently at the point where people are starting to ask these kinds of
research questions and are starting to find this information. My study will
help build that library on LGBTQ topics/ substance abuse topics.
Limitations of the study
The limitations of this study include but are not limited to the planned
and crafted participant demographics of the queer groups. This might not
have the most accurate depiction of a whole group of people and would need
to have this study re-done or have similar studies done to help validate this
studies results.
One of the limitations of the study is that in theory people not from the
state of Minnesota who participated might have more self-driven motivation
for treatment because it is likely that the queer participants might be coming
from out of state to participate and might not have had the opportunity
otherwise. Due to this, the queer participants might have started the study
with more self-motivation than the heterosexual comparison group. Another
limitation is that the Pride Institute treatment center only has 8 beds
available at a time and so at this point it would not realistically be able to
take in 12 participants for the study.
A few other limitations include the survey questions which might not
have been all-inclusive of experience differences. The survey questions also

might have been leading to the participants. The study might not have had
the most accurate budget, so the budget should attempt to be higher in
order to make sure all costs would be covered. Another limitation might be
unexpected costs. People might leave treatment early and might refuse to
participate in the study after leaving treatment. Survey questions would
have questions about if participants wanted to leave or did leave treatment
or relapsed or wanted to relapse, but the limitation might be finding and
getting people to participate in the survey after leaving treatment.
Other limitations would include the study not following them for up to 5
years after the study, checking in with the participants once every year.
Another limitation would be not including other factors that might lead to a
relapse throughout treatment or after treatment. Are the relapse triggers
related to gender identity?
Another limitation that isnt factored in is when they leave treatment
did they stay in areas that supported queer sobriety? Did they go back
home? What environments are they around after treatment and how do
those spaces factor into long term recovery or relapse?
Conclusion
Assuming that the study indicated that queer individuals do show
significantly better outcomes and experiences with a LGBT specific treatment
center, it would prove a basis for creating more LGBT specific treatment
centers. Advocating & creating more LGBT specific treatment centers around
the US would make this form of treatment more accessible to those that
would benefit from this treatment. In making this option more accessible by
location there is higher potential that state insurance might be able to cover
this treatment. If state insurance still wouldnt cover an individual to access
this treatment, this study would allow for the argument of ethics in terms of
what is known to be more beneficial for queer individuals success in
recovery. The hope is that this study would help lead the way for LGBT

individuals to have more accessibility to substance abuse treatment that is

geared towards addressing their specific needs holistically as a LGBT
individual seeking recovery.

References
Evan Senreich (2009) Demographic, Background, and Treatment Factors
That Affect Gay and Bisexual Clients in Substance Abuse Programs, Journal of
LGBT Issues in Counseling, 3:3-4, 177-197, DOI
10.1080/15538600903347371
Michael P. Chaney & Michael D. Brubaker (2012) addiction in LGBTQ
Communities: Influences, Treatment, and Prevention, Journal of LGBT Issues
in Counseling, 6:4, 234-236, DOI:10.1080/15538605.2012.725649
Cochran, B., Peavy, M., & Santa, A. (2007). Differentiating LGBT Individuals in
Substance Abuse Treatment: Analyses Based on Sexuality and Drug
Preference. Journal of LGBT Issues in Counseling. DOI:
10.1300/J463v03n02_07

Brian J. Drew. (2012) A Review of Gay Men And Substance Abuse: A Basic
Guide for Addicts and Those Who Care for Them, Journal of LGBT issues in
counseling, 6:1, 86-90, DOI:10.1080/15538605.2011.629168
Noell L. Rowan & Sandra S. Butler (2014). Resilience in Attaining and
Sustaining Sobriety Among Older Lesbians With Alcoholism, Journal of
Gerontological Social Work, 57:2-4,176-197, DOI:
10.1080/01634372.2013.859645
PRIDE Institute: Creating a Healthy LGBT Community (n.d.). Retrieved
November 29, 2014, from http://pride-institute.com/about/lgbt-treatmentcenters-locations/