ARQ2: Asking the right questions 2 - Talking With Clients about Sexual Orientation And Gender Identity in Mental Health, Counselling and Addiction Settings

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Link: http://www.camh.net/Publications/Resources_for_Professionals/ARQ2/arq2.pdf
Org: Centre for Addiction and Mental Health

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.