Substance Use Among Women Who Have Sex with Women Public Deposited

http://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/b8515r33h

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  • Professional organizations in the fields of counseling and psychotherapy-related professions all require counselors and counseling students to work with a vast array of potential clients who may differ significantly from themselves. For example, these counselor and client differences can include one or several factors such as age, race, ethnicity, ability status, socioeconomic status, sexual orientation and/or gender identity. As part of building up counselor competency to work with diverse individuals, ethical standards require counselors and counseling students to seek out relevant literature as it relates to appropriate assessment, intervention and advocacy for their clients. Likewise, the Substance Abuse and Mental Health Services Administration (SAMHSA) requires counselors and counselor supervisors within the substance use counseling specialty to attend to issues of diversity both within the counselor to client relationship but also the supervisor to supervisee relationship. Additionally, substance use counseling supervisors are required to provide or coordinate appropriate and relevant supervisee training as needed related to issues of diversity to empower counselors to better advocate for both individual client needs as well as organizational change when appropriate. As part of a commitment to explore issues related to multicultural counseling and contribute to relevant literature, the research presented in this dissertation sought to study a population that often goes unnoticed and slips through the cracks of researcher consciousness. Few research studies that explore issues related to substance use or substance use as it relates to sexuality focus exclusively on female-identified populations. As such, women who have sex with women (WSW) often go unnoticed within study populations and become an invisible minority. Evidence exists to suggest women who report same-sex partners may be at elevated risk for experiencing negative health effects from alcohol and tobacco use. Using substances such as alcohol and tobacco at higher rates and frequencies can result in significant negative medical, social and interpersonal outcomes. Important common factors appear numerous times in the literature base on problematic substance use within lesbian and bisexual populations. For example, women who report same-sex partners more commonly report being current or former smokers, are less likely to abstain from alcohol and report more frequent instances of being drunk and an overall higher rate of alcohol consumption. The current study first utilized multiple regression analyses to examine the predictability of known demographic and behavioral risk factors for increased substance use among a sample of WSW who participated in the New York City Community Health Survey ( NYCCHS). Age, annual household income, race and past or current history of depression were included in the regression analyses to determine the predictability of these variables on participants self-reported levels of alcohol and tobacco use. Results showed that within the sample of WSW, age and a past or current history of depression were significant predictors of alcohol use. Race was the only significant predictor of tobacco use. Next, drawing upon the same sample of WSW in the NYCCHS, three two-tailed t-tests for independent means were performed to determine if a difference exists on levels of alcohol and tobacco use between WSW and who have experienced interpersonal violence, as quantified by the reported experience of either intimate partner violence or unwanted sexual contact, and WSW who have not experienced interpersonal violence. For WSW who reported alcohol use within the last 30 days, results showed that there exists a significant difference between the number of alcoholic drinks consumed between WSW who also reported interpersonal violence and WSW who did not report interpersonal violence. For WSW who reported any lifetime use of alcohol, results also showed a significant difference between the number of alcoholic drinks consumed between WSW who also reported interpersonal violence and WSW who did not report interpersonal violence. There was no significant difference in tobacco use between the two groups of WSW. The primary implication that emerged from this study was that women who report same-sex partners might be at increased risk of experiencing negative life outcomes stemming from elevated alcohol use and, in some instances, tobacco use. This population of WSW often goes unnoticed both in the realm of research in psychology and related fields and also within the context of treatment-setting environments. Sexual behavior and sexual orientation are often conflated. As such, women who have same-sex partners but do not identify openly or otherwise as lesbian, bisexual or other sexual minority, can frequently fall victim to heteronormative expectations and assumptions in community counseling environments but also within the intimacy of the therapy room. Particularly in treatment setting specific to substance use disorders and co-occurring disorders, these results reinforce the importance of counselors not only inquiring about sexual orientation but also remaining mindful and sensitive to gendered language when exploring past and current client relationships.
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