Year of Award


Document Type


Degree Type

Master of Arts (MA)

Other Degree Name/Area of Focus


Department or School/College


Committee Chair

Bryan Cochran, Ph.D.

Commitee Members

Kari J. Harris, Ph. D, Christian Zal-Herwitz, Ph.D.


LGBTQ; Substance Use Treatment


University of Montana

Subject Categories

Clinical Psychology | Health Policy | Health Psychology


Health disparities researchers have identified elevated rates of difficulties among gender and sexual minorities (GSM). In addition to a higher rate of general mental health issues, there is also a higher prevalence rate of substance misuse among GSM individuals when compared to the general population. Specific issues, such as stigma and oppression faced by GSMs, might have a direct linkage with the higher prevalence rate and might also impact treatment outcomes. To understand the specific factors that lead to substance misuse, as well as to understand the unique patterns of treatment-seeking and adherence among GSM clients, the development and dissemination of LGBTQ specific treatment programs are needed.

In 2007, Cochran, Peavy, and Robohm conducted a study of treatment programs which indicated that they provided specialized services for gay and lesbian clients; however, phone calls to these agencies revealed that over 70% of these agencies actually did not provide services that were different from the agencies' general services. Given the progress and development in the last decade regarding awareness of GSM rights, the current study aimed to gain a renewed understanding of the state of GSM-specific substance treatment in 2020 using a similar methodology. Results indicated that although there has been an increase in both the number and percentage of agencies that provide LGBTQ-specific services since 2007, fewer than 1 in 5 agencies who indicated offering LGBTQ-specific treatment on the National Survey of Substance Abuse Treatment Services (N-SSATS) survey actually provided such services (17.4%) in 2020. Additionally, our findings indicated a strong relationship between a positive (simulated) treatment-seeking experience and the agency staff’s breadth and depth of knowledge of available services. Implications, limitations, and directions for future research for GSM clients seeking specialized services are discussed.

Keywords: substance use, substance misuse, LGBTQ specific treatment, Gender and Sexual Minorities (GSM), initial contact



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