Substance abuse treatment providers' explicit and implicit attitudes regarding sexual minorities

Lesbian, gay, bisexual, and transgender (LGBT) individuals have been found to have elevated rates of substance use disorders when compared with heterosexuals. However, little is known about the challenges a sexual minority might face in presenting for substance use treatment. In this study, treatment providers' attitudes toward LGBT individuals were assessed among a sample of 46 substance abuse treatment counselors who provide publicly funded treatment. Participants completed both explicit measures of heterosexist bias and an implicit measure designed to assess for biases that exist at an automatic, uncontrolled level. Results indicate that treatment counselors' negative biases regarding LGBT individuals were stronger for heterosexual counselors and for those with few LGBT friends. However, biases among this sample were significantly less than in comparison samples. Findings were also related to a newly developed measure of cultural competence in working with LGBT substance users. Implications for provision of appropriate services and recommendations to treatment agencies are discussed.