From: MShernoff@aol.com
Date: Fri, 17 Jan 1997 07:40:19 -0500 (EST)
Subject: family therapy with chemically dependent gays & lesbians

	Family Treatment with Chemically Dependent Gay Men and Lesbians
Published in The Journal of Chemical Dependency Treatment, V.4, No.1, 199=
1
Michael Shernoff, CSW, MSW & Dana Finnegan, PhD, CAC
 1991 Michael Shernoff & Dana Finnegan.
Permission is granted to copy or reproduce this article either in full or=
 in part, without prior written authorization of the authors on the sole =
condition that the authors are credited and notified of reproduction.
	ABSTRACT
This article will examine three issues: (1) the context within which fami=
ly treatment of chemically dependent gay men and lesbians takes place; (2=
) the concepts which underlie any understanding of how to provide quality=
 treatment to them; and (3) examples of practical approaches to providing=
 such treatment.
	INTRODUCTION
When chemical dependency counselors work with lesbians and gay men, it is=
 important for them to consider both the context of their clients' lives =
and the concepts that influence them. First, as is true of all people str=
uggling to recover from chemical dependency, the situations, feelings and=
 attitudes that gay and lesbian people must deal with are often complex. =
Counselors need, however, to learn about, become sensitive to, acknowledg=
e, and respond to the stressors specific to being lesbian or gay in this =
society.
Many of the difficulties experienced by lesbians or gay men that are uniq=
ue to this population are generated by homophobia. For example, growing u=
p as a gay man or lesbian in a heterosexual and
homophobic family and having to keep secret one's sexual identity and aff=
ectional preference creates a powerful dysfunction that is a result not o=
f the individual's homosexuality but of society's homophobia.
Thus it is not enough to say that clients' chemical dependency is always =
the only justifiable focus early in treatment. There are times when peopl=
e's concerns about their sexual orientation may demand attention if they =
are to get or stay clean and sober. For instance, counselors need to reco=
gnize that sometimes it is very important to validate client's bitter or =
pained assertions that homophobia has seriously contributed to their chem=
ical dependency.
Second, the definitions of family are changing in this culture, and the m=
eanings of these new definitions need to be applied to lesbian's and gay =
men's lives. All too often there is a tendency to see lesbians and gay me=
n primarily, if not solely, as individuals rather than as members of fami=
lies of origin and as creators of new family systems. These families of c=
reation may serve as additions to and/or placements for nuclear families.=

Therefore, a new comprehensive perspective on family is called for. Couns=
elors need to know that gay men and lesbians may have children from earli=
er heterosexual relationships or may choose to have children by artificia=
l insemination or through adoption. Furthermore, gay people who do not ha=
ve children usually create a family system comprised of friends, some of =
whom may be current or ex-lovers.
	CHEMICAL DEPENDENCY IS A FAMILY ILLNESS FOR ALL CLIENTS
In the 1970's, many chemical dependency counselors did not tend to "think=
 family" when they worked with their chemically dependent client. If they=
 thought about the family, it usually was to consider whether or not the =
spouse (usually the wife) could or would be helpful to the addicted clien=
t's recovery. But most counselors were not trained to think of the indivi=
dual client as part of a larger system that impacted upon the client's ef=
forts to recover from alcoholism or other drug abuse. That perspective ha=
s changed significantly in the past ten or fifteen years. Most profession=
als now treat chemical dependency as a family illness at least with clien=
ts who are heterosexual or presumed to be so.
Unfortunately, this family perspective often does not get applied to clie=
nts who are lesbian or gay. All too frequently, counselors view and treat=
 lesbian or gay clients as if they were single, discrete beings who hail =
from some distant and unknown planet without any human relationships. Cou=
nselors who do not assess lesbian or gay clients within the context of th=
eir families and friendships may provide these clients with good individu=
al treatment, but too often ignore their larger, critically important hum=
an systems.
Perhaps because so many heterosexual counselors have little if any knowle=
dge of or personal acquaintance with gay men or lesbians, they regard the=
 lesbian or gay client as different and foreign to their experience. Thus=
, all too often, clinicians who know that a family perspective is vital t=
o good treatment because chemical dependency is a family disease do not r=
ecognize the relevance of that perspective to gay men and lesbians who ar=
e chemically dependent.
	THE DYSFUNCTIONAL NATURE OF HOMOPHOBIC FAMILIES
The third consideration counselors need to bear in mind is that growing u=
p lesbian or gay in a "heterosexual family" is, by its very nature, a dys=
functional process unless the family is not homophobic. Unfortunately, mo=
st families are at least somewhat homophobic. We are not saying that bein=
g lesbian or gay is dysfunctional. Rather, we are contending that when pe=
ople grow up in a family system where they cannot be or say who they trul=
y are, they are placed in a position of dysfunction. The prejudicial and =
oppressive values of the system and the actions based on those values mak=
e the system, not the individual, dysfunctional.
A system is dysfunctional when it forces its members to create a "false s=
elf" in order to survive. And that is precisely what children or adolesce=
nts who become aware of same-sex feelings and attractions do to survive. =
They create a false self which is different from who they really are and =
which prevents them from being known by even those closest to them. They =
must "split off" and hide a central part of themselves and must live a li=
e within the heart of their family. If other dysfunctional features exist=
 in the family system for example, chemical dependency then the lesbian o=
r gay child must contend with intensified problems, a kind of "double tro=
uble."
This context and these concepts need to form the backdrop for all conside=
rations about treatment approaches. Otherwise, we will add to our lesbian=
 and gay male clients' problems, rather than contribute to their solution=
s.
	Clinical Applications
Rhonda was a thirty five year old married housewife living in a medium si=
zed midwestern city who had three prior admissions for detox. Each of her=
 relapses had occurred while she was attending AA and ostensibly "working=
 her program." She presented as seriously depressed and freely talked abo=
ut wanting to hurt herself. During an individual counseling session, Dori=
s, a lesbian nurse on the inpatient unit, shared with Rhonda that ten yea=
rs earlier she had almost killed herself with prescription drugs and alco=
hol when this appeared to be an easier solution than leaving her husband =
of twelve years because she could no longer pretend that she was not attr=
acted to women. Rhonda's eyes widened and she began to ask the nurse ques=
tions about her experience, without once ever admitting that she might ha=
ve similar feelings. A few weeks after Rhonda was discharged Doris ran in=
to Rhonda at an AA meeting. Rhonda told Doris that her disclosure provide=
d for the first time in her adult life hope that perhaps she could stop u=
sing.
When questioned about why she had chosen to take this therapeutic approac=
h, Doris explained that she had considered all other possible reasons for=
 Rhonda's continued relapsing. As far as she could see there were no vali=
d explanations for Rhonda's inability to maintain her sobriety when she w=
as apparently doing everything right and going to AA every day. "I asked =
myself what could possibly be going on for this woman that I didn't know =
about or hadn't asked about that would explain her picking up. Something =
in the kind of pain that Rhonda was expressing reminded me of my own pain=
 and conflict before I got sober," Doris said. "So I decided to take a ch=
ance by sharing my story with this patient. She was too fragile for me to=
 ask directly about the possibility that she might be lesbian.
Chemical dependency workers can learn an important lesson from this case.=
 The lesson is that when a patient is relapsing in active drug/alcohol us=
e without any obvious or apparently understandable reason, unresolved sex=
ual identity conflict may well be the cause. Counselors need to be willin=
g and ready to explore this possibility with appropriate patients.
One suggested intervention is to share Doris's story with a client and sa=
y "I don't know if this has any relevance for you, bu! thought I would ju=
st share this anyway." When questioned about what in addition to her own =
intuition and the seeming lack of a reasons for Rhonda's inability to rem=
ain sober had clued Doris in issues about lesbianism, Doris said she reme=
mbered that when s asked about Rhonda's marriage and sex life with her hu=
sband Rhonda had ever so slightly shuddered and looked away. She denied a=
ny sexual or other abuse from her husband who was a non drinker in Al-Ano=
n. "This subtle reaction, that Rhonda was probably not even aware of, jus=
t rang a bell," Doris explained. Retelling Rhonda's story would be an exc=
ellent use of metaphor during treatment, a well-accepted family and syste=
ms technique.
Rhonda's case is a good illustration of why counselors need question all =
clients about sexual orientation. It is the responsibility of each counse=
lor to take the lead in this area the same way Counselors routinely quest=
ion early family history, dynamics of shame denial and spirituality. By o=
mitting questions about sexual orientation, or the more subtle questions =
about sexual or affectional feelings or fantasies for a person of the sam=
e sex, the counselor is obtaining information about all the possible cont=
ributing factors achieving and maintaining sobriety.
Thus during interviews or counseling sessions counselors should specifica=
lly and routinely be asking all clients questions about significant love =
relationships or spouses and lovers instead of only using the words marri=
ages, husbands and wives. However, directly asking a patient who is only =
a few days sober, "What is your sexual orientation?" may be too threateni=
ng for the client to answer honestly. A gentler way of opening this area =
up is to ask, "Have you ever had erotic or romantic feelings, fantasies o=
r dreams that involved a person of the same sex even if you have never ac=
ted on these feelings?" Even if the client doesn't answer these kinds of =
questions and appears uncomfortable, counselors shouldn't take this silen=
ce as an indication that questions or statements about sexual orientation=
 are not on target. Furthermore, it is important for counselors to ask th=
em in order to convey to a frightened patient that the counselor is willi=
ng to talk about and hear issues pertaining to sexual identity.
Yet if a client's denial about his or her own sexual orientation is life =
threatening, the way it clearly was in Rhonda's case, then this denial mu=
st gently and empathically be addressed. If Rhonda had not even heard tha=
t there was a professional who could articulate her intimate concerns, sh=
e probably would have continued to use or possibly would have killed hers=
elf. Generally these are patients who have had chronic slips for no appar=
ent reason, or people who wind up In psychiatric units following an unexp=
lainable suicide attempt. Very often these are heterosexually married ind=
ividuals who appear to be the farthest thing from lesbian or gay. They of=
ten have children. For these people, finally having a health care or subs=
tance abuse professional help them to look at this part of themselves in =
a nonjudgmental manner may be the only road to recovery.
	NONTRADITIONAL FAMILIES
A family or systems perspective that includes the varieties of diverse fa=
mily types that increasingly more Americans have created for themselves i=
s essential in the field of substance abuse even if the identified patien=
t is definitely not lesbian or gay. The authors are familiar with a case =
where a young adult was in rehab. His mother is a lesbian who has lived w=
ith her woman lover for the past twelve years. The lover was and remains =
an important parental figure to this young man. Even after both women vis=
ited him during rehab, none of the staff ever asked who his mother's frie=
nd was or about the nature of this young man's relationship with this wom=
an.
When this man was discharged from rehab, he went to live with these two w=
omen, one of whom is in recovery and the other a long time member of Al-A=
non. Thus he went directly from rehab to live in a family system that the=
 treatment facility knew nothing about.
This man had not even discussed with his counselor how stressful it was f=
or him to be living with two lesbians, even though he really liked both o=
f them. This man has tremendous conflicts that stem from his being ashame=
d that his mother is a lesbian. He never talked about this during rehab, =
and for a long time never shared this information either with his sponsor=
 or during meetings. Had one of these women been an active alcoholic or d=
rug addict his prospects for continued sobriety would have been even more=
 threatened.
	SHAME REGARDING LOVING SOMEONE WHO IS LESBIAN OR GAY
A related area that needs to be explored is asking heterosexual patients =
in treatment about siblings who might be lesbian or gay. One seventeen ye=
ar old woman just entering rehab for the first time was very frightened a=
bout her older sister. She adored this sister who was a lesbian and feare=
d this might mean that she was one also. In addition, she was very ashame=
d that her beloved sister was a lesbian, and that if her friends found th=
is out, they would tease her. If this young woman's counselors in the reh=
ab had not asked about her family members in enough detail so that her si=
ster's lesbianism was unmentioned, they could not have helped her deal ei=
ther with her fears regarding her own sexual orientation or her shame abo=
ut her sister. If either of these issues were left undiscussed in the ear=
ly phase of recovery, they could have contributed to this person's relaps=
e.
If parents have had a difficult time accepting the homosexuality of the b=
rother or sister of the individual in treatment, or if this is a shame-fi=
lled family secret, probing this can offer valuable insights into how rig=
id and/or dysfunctional the family system is. This information is essenti=
al for the counselor to learn in order to ascertain what appropriate disc=
harge and after-care planning will consist of.
	ISOLATION
Long term treatment for the lesbian or gay man who is in recovery must ta=
ke a family perspective which accounts for both his o, her family of orig=
in as well as any family systems that he or she has created. This is cruc=
ial because many lesbians and gay men grow up feeling terribly isolated. =
This sense of isolation persists and increases if they marry and have fam=
ilies. Even for some well-integrated lesbians or gay men who have friends=
hip groups, lovers and perhaps even children, there often remain feelings=
 of isolation and alienation that stem from unresolved feelings about the=
ir own homosexuality and society's homophobia.
As mentioned earlier, an important consideration counselors need to bear =
in mind is that growing up gay or lesbian in a family that assumes the he=
terosexuality of all its members is, by its very nature, a dysfunctional =
process unless the family is not homophobic.
Sam, always his grandmother's favorite, knew that he was attracted to oth=
er boys for most of his life, and somehow also knew that he couldn't talk=
 about this with anyone. One day when he was ten, he was reading Time mag=
azine with his grandmother. In response to a story about homosexuals she =
casually said, "We have to pray for those sick people." Sam recounted in =
a therapy session that he clearly remembers how much this comment frighte=
ned him and made him sad because he knew that grandma was talking about h=
im but that she had no idea he was one of those people she was talking ab=
out. For the first time in his life he felt very distant from her since h=
e now began to doubt whether she would love him if she knew that he was "=
one of those sick people."
For Sam this was the beginning of creating a false self that resulted in =
his having a dysfunctional relationship with an otherwise generally stabl=
e and loving family. His resolve to hide his strong feelings for other bo=
ys and men grew after this incident. Perceiving that in order to keep his=
 family's adoration he needed to pretend to be different from who he real=
ly was caused Sam to develop a lot of shame about some of his most centra=
l and most normal feelings. In order to protect his status of being loved=
 and valued by his family he began trying to deny that he even had feelin=
gs for boys because his feelings were different from what was expected of=
 him by his family. He also carefully avoided discussing these feelings a=
nd tried to behave in the manner that would assure the continued respect =
and love of his family. This was the beginning of Sam's behaving in co-de=
pendent manner that has plagued him ever since. Luckily aside from normal=
 unexamined homophobia and heterosexual bias Sam's family was not dysfunc=
tional in other ways. Thus there we not secrets related to alcoholism, vi=
olence or incest that also had be hidden and would have become additional=
 sources of shame guilt
Once again we reiterate that we are not saying that being lesbian or gay =
is in itself dysfunctional. Rather we are pointing out that society's pre=
judicial and oppressive values that simply assume that everyone is the sa=
me, i.e., heterosexual, result in the majority children who grow up to be=
 lesbian or gay feeling like outsiders within their own families. This fe=
eling of difference becomes translated into being wrong or bad. If other =
dysfunctional features exist in the same family system for example, alcoh=
olism then the gay or lesbian child must contend with intensified problem=
s which compound the hurt they already feel living as a member of their p=
articular family.
	SHAME THAT PREDATES HOMOSEXUAL FEELINGS
As the authors do long term intra-psychic therapy, we are increasingly fi=
nding that even after many years abstinence from alcohol or drugs our cli=
ents discover memories of early childhood abuse and incest that have been=
 buried deep in their unconscious. Very often the abuse or incest occurre=
d even before the child knew he was gay or she was lesbian. Most often th=
e shame and sense of difference caused by the abuse predates any sense of=
 sexual identity formation. During the course of therapy, most gay men or=
 lesbians will easily recall early childhood memories of feeling differen=
t and bad which they connect to their homosexuality. While these memories=
 and feelings are important to explore, the skilled therapist must also l=
ead his or her client in a search that could turn up feeling self-loathin=
g and low self-esteem that occurred even before their feelings for person=
s of the same sex began to emerge. The counselor then can help the client=
 differentiate between internalized homophobia and other sources of shame=
=2E
Especially with clients who are in recovery from substance abuse, questio=
ning them about memories they have that predate the formation of a sexual=
 identity is essential. Some people knew that they were attracted to othe=
r boys or girls from their earliest awareness. Other people did not begin=
 to recognize these feelings or suppressed them until puberty or even adu=
lthood. Often gay or lesbian clients will not have looked at their lives =
and experiences prior to their first feelings of shame or difference that=
 stem from the onset of homosexual feelings. In order for true healing an=
d insight to occur, clients must learn to differentiate between the probl=
ems that have their etiology in traumas experienced as a result of situat=
ions that were distinct and separate from their homosexuality. Yet the sh=
ame about their early homosexual feelings is usually viewed by clients as=
 the only reason they have felt different or damaged. Skilled therapy nee=
ds to help clients tease apart these separate, yet interrelated issues. O=
ne manifestation of internalized homophobia is commonly exhibited when le=
sbian or gay clients blame all of their early painful feelings solely upo=
n their homosexuality. A thorough therapeutic exploration of the early fa=
mily reality is necessary for both the therapist and client to gain a goo=
d understanding of what it was like for this child to grow up, and in wha=
t ways he or she was damaged long before same sex feelings emerged.
	HEALING THE CHEMICALLY DEPENDENT FAMILY SYSTEM
When a lesbian or gay man abuses alcohol or drugs, the dysfunction the su=
bstance abuse creates for his or her family of creation (lover, roommate =
or friends) is in addition to the historical dysfunction each lesbian or =
gay man grew up with as a member of a homophobic family. These dual aspec=
ts of dysfunctions occur simultaneously and inter-relatedly for both the =
person who is abusing as well as for his or her support system or lover, =
friends and nuclear family. For real and lasting sobriety to be achieved =
these different but complementary dysfunctions must be addressed and brou=
ght into the open for all parties involved.
A family or systems perspective is also useful working with lesbians or g=
ay men who have a well integrated identity as gay or lesbian. One charact=
eristic of men and women who have developed a positive lesbian or gay ide=
ntity is that they have formed a strong family of supportive friends and =
perhaps are in a committed relationship. The following example illustrate=
s how understanding the dynamics of these families can be useful when wor=
king with a ga man in recovery.
Ralph is a fifty year old gay white man who lives in Manhattan. He has be=
en with his lover Paul for fourteen years. He sought out therapy with one=
 of the authors because he was concerned about his alcohol and cocaine us=
e. After the first consultation he began to attend AA and recently celebr=
ated his two year anniversary clean and dry.
Ralph and Paul had always done a lot of cocaine together, especially when=
 having sex. Even after Ralph entered the program, Paul continued to use =
in their home and would attempt to seduce Ralph into using so that they c=
ould have sex. On advice from his sponsor, Ralph elected to tell Paul tha=
t he would love to have sex with him, but only if he wasn't under the inf=
luence of any drug. This enraged Paul, and they have not had sex in over =
eighteen months.
In Ralph's thirteenth month of sobriety, he and Paul had an argument that=
 escalated into a fist fight. Greatly shaken by the domestic violence, Ra=
lph temporarily moved out of their apartment and in with his sponsor. Sim=
ultaneously he began attend Al-Anon meetings.
They eventually negotiated Ralph's moving back in on the condition that P=
aul stop using drugs and go to AA. Newly sober, Paul was not interested i=
n having sex. This caused Ralph a great deal of frustration since he and =
Paul shared the same bed, were both committed to monogamy, and they did n=
ot have any physical affection Shortly after Paul celebrated 90 days sobe=
r Ralph and he began talking about slowly trying to resume being physical=
 and sexual. Two days later Paul told Ralph that he had used cocaine rece=
ntly.
Because the only blood family that Ralph has is one sister who lives over=
 fifteen hundred miles away, and with whom he is not particularly close, =
Paul is his primary family. Their extended family of creation has shrunk =
since the onset of AIDS. More than ten close friends who they considered =
to be "family" have died in the past four years.
This couple is exceptionally stressed for several reasons. First of all t=
hey are mourning their decimated friendship group. Two of these people di=
ed in the past three months, and both Ralph and Paul were very involved i=
n caring for these men as they got progressively more debilitated. Their =
relationship is currently and actively dysfunctional since Paul is still =
abusing cocaine. Ralph feels very dependent upon Paul even though due to =
Paul's drug abuse he is rarely emotionally available to Ralph. Only a fam=
ily/systems approach to treatment can address the multiple stressors Ralp=
h is currently struggling with. Ralph's treatment consists in part of enc=
ouraging him to build a new family within AA that includes his sponsor an=
d supportive friends he has met in the rooms. The suggestion that Ralph a=
ctively pursue building a new family within AA was aimed at removing the =
pressure Paul felt about having to be all things to Ralph.
Using a family/systems approach to treatment helps the newly recovering l=
esbian or gay client to understand, value and nurture his or her relation=
ships with lovers and friends as well as blood family In effect this form=
 of treatment is essential for lesbians and gay men who have proven thems=
elves remarkably resourceful in creating new families that support and ce=
lebrate their lifestyle and relationships. For recovering people who are =
lucky enough to live in areas where there are lesbian and gay AA meetings=
, sober families of recovering people have been created as well, and are =
an essential component to living clean and sober.
	THE IMPACT OF AIDS ON GAY AND LESBIAN PEOPLE IN RECOVERY
Counselors and therapists need to recognize another important issue that =
is relevant to family work with their lesbian and gay clients. For more t=
han ten years now, since the onset of the AIDS health crisis, these famil=
ies have lost many members. Lesbians and gay men have taken care of belov=
ed friends with AIDS and wale helplessly as they died.
For some people like Ralph and Paul, almost entire friend' groups have be=
en wiped out. This has created some new problems for recovering people wh=
o have achieved and maintained their sobriety in lesbian and gay AA. Peop=
le with AIDS share in the rooms about their illness, deterioration, fears=
 and early demise. Others are sharing about their pain, rage and grief at=
 having loved ones achieve sobriety, only to watch them wither and die fr=
om AIDS. Along with the joy and serenity of sobriety, the lesbian and gay=
 AA rooms contain an enormous amount of pain and sadness these days. Some=
 of our clients report that they cannot go to these meetings as much anym=
ore, or in some cases at all, because it is too painful to listen to what=
 is being shared, to see sober friends waste away, and to sit in the room=
 with all the ghosts of friends who died.
Gay or lesbian clients who are struggling to maintain sober today face th=
e additional stress of living in a community increasingly devastated by A=
IDS. Their friends, their lovers or they themselves may be infected with =
HIV or may be dying from AIDS. Counselors must recognize that these frien=
dship groups and relationships constitute families for their clients. In =
the counseling they must clearly communicate their understanding that the=
se are families, and then validate and honor these family systems. Doing =
this will empower both the client and his or her family of creation. Only=
 by fully empathizing with how powerful the connections are between the c=
lient and the person or people who are ill can the counselor help the cli=
ent do the grief work and mourning that is necessary. Ultimately the clie=
nt will need the counselor's help and support to build new relationships =
and family systems to replace ones that have been decimated.
	RECOMMENDATIONS
=10	1. Assess clients' multiple family structures (families of origin and=
 creation), the impact of chemical dependency on those structures, and th=
e impact of those structures on the clients' chemical dependency.
=10	2. Provide support to clients for distancing from homophobic families=
 of origin, especially those who see the clients' chemical dependency as =
a "natural" component or outgrowth of the "sickness" of homosexuality.
=10	3. Recognize and help clients see that families of creation and origi=
n may need to keep them, the Identified Patient, actively chemically depe=
ndent, in order to maintain the I.P.'s role as symptom bearer. Keeping th=
e I.P. in this role can serve the function of helping families deny their=
 own dysfunctions.
=10	4. Provide support for distancing from chemically dependent families =
of creation (origin, also) when they view clients' chemical dependency as=
 "natural" to the lesbian/gay lifestyle and not as a destructive illness.=

=10	5. Help lesbian and gay clients who may be newly "coming out" not to =
jump into new relationships in their first year of recovery.
=10	6. Be aware of the issues facing newly recovering lesbian or gay peop=
le who are part of established couples. These clients need help in modify=
ing their expectations and in finding or creating support networks.
=10	7. Recognize and helping clients recognize that the recovery process =
can stir up their internalized homophobia which they blunted or anestheti=
zed with alcohol and/or drugs. Also, their recovery may stir up other peo=
ple's homophobia as the recovering client's attempt to take their place i=
n the family of origin as their authentic selves.
	CONCLUSION
It is important for chemical dependency counselors to keep certain points=
 in mind when working with gay or lesbian clients. One is that chemical d=
ependency is a family disease, one that intimately and powerfully affects=
 all who are involved in the family system of the chemically dependent pe=
rson, regardless of his or her sexual orientation. This fact requires a f=
amily systems perspective if one is to adequately address the ravages of =
the disease. Another point is that very little support or recognition is =
afforded to lesbian or gay love relationships, friendships, and families.=

Thus the well-meaning counselor who fails to work from a family perspecti=
ve with lesbian and gay clients is not helping clients to establish the f=
oundations of long-term recovery. Rather, this counselor may be undermini=
ng the recovery process by blocking or at the least ignoring the system w=
ithin which clients must recover. It imperative to know whether or not cl=
ients' support systems are positive or negative. Without this information=
, aftercare cannot be adequately planned or carried out. The last and mos=
t important point centers on counselors' attitudes. Unless counselors are=
 willing to respect and honor the created families of lesbians and gay me=
n and to work with those systems as family systems, the treatment offer, =
will be seriously lacking, if not directly harmful.
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ork 29(4), 393-396.
Ziebold, T.O. & Mongeon, J. (Eds.) (1982). Alcoholism & homosexuality. Ne=
w York: The Haworth Press, Inc.
=0D
Key Words: lesbians, lesbians, lesbians, lesbians, gay men, gay men, gay =
men, gay men, drug treatment, drug treatment, drug treatment, drug treatm=
ent, families, families, families, families, =

chemical dependency, chemical dependency, chemical dependency, chemical d=
ependency
=0D
Michael Shernoff is a psychotherapist in private practice in Manhattan an=
d can be reached at mshernoff@aol.com or at his home page http://members.=
aol.com/therapysvc
 =

Dana Finnegan is co director of Discovery Counseling Center and is on the=
 board of the National Association of Alcoholism Professionals.  She can =
be reached at 271 Essex St. Millburn, NJ 07041=

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