Integrated Support Groups Promising Practices 116 Nassau Street

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Integrated Support Groups: Promising Practices 116 Nassau Street, 3 rd Floor, New York, NY

Integrated Support Groups: Promising Practices 116 Nassau Street, 3 rd Floor, New York, NY 10038 212 -714 -1184 | www. avp. org 24 -Hour, Bilingual Hotline 212 -714 -1141 www. avp. org 212. 714. 1141/24 hour bilingual hotline

Your Trainers Darlene S. Torres LMSW, Pronouns: she/hers Co‐Director of Client Services dtorres@avp. org

Your Trainers Darlene S. Torres LMSW, Pronouns: she/hers Co‐Director of Client Services dtorres@avp. org 212. 714. 1184 ext 14 Suzy Salamy, MSW, Pronouns: she/hers Senior Manager of Clinical and Advocacy Programs ssalamy@avp. org 212. 714. 1184 ext 40 www. avp. org 212. 714. 1141/24 hour bilingual hotline

The New York City Anti-Violence Project (AVP) is dedicated to eliminating hate violence, sexual

The New York City Anti-Violence Project (AVP) is dedicated to eliminating hate violence, sexual assault, stalking, and domestic violence in lesbian, gay, bisexual, transgender, queer, and HIVaffected communities through counseling, advocacy, organizing, and public education. AVP is the only organization in NYC that provides direct services to LGBTQ victims of violence. We are nationally recognized as experts on best practices when working with LGBTQ survivors of violence. We have been recognized by the White House as Champions of Change www. avp. org 212. 714. 1141/24 hour bilingual hotline

The New York City Anti-Violence Project Client Services Legal Services Community Organizing - -

The New York City Anti-Violence Project Client Services Legal Services Community Organizing - - - www. avp. org 24 -hour hotline Short-term individual supportive counseling DV Shelter Advocacy Support Groups Hate Violence, Sexual Violence, Intimate Partner Violence Advocacy, Referrals Hospital, precinct, and court accompaniments OVS assistance Community Leadership Institute Advocacy Program Economic Empowerment Project - Consultation Advocacy Representation Orders of Protection Family Law Housing Law Referrals - Education and Training Institute Hotline Crisis Counselor Training Rapid Incidence Response New York State LGBTQ Intimate Partner Violence Network National Coalition of Anti. Violence Programs Public Advocacy Community Leadership Institute Organizing Program Volunteer Opportunities and Outreach Speaker’s Bureau Community Safety Nights Community Action Committees Political Education 212. 714. 1141/24 hour bilingual hotline

Why are we here? • Participants will become familiar with LGBTQ 101 • Identify

Why are we here? • Participants will become familiar with LGBTQ 101 • Identify unique barriers that this community faces • Begin to understand how and why integrated support groups across the gender and sexuality spectrum can work www. avp. org 212. 714. 1141/24 hour bilingual hotline

Language & Terminology www. avp. org 212. 714. 1141/24 hour bilingual hotline

Language & Terminology www. avp. org 212. 714. 1141/24 hour bilingual hotline

What is “LGBTQ”? www. avp. org 212. 714. 1141/24 hour bilingual hotline

What is “LGBTQ”? www. avp. org 212. 714. 1141/24 hour bilingual hotline

What is “LGBTQ”? A standard acronym: • Lesbian • Gay • Bisexual • Transgender

What is “LGBTQ”? A standard acronym: • Lesbian • Gay • Bisexual • Transgender • Queer *These terms are fluid and DO NOT represent all sexual orientations/gender identities. It is always best to respect individuals’ self-determination and honor the terms they use to identify themselves www. avp. org 212. 714. 1141/24 hour bilingual hotline

Let’s talk about Sex and Gender www. avp. org 212. 714. 1141/24 hour bilingual

Let’s talk about Sex and Gender www. avp. org 212. 714. 1141/24 hour bilingual hotline

Why is this Important? • There are limited traditional ideas about sex and gender

Why is this Important? • There are limited traditional ideas about sex and gender • High levels of violence and discrimination happen to LGBTQ individuals who do not follow traditional gender roles • Most homophobic/transphobic attitudes stem from assumptions around gender and sex. Knowing this will increase your ability to assist LGBTQ survivors of violence. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Traditional Definitions of Sex • SEX How is sex defined? - The biological and

Traditional Definitions of Sex • SEX How is sex defined? - The biological and physiological characteristics that define men and women. (World Health Organization). • What makes up our sex? Primary sex characteristics - penis, testes, vagina, uterus, and ovaries. - Chromosomes most influence primary sex characteristics. - Hormones • We often rely on secondary sex characteristics to help us ‘figure out’ if someone is male or female – – www. avp. org Facial hair Height Body mass Vocal range 212. 714. 1141/24 hour bilingual hotline

Gender What is gender? Refers to the socially constructed roles, behaviors, activities, and characteristics

Gender What is gender? Refers to the socially constructed roles, behaviors, activities, and characteristics that society considers appropriate for men and women (World Health Organization). www. avp. org 212. 714. 1141/24 hour bilingual hotline

Gender Identity • This is unique to every individual • A person’s internal and

Gender Identity • This is unique to every individual • A person’s internal and lived understanding of their gender • A person’s gender identity may not always match the sex they were assigned at birth • The term that is used when assigned sex does not match a person’s gender identity is Transgender. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Sexual Orientation and Gender Identity • Sexual Orientation is about who you are romantically,

Sexual Orientation and Gender Identity • Sexual Orientation is about who you are romantically, sexually and/or spiritually attracted to. • Gender Identity is about how you understand your own gender and how you express that. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Cisgender The term used to describe people whose sex assignment at birth corresponds to

Cisgender The term used to describe people whose sex assignment at birth corresponds to their gender identity and expression, or who is not transgender. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Transgender: An Umbrella Term • The term transgender is an umbrella term used to

Transgender: An Umbrella Term • The term transgender is an umbrella term used to describe people whose way of understanding and expressing their own gender, is different from what society expects • People who identify as transgender may use different pronouns at certain times in their lives, change their name, or change the way they dress www. avp. org 212. 714. 1141/24 hour bilingual hotline

Original graphic by eliaserickson. tumblr. com via Buzz. Feed & Pinterest -- Resolution Upconvert

Original graphic by eliaserickson. tumblr. com via Buzz. Feed & Pinterest -- Resolution Upconvert by Fairy Jer. Bear

Transgender Individuals • Transitioning means moving into the life of one’s gender identity. •

Transgender Individuals • Transitioning means moving into the life of one’s gender identity. • Not all trans people transition ☺ • Gender identity expression may take many forms depending on personal preference, culture, sexual orientation, and class, among other considerations (i. e. safety) www. avp. org • Some steps taken by a person who identifies as transgender or gender non-conforming can include: – Hormone therapy – Name change – Pronoun change 212. 714. 1141/24 hour bilingual hotline – Change in gender expression (clothing, make

How to ask Questions about Identity • It is important to remember that we

How to ask Questions about Identity • It is important to remember that we cannot ‘figure out’ how someone identifies just by looking at them →We have been taught to rely on stereotypes to help us identify if someone is a man or woman, gay, lesbian, bisexual • Gender identity and sexual orientation are beneath the surface • Because of this, we should not make assumptions nor rely on information that it documented on a chart or intake form. www. avp. org 212. 714. 1141/24 hour bilingual hotline

How to ask questions about identity: Helpful tips • To start: “I like to

How to ask questions about identity: Helpful tips • To start: “I like to make sure that I have all the information correct. On your paperwork it says your name is _____” Is this the name you would like me use? ” • Avoid asking “What is your real name? ” →Instead ask, “What is your given name? • Avoid asking “are you a man or woman/male or female? ” →Instead ask, “How do you identify your gender? www. avp. org 212. 714. 1141/24 hour bilingual hotline

Privilege, Oppression & LGBTQ Communities www. avp. org 212. 714. 1141/24 hour bilingual hotline

Privilege, Oppression & LGBTQ Communities www. avp. org 212. 714. 1141/24 hour bilingual hotline

What is Oppression? “Oppression is a pattern or system of inequality, which gives power

What is Oppression? “Oppression is a pattern or system of inequality, which gives power and privileges to one group of people at the expense of another. ” -GLSEN, 2004: Jumpstart Guide, Part V POWER PREJUDICE A set of negative personal beliefs about a group + The capacity to make and enforce decisions. Access to social and economic systems, groups, or individuals who own and control resources of governing bodies. = OPPRESSION RACISM. . . SEXISM…ABLEISM…AGEISM…CLASSISM… HETEROSEXISM. . . ETHNOCENTRISM 22

Privilege is: An unearned right, advantage, or immunity granted or available only to a

Privilege is: An unearned right, advantage, or immunity granted or available only to a particular person or group of people. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Discrimination and Oppression LGBTQ communities experience different types of discrimination at different levels. These

Discrimination and Oppression LGBTQ communities experience different types of discrimination at different levels. These include: Homophobia Biphobia Transphobia Heterosexism Sexism www. avp. org 212. 714. 1141/24 hour bilingual hotline

FABRIC OF OPPRESSION IN THE U. S. * SOCIAL GROUP AGENT / PRIVILEGED ABILITY

FABRIC OF OPPRESSION IN THE U. S. * SOCIAL GROUP AGENT / PRIVILEGED ABILITY STATUS Able‐bodied and people not People living with disabilities ABLEISM living with disabilities AGE Adults 20‐ 50 APPEARANCE / BODY GENDER Western standard of beauty Everyone not fitting the standard Gender conforming boys and Girls and women; men Gender non‐conforming; Transgender populations NATIONALITY U. S. citizens Non‐U. S. citizens GENDER OPPRESSION (sexism, transmisogyny, transmisogynoir, transphobia) XENOPHOBIA RACE White people People of Color RACISM RELIGION Christians Non‐Christians RELIGIOUS OPPRESSION SEXUAL ORIENTATION Heterosexual / People identifying as “straight” SOCIOECONOMIC STATUS / ECONOMIC CLASS TARGET / OPPRESSED Youth and those over 50 OPPRESSION AGEISM LOOKISM LGBTQ people and other non‐ HETEROSEXISM heterosexuals Wealthy and owning classes; The poor; Upper middle class The working class CLASSISM *From the National Conference of Diversity www. avp. org 212. 714. 1141/24 hour bilingual hotline

Four I’s of Oppression Example: Transphobia Ideological: the creation and overall acceptance of a

Four I’s of Oppression Example: Transphobia Ideological: the creation and overall acceptance of a gender binary (male / female) that reinforces societal rigidity around any gender identity that falls within or out of the spectrum; particularly in regards to how a person should act and/or look. The system that reinforces this is called heteronormativity. Institutional: the passing of House Bill 2 in North Carolina’s legislature; a sweeping law that reverses a Charlotte ordinance that had protected Transgender people who use public restrooms based on their gender identity. Interpersonal: a cisgender individual taking it upon themselves to police a transgender person’s right to use a public restroom reflective of their gender identity through verbal or physical violence. Internalized: an individual feeling like their transition must look or present a particular way in order to be “accepted” or “valid” as transgender; feeling like one must “pass” within the gender binary (male or female); or even that there’s something wrong or not normal about themselves because they are trans. www. avp. org bilingual hotline 26

A note on Intersectionality is a way of taking into consideration all of the

A note on Intersectionality is a way of taking into consideration all of the factors that together make up our identities: • race • ethnicity • class status in society • sexuality • gender identity • abilities • age • immigration status www. avp. org 212. 714. 1141/24 hour bilingual hotline

Why should we think about this? In order to provide comprehensive services to a

Why should we think about this? In order to provide comprehensive services to a survivor of violence, we must take intersectionality into account. We have to be aware of the intersections of a person’s identity and how that can impact a person’s life experience and experience with social services, law enforcement etc. • 911 Being a Number 1 Safety Tip: →Homophobia, transphobia, racism and sexism and other oppression might mean this is not an option for the survivor • How do we develop different approaches to safety? www. avp. org 212. 714. 1141/24 hour bilingual hotline

Structural Barriers for LGBTQ Survivors Elevated rates of poverty and job instability in LGBTQ

Structural Barriers for LGBTQ Survivors Elevated rates of poverty and job instability in LGBTQ communities exacerbate these inequities, often translating into limited health benefits and lower ability to pay for needed services out of pocket. This is particularly true for LGBTQ people who are members of other marginalized identity groups and those marginalized within our communities, including people with low-incomes, people living with HIV/AIDS, immigrants, formerly incarcerated people, youth, elders, people of color, TGNC people, people living with disabilities and sex workers. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Structural Barriers for LGBTQ Survivors Re-victimization by Service Providers • Having to educate providers

Structural Barriers for LGBTQ Survivors Re-victimization by Service Providers • Having to educate providers on LGBTQ sensitivity • Not knowing if services are open to LGBTQ people - Invisibility in agency settings - Facing biased or unwelcoming intake forms • Fear of coming out/being outed • Experiencing ridicule and mistreatment • Fear of losing services/receiving substandard care www. avp. org 212. 714. 1141/24 hour bilingual hotline

IMPACT OF VIOLENCE ON LGBTQ SURVIVORS www. avp. org 212. 714. 1141/24 hour bilingual

IMPACT OF VIOLENCE ON LGBTQ SURVIVORS www. avp. org 212. 714. 1141/24 hour bilingual hotline

What the Stats say: ncavp. org • National Coalitions of Anti-Violence Programs – Produces

What the Stats say: ncavp. org • National Coalitions of Anti-Violence Programs – Produces two national reports – Intimate Partner Violence and Hate Violence www. avp. org 212. 714. 1141/24 hour bilingual hotline

NCAVP 2015 IPV Report • 1, 976 survivors of IPV who reported to 17

NCAVP 2015 IPV Report • 1, 976 survivors of IPV who reported to 17 NCAVP member organizations from 14 states across the country • People of color made up 77% of the reports of LGBTQ and HIV‐affected IPV homicides, and 54% of the total number of survivors who reported to NCAVP members in 2015. • Transgender women were three times more likely to report experiencing sexual violence and financial violence. • LGBTQ survivors with disabilities were two times more likely to be isolated by their abusive partner and four times more likely to experience financial violence. • 44% of survivors attempting to access emergency shelter were denied and 71% reported being denied because of their gender identity. • Out of the total number of survivors who interacted with law enforcement, 25% said that the police were either indifferent or hostile, and 31% of LGBTQ survivors who interacted with police said they experienced misarrest.

Key Findings of anti‐lgbtq homicides in 2017 • As of August 23 rd, 2017,

Key Findings of anti‐lgbtq homicides in 2017 • As of August 23 rd, 2017, NCAVP has recorded reports of 36 hate violence related homicides of LGBTQ and HIV affected people, the highest number ever recorded by NCAVP. This number represents a 29% increase in single incident reports from 2016. So far in 2017, there has been nearly one homicide a week of an LGBTQ person in the U. S. • The victims of these hate violence related homicides have overwhelmingly been transgender women and queer, bi, or gay cisgender men. • There was a significant increase of reports of homicides of queer, bi, or gay cisgender men, from 4 reports in 2016 to 17 reports in 2017. • For the last five years NCAVP has documented a consistent and steadily rising number of reports of homicides of transgender women of color, which continued into 2017.

Key Findings of anti‐lgbtq homicides in 2017 • • • In August of 2017,

Key Findings of anti‐lgbtq homicides in 2017 • • • In August of 2017, NCAVP has already collected information on 19 hate‐ violence related homicides of transgender and gender non‐conforming people this year, compared to 19 reports for the entire year of 2016. 16 of these homicides were of transgender women of color. Of the total number of homicides in 2017, 75% of the victims were people of color: 20 (56%) of the victims were Black, 3 were Latinx, 2 were Asian, and 1 was Native. Additionally, 9 (25%) of the victims were white and 1 victim’s racial and ethnic identity is unknown to NCAVP at this time. • 64% of the victims were under the age of 35. Guns were used in 47% of the total number of homicides thus far in 2017. New York and Texas had the most anti‐LGBTQ homicides, with 5 victims from each state.

Expecting Rejection Rood, et al; Transgender Health 2016, 1. 1 • A study in

Expecting Rejection Rood, et al; Transgender Health 2016, 1. 1 • A study in Transgender Health, examined the psychological distress transgender and gender non‐conforming individuals experience because they are often the target discrimination and violence. • Findings suggest that expecting rejection is a frequent and salient internal stressor for TGNC individuals and that distress faced by many transgender individuals stems from social rejection and violence. • Overall, participants noted that expecting rejection in most environments is almost inevitable and a fundamental part of being TGNC identified. Participants reported feeling: – Anxious – Nervous – Physical and mental exhaustion – Depressed – Self‐loathing – Angry – frustrated www. avp. org 212. 714. 1141/24 hour bilingual hotline

Coping Strategies Used to Manage the Expectation of Rejection Rood, et al; Transgender Health

Coping Strategies Used to Manage the Expectation of Rejection Rood, et al; Transgender Health 2016, 1. 1 • Avoidance or Escape – Engaging in avoidance strategies (avoiding situations all together). • Substance Use • Cognitive or emotional coping strategies – Ruminating on what could occur or what had already happened in the past. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Intersections of Race and Ethnicity Rood, et al; Transgender Health 2016, 1. 1 •

Intersections of Race and Ethnicity Rood, et al; Transgender Health 2016, 1. 1 • Being a POC increases the expectation of rejection and helps you to prepare for the rejection • Participants in the study were clear in their belief that being a POC increases their risk for discrimination and violence “There are definitely situations in which I might not even be thinking about my gender identity, but ill expect to experience some form of discrimination or some sort of danger just based on my racial identity. ” (Latino, masculine) www. avp. org 212. 714. 1141/24 hour bilingual hotline

Integrating Your Support Groups Promising Practices www. avp. org 212. 714. 1141/24 hour bilingual

Integrating Your Support Groups Promising Practices www. avp. org 212. 714. 1141/24 hour bilingual hotline

Getting Started: Questions to Ask Yourself • What are the gaps in service at

Getting Started: Questions to Ask Yourself • What are the gaps in service at your organization with respect to LGBTQ communities? • Are the support groups currently offered at your organization inclusive? – From Forge: • The impact of sex‐‐segregated services run rampant • Men (straight, gay, bisexual, and transgender) and transgender individuals (MTF, FTM, gender variant, etc. ) are unable to access the majority of sex‐segregated services designed to provide resources, support, and healing to sexual assault survivors. • When it comes to sexual assault, no class of people is “privileged” or has it “easier” than another. • Being a survivor means living with the immediate and long–term impacts of trauma. Everyone deserves the right to heal. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Why Group Therapy? Purpose • Group therapy attempts to give individuals a safe and

Why Group Therapy? Purpose • Group therapy attempts to give individuals a safe and comfortable place where they can work out problems and emotional issues. • Participants gain insight into their own thoughts and behavior, and offer suggestions and support to others. • It is a place to express more than what is ordinarily acceptable, to ritualize impossible feelings, to reach out with risky feelings, to practice new ways of being. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Intake and Assessment What do you typically assess for? • Participants who may be

Intake and Assessment What do you typically assess for? • Participants who may be suicidal , homicidal, psychotic, or in the midst of a major acute crisis – These folks are typically not referred for group therapy until their emotional state has stabilized. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Questions about forming the group • How do you determine group topics, i. e.

Questions about forming the group • How do you determine group topics, i. e. do the topics derive from presenting needs as reported by existing clients, from clinical staff interest/discretion, or derived from other sources of inspiration? – At this point, we provide two specific groups for survivors of sexual violence and one for survivors of intimate partner violence. Of course, these victimizations may overlap. We allow the client to decide what group is of interest to them and we then conduct an intake for whichever group they would like to join. www. avp. org 212. 714. 1141/24 hour bilingual hotline

What is Unique About our Intake • The intake is conducted jointly by the

What is Unique About our Intake • The intake is conducted jointly by the co‐ facilitators to help provide balance when deciding if they client is appropriate or ready for the group. • We have developed intake material that is specific to the type of violence that the client may have experienced. • The intakes a basic bio/psycho/social of the client and asks specifics around the incidence of violence that they would like support around. www. avp. org 212. 714. 1141/24 hour bilingual hotline

 • We take into account where the client is with their healing process,

• We take into account where the client is with their healing process, how long ago the incident/s took place and whether they have been in therapy or not. • We also assess the clients’ mental health and whether any diagnosis they may have is well maintained or could possibly interfere with the group dynamics. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Things to consider • How do we integrate support groups that include survivors that

Things to consider • How do we integrate support groups that include survivors that hold identities of their perpetrators of violence? – Intersectionality – Gender based violence and the LGBTQ communities – Corrective emotional experience – What if the facilitator is not hold the same gender identity as the group? www. avp. org 212. 714. 1141/24 hour bilingual hotline

Safe Spaces • How do you provide a safe space in an inclusive group

Safe Spaces • How do you provide a safe space in an inclusive group addressing trauma for group members with a history of gender-based trauma who report current and severe gender-based trauma triggers? – We provide services to people across the gender and sexuality spectrum. Therefore, there will most likely be people with varying identities within the support groups. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Safe Spaces • The identity based work we do allows us to be less

Safe Spaces • The identity based work we do allows us to be less rigid in traditional understandings and facilitation of sex based or gender based segregated groups. • We directly address how the clients gender identity and sexual orientation have been impacted by this violence. • This may include cisgender gay men, transgender heterosexual women and lesbians all in a group for survivors of sexual violence. Their commonality may be being part of a marginalized sexual or gender identity while be survivors of sexual violence perpetrated by cisgender men. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Case Example • We had four clients who identified as cisgender Queer or bisexual

Case Example • We had four clients who identified as cisgender Queer or bisexual women and one cisgender Lesbian. • Four out of the five women were survivors of sexual assault perpetrated upon them by cisgender men. • One of them was assaulted by cisgender woman. • Although, we did discuss their experiences of sexual violence in regard to cisgender men, it was important and a helpful reminder that women may also be perpetrators of sexual violence. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Case Example • Three cisgender gay men, all Latino. One cisgender, bisexual white woman,

Case Example • Three cisgender gay men, all Latino. One cisgender, bisexual white woman, one Queer Latina woman and one white genderqueer person who was non binary. • All of the violence perpetrated upon them was by men. • Recognizing and processing the shared gender identity of the men in the group and the perpetrators. • Using it as a way to have a corrective emotional experience. www. avp. org 212. 714. 1141/24 hour bilingual hotline

Questions? www. avp. org 212. 714. 1141/24 hour bilingual hotline

Questions? www. avp. org 212. 714. 1141/24 hour bilingual hotline