Purpose: This descriptive study explores the 6 and 12 month treatment progress of a sample of self-identified lesbian and bisexual women (n=359) who were enrolled in the SAMHSA funded Women with Co-Occurring Disorders and Violence study (WCDV) in comparison to the heterosexual women in the study (n = 1893). The treatment outcomes compared include drug use, alcohol use, mental health functioning, and trauma symptom severity. In addition, comparative self-reports of health, employment, education, living situation, parenting effectiveness, and day-to-day functioning are presented.

Methodology: A multi-dimensional instrument was administered during an in-person interview at nine sites across the U.S. with women who have substance abuse and mental health issues, and a history of interpersonal trauma. The baseline instrument was administered within one month of a respondent's treatment entry and again at 6 and 12 months thereafter. This study compares the outcomes of the lesbian and bisexual women in the sample with the heterosexual women on the Alcohol and Drug Abuse Composite Index (ACI and DCI) of the Addiction Severity Index (McLellan, et al., 1972), the Global Severity Index (GSI; Derogatis, 1983), and the Post-Traumatic Stress Diagnostic Scale (PSS; Foa, Cashman, Jaycox & Perry, 1997).

Results: The lesbian and bisexual women in this study are different in key indicators of social capital and opportunity than in many other available studies. They are poor with 74% below the poverty threshold, have more limited educations (77% do not have a GED), and nearly 54% are African American or Latina. As previously reported the lesbian and bisexual women presented to treatment with markedly more severe histories of interpersonal abuse (both physical and sexual) especially in childhood (Dodd, Savage, Finklestein & Rose, 2004). They presented with notably more severe symptoms on three of four outcome measures (ASI-Drug composite, GSI and PSS) but were not different on ASI-Alcohol composite. The results indicate that despite presenting with significantly more serious symptoms on the majority of the measures these differences in outcome subsided over time. Results at 6 months indicated significant differences on the ASI (Χ² = 10.9, df = 4, p. = .027), the DCI (Χ² = 9.2, df = 3, p. = .027) and the GSI (Χ² = 10.9, df = 3, p. = .012). While at 12 months the only significant difference was on the PSS (Χ² = 8.2, df = 3, p. = .04).

Implications for practice: The treatment outcomes for lesbian and bisexual women in this study offer cause for optimism. Gender specific treatment was successful in remediating many of the symptoms experienced by the women at the outset of treatment. Sexual orientation was not a significant predictor of successful treatment outcome. So, when barriers to treatment can be overcome prospects for change are promising.