Nursing homework help

Respond to at least two of your colleagues’ posts considering some of the following:

• Share a new insight or perspective you learned or thought of in terms of advocacy in reading your colleague’s portfolio
• Share with your colleague how you think power, or privilege, or oppression may impact or influence the target problem at institutional, community, or public policy levels.
• Share a suggestion or new insight with your colleague about collaboration to influence public policy.

COUN 6785: Social Change in Action: Prevention, Consultation, and Advocacy Social Change Portfolio Brianna Mattiucci Contents Below are the titles for each section of the Social Change Portfolio. To navigate directly to a particular section, hold down and click on the desired section below. Please do not modify the content section, nor remove the hyperlinks. [Please note that in brackets throughout this template you will see instructions about information to include in each section. Please delete the instructions that are found in brackets, including this message, and replace the bracketed instructions with the relevant content for each section]. Overview Introduction Scope and Consequences Social-ecological Model Theories of Prevention Diversity and Ethical Considerations Advocacy References ScholarWorks Contributor Agreement OVERVIEW Keywords: DUIs, DUI Rates, Alcohol Consumption, Jackson County, Georgia DUI Rates in Jackson County, Georgia [Complete this section Week 10, prior to final submission of your portfolio. Complete this section using the headings below as a guide. Please write in full sentences using APA style. This section should be no longer than one page]. Goal Statement: The goal of this prevention portfolio is to provide education to adults on the risks associated with conviction of a DUI while reducing rates of DUIs in Jackson County, Georgia. Significant Findings: [One paragraph summary of the population, problem, key findings and recommendations. This is like an abstract written for a scholarly research paper. Cite sources as needed] Objectives/Strategies/Interventions/Next Steps: [At least five. Write these to guide professionals in the field. Include specific action items as well as at least one community-based partner agency, for example, the evidenced-based program in the Theories section]. INTRODUCTION DUI Rates in Jackson County, Georgia Driving while under the influence [DUI] includes dangerous driving impairments caused by alcohol, other drugs, or controlled substances (Legal Information Institute, 2022). The date and rates of prevalence have been collected at both a local level and a national level from 2017 to 2020. This study takes place in Jackson County, Georgia, a developing county north of Atlanta. Jackson county is rated 15th out of 159 counties in the state of Georgia pertaining to health and is amongst the healthiest counties in Georgia (County Health Rankings & Roadmaps, 2018). Being convicted of a DUI can impact one’s family, their socio-economic status, as well as their physical and mental health. Conviction of a DUI can impact one’s socio-economic status through fees and jail time while simultaneously impacting the familial unit if there is a loss in income due to jail time, repetitive conviction rates and license revocation (Law Offices of Richard S. Lawson, 2022). Additionally, multiple convictions may lead to substance abuse and treatment plans which may indicate a much larger issue such as a substance abuse illness, major depressive disorder, or Post-Traumatic Stress Disorder [PTSD] (Nelson, et al., 2015). By providing education and resources to individuals, the goal is to reduce the amount of DUIs experienced in Jackson County. PART 1: SCOPE AND CONSEQUENCES DUI Rates in Jackson County, Georgia The target population includes excessive DUI rates in Jackson County, Georgia. As soon as alcohol enters the blood stream there is an effect on one’s cognitive and physical functions such as relaxed judgment and mood alterations (NHTSA, n.d.). As soon as alcohol enters the bloodstream, one’s cognitive and physical functions such as relaxed inhibitions and mood alterations may take place (NHTSA, n.d.). In 2019, Georgia was ranked 42nd out of 50 states with Montana at the top of the list for total DUIs (Zutobi, 2022). Recent data has not been recorded for DUIs by state, or county, therefore, the most recent year for data was 2019 across most sources, with the exception of the Georgia Department of Driver Services having data from 2020 (Georgia Department of Driver Services, n.d. & NHTSA, n.d.). Jackson County is a small county in Georgia that is currently expanding, however, there are still limited activities and alternative methods of transportation for the individuals in the community. Jackson County offers limited restaurants and the restaurants offered promote low-cost and happy hour priced alcoholic beverages. Currently, there are no methods for public transportation and very limited options for alternative methods of transportation. For instance, Lyft and Uber services are only available during certain hours, and those hours do not include evening hours. Ultimately, this increases consumption of alcohol due to low cost while unconsciously encouraging individuals to drive home after consuming alcohol. Prevention of DUI’s and recognition of repeat offenders through adequate treatment programs and education will benefit the community by helping to recognize undiagnosed mental illness in repeat offenders, as well as reduce socio-economic impacts that a DUI may bring an individual. Conviction of one or more DUIs may lead an individual to lose their employment, have fines ranging from $200 to $5,000, community service, surrendering of their license and registration to the state, as well as a maximum of one year in prison thus impacting their income (Law Offices of Richard S. Lawson, 2022). In addition to socio-economic concerns pertaining to DUI convictions, there are mental health concerns such as substance abuse and addiction as well as other co-morbid and potentially undiagnosed mental illnesses such as major depressive disorder and PTSD (Nelson, et al., 2015). Conviction of one or multiple DUIs can impact the individual, familial unit, and community. This prevention program is designed to target anyone over the age of 21 who considers getting behind the wheel of a car after consuming alcoholic beverages. Although DUI convictions have steadily decreased in Jackson County since 2018, access to alcohol has become easier for the residents due to delivery services such as door dash, open container laws in city limits as well as happy hour pricing and alcohol advertisements for local restaurants. PART 2: SOCIAL-ECOLOGICAL MODEL DUI Rates in Jackson County, Georgia The social-ecological model looks at the intersectionality of the individual, their relationships, the community as well as societal factors for an individual (CDC, n.d.). The socialecological model looks at preventing risk while also considering how each level influences another when it comes to exposure to risk (CDC, n.d). Individual Risk Factors Individual risk factors consider how biology and personality traits may influence risk and violent behaviors (CDC, n.d.) These factors can include race, age, gender, socio-economic status as well as history of abuse (CDC, n.d.) Risk factors associated with conviction of a DUI include substance abuse, comorbidity with other psychiatric disorders such as major depressive disorder and anxiety (Gibson, et al., 2018). Jackson County is a small county that is currently expanding with a population of 80,286 people (United States Census Bureau, n.d.). Since the county is still developing, there are limited sources of entertainment. For example, our county does not have a movie theater, strip malls, or major retailers such as T.J. Maxx, Target, or Home Depot. The main source of entertainment in the county are restaurants which promote low-cost alcoholic beverages. Individuals who are younger in age tend to be at a higher risk for receiving a DUI conviction (Gibson, et al., 2018). Additionally, younger drivers tend to mix alcohol with other illicit drugs which contribute to an increased rate of DUI conviction (Gibson, et al., 2018). Across recent years, the rate for DUI convictions in women have increased while DUI convictions for men have decreased (Gibson, et al., 2018). As we have progressed as a nation, gender equality and representation in the police force has promoted equal treatment in traffic stops (Gibson, et al. 2018). Protective Factors Prevention of conviction of DUIs include reduced reoccurrences, increased counseling, increased treatment for comorbidity of psychiatric illnesses as well as other substance abuse issues, and increased spirituality (Gibson, et al., 2018). Reduced reoccurrences prevent jail time, increased fines as well as license suspensions (Law Offices of Richard S. Lawson, 2022). Counseling and additional treatment programs for DUI convictions and substance abuse includes coping mechanisms for when an individual wants alcohol or other illicit drugs (Leitz & Hodge, 2013). In the state of Georgia, DUI risk reduction programs provide treatment and assessment to individuals who have one or more DUI convictions (Law Offices of Richard S. Lawson, 2022). Additionally, treatment programs such as Preventing Alcohol Related Crashes [PARC] encourages individuals not to drive to drinking events which encourages controlled drinking and controlled driving to events where drinking is occurring (Gibson, Woodford, & Czeizinger, 2018). Therefore, this encourages individuals to seek alternative transportation methods to events where drinking is occurring to reduce the risk of obtaining a DUI conviction. Spirituality and religion have shown to help individuals with resilience in stressful situations (Leitz & Hodge, 2013). Incorporating spirituality and religion into one’s daily life helps reduce the rate of substance abuse (Leitz & Hodge, 2013). This means that finding resilience and strength through spirituality and religion has shown to reduce the use of illicit drugs. Jackson County, Georgia has 76 registered churches across denominations (GNIS, n.d.). A wide variety of church accessibility can help those who are using religion and spirituality to reduce their alcohol or drug intake. Relationship Risk Factors Relationship risk factors includes a person’s social circle, peers, or partners contributing to violence (CDC, n.d.) Risk factors include economic impacts on the family and influences of substance abuse on children or other family members (Law Offices of Richard S. Lawson, 2022). As an individual obtains more DUI convictions, they may receive fines and jail time which can directly impact their romantic relationship and their family (Law Offices of Richard S. Lawson, 2022). In Jackson County the rate of second time offenders has reduced each year since 2018 (Georgia Department of Driver Services, n.d.; & NHTSA, n.d). In 2018, Jackson County had 30 second time DUI offenders. In 2019 there were 12 second time offenders, and in 2020 there were 9 second time offenders (Georgia Department of Driver Services, n.d.; & NHTSA, n.d). Alcohol abuse and substance abuse are learned behaviors that occur in social situations, through peer pressure, or by watching family members (Valeria Saladino, et al., 2021). Furthermore, it is imperative to know that children learn from their parents, therefore, starting drug talk early on with children can decrease the cycle of alcohol and substance abuse (Valeria Saladino et al., 2021). Having an unhealthy parent-child relationship when it comes to drug talk can increase the chances that a child will develop an alcohol or substance abuse problem later in life, which will ultimately affect their family relationship. Lastly, children who have fathers who are incarcerated are more likely to develop an alcohol or substance abuse problem (Valeria Saladino, et al., 2021). Therefore, if an individual is incarcerated due to DUI convictions, their children are more likely to develop an alcohol or substance abuse problem in adolescence or later in life. Protective Factors Protective factors include a positive relationship with one’s family and developing relationships that promote a positive social environment such as spirituality or religion in treatment. Having a healthy parent-child relationship can promote positive discussions regarding alcohol and substance abuse (Valeria Saladino, et al., 2021). Parental support and open lines of communication reduce rates of adolescent alcohol and substance abuse. Additionally, including spirituality and religion increases an individual’s resilience to become involved in risky behavior (Leitz & Hodge, 2013). Being involved in spiritual or religious groups increases an individual’s peer support circle as well as encourages utilization of community resources (Leitz & Hodge, 2013). Being involved in a socially supportive spiritual or religious group helps keep an individual’s focus on their spirituality rather than the alcohol or illicit drug (Leitz & Hodge, 2013). Encouragement and support help to minimize the use of alcohol or other illicit drugs. Community Factors Risk Factors Accessibility to alcohol as well as low-cost and happy hour prices bring in customers who would not normally pay for expensive alcohol. Furthermore, many community events include access to alcoholic beverages. In Jackson County, the downtown cities within the county, such as downtown Braselton have an open container law. The open container law in downtown Braselton means that an individual is allowed to walk around the city limits with a purchased alcoholic beverage from participating locations (Code of Ordinances, 2021). This ordinance is year-round and is not limited to events. Each establishment that sells alcohol is allowed to provide their customers with one to-go alcoholic beverage in a branded to-go cup. Lastly, law enforcement agencies are spending a multitude of time with DUI traffic violations when they could be putting their efforts towards other traffic violations and potential crime. Protective Factors Protective factors include providing alternative transportation to adults who have been drinking in order to reduce the rate of adults driving when they have been drinking. Alternative transportation can include options for Lyft and Uber as well as taxis. Currently in Jackson County, there is limited access to additional transportation. There is no public transportation and Lyft services are only available during certain hours. These hours are normally first thing in the morning and do not include evening hours. Additionally, reducing the rate of DUI convictions and the rate of individuals driving after consuming alcohol will allow law enforcement agencies to put their efforts into protecting the community and other traffic violations. Societal Risk Factors Societal risk factors include cultural norms, health, and social policies that encourage risk violent behaviors (CDC, n.d.). Currently, advertisements for alcohol are plastered all over the internet, billboards, and television. Advertisement for alcohol has shown to significantly increase the sales while also bringing awareness towards brands that may not have been noticed prior to advertisement (Stautz, et al., 2017). Additionally, alcohol advertisement can lead to increased health risks and promotion of drinking culture within society (Stautz, et al., 2017). Meaning alcohol advertisements promote drinking and an unhealthy drinking culture in society. Alcohol advertisement typically increases an individual’s desire to consume as well (Stautz, et al., 2017). Therefore, alcohol advertisement and consumption at public places and events can unconsciously encourage an individual to consume alcohol increasing the risk that they will get behind the wheel of a vehicle after consumption. Ultimately this increases the risk for conviction of a DUI. In Jackson County, there is one local restaurant that promotes a drink feature of the day for both lunch and dinner as well as signature drink menus for city events. The drink features and limited menu for events is designed to encourage individuals to try their limited time offers. Additionally, local liquor stores have been added to delivery services such as door dash to make purchase and consumption easier. Promotions for liquor stores include free delivery or money off of your first purchase. This makes alcohol accessible and easier to consume. Protective Factors Protective factors include limiting exposure on alcohol advertisements, alcohol warning advertisements, and public education on alcohol consumption and DUIs. Alcohol warning advertisements include risks that are associated with consuming alcohol and driving under the influence. Many times, after seeing alcohol warning advertisements, individuals reported a lower desire to consume alcohol (Stautz, et al., 2017). Restriction on alcohol advertisement is a costeffective way to reduce alcohol consumption (Stautz, et al., 2017). Companies are no longer spending money on advertisement therefore funds can be utilized elsewhere. Additionally, companies who promote the advertisements are no longer purchasing the advertisements thus allowing funds to divert elsewhere. Education programs such as PARC are a way for individuals to learn about the risks associated with drinking and driving (Gibson, et al., 2018). Education about risk factors associated with DUI conviction includes alternative transportation methods, fines associated with conviction, and personal impacts such as jail time or suspension of one’s license. PART 3: THEORIES OF PREVENTION DUI Rates in Jackson County, Georgia Trans-Theoretical Model for Behavior Change The trans-theoretical model [TTM] for behavior change was originally introduced in 1982 and has been a useful intervention to help reduce drinking problems and other issues related to alcohol (Wilson, 2021). The concept of TTM is that individuals go through several stages before change actually occurs (Wilson, 2021). Additionally, people are able to change behavior if they are willing to make the changes themselves (LaMorte, 2022). Lastly, TTM is not a linear process, there are many individuals who may regress during the intervention but once an individual enters the final stage, regression is not common (LaMorte, 2022). TTM consists of six stages, precontemplation, contemplation, preparation, action, maintenance, and termination (Wilson, 2021). During the precontemplation stage, individuals are not unaware that a problem exists, and they are not considering making a change (Wilson, 2021). During the contemplation stage, an individual is aware that a problem does exist, and they are considering developing a plan to change that behavior (Wilson, 2021). However, in the contemplation stage, many individuals also feel like they do not need to change the behavior (Wilson, 2021). This can ultimately lead to regression. During the preparation stage, an individual is aware that a problem does exist, and they have created a plan to change the behavior (Wilson, 2021). During the action stage, individuals have begun to change the behavior (Wilson, 2021). However, individuals must have successfully gone through the action stage for six months prior to entering into the maintenance stage (Wilson, 2021). Once the behavior has been successfully changed for at least six months, individuals enter into the maintenance stage, however, there is always a chance of regression even if the behavior has been changed for six months or more (Wilson, 2021). Lastly, in the termination stage, individuals will not relapse, and the behavior will not return (Wilson, 2021). Cognitive Behavioral Therapy with DUI Offenders Over the last decade, there has been an increase in DUI convictions and alcohol related deaths despite the increase in alcohol and DUI awareness and education (Osilla, et al., 2019). Programs are designed to target first time offenders from reoffending and while the rates of reoccurrence are statistically lower, it does not account for individuals who were not arrested for a DUI although they may have been driving under the influence (Osilla, et al., 2019). Cognitive behavioral therapy [CBT] uses problem solving skills and cognitive restructuring to address how an individual’s thoughts, feelings and actions influence each other causing the person to react in harmful or dangerous ways (Osilla, et al., 2019). CBT as it relates to alcohol consumption and DUI conviction looks at restructuring the triggers behind an individual’s alcohol consumption (Osilla, et al., 2019). For example, peer pressure to drink while at a social gathering. CBT for first-time offenders adapts the sessions to help restructure cognitive thinking as it pertains to triggering situations for alcohol consumption while also focusing on cognitive behavioral strategies to make informed decisions regarding transportation after alcohol consumption (Osilla, et al., 2019). One of the main themes when working with first time DUI offenders and CBT is to prevent additional DUI convictions. CBT has shown to be an effective method, even more so than DUI reduction programs, to help reduce the consumption of alcohol while also reducing recidivism amongst individuals with a prior DUI conviction (Osilla, et al., 2019). Those who have successfully completed CBT programs have lower alcohol use and lower recidivism rates compared to individuals who completed a DUI risk reduction program (Osilla, et al., 2019). PART 4: DIVERSITY AND ETHICAL CONSIDERATIONS DUI Rates in Jackson County, Georgia In Jackson County, Georgia 25.3% of the population is 18 years of age or older with nearly an equal divide of women and men, women falling at 50.2% of the population (United States Census Bureau, 2021). Jackson County is a predominately white county with 87.1% of the residents, followed by Hispanic at 9.6% of the population (United States Census Bureau, 2021). Black individuals consist of 8.1% of the population, while the Asian population makes up 2.3% of Jackson County (United States Census Bureau, 2021). In Jackson County, 86.3% of the population has a high school degree and 25% of the population has a bachelor’s degree or higher (United States Census Bureau, 2021). The median household income ins $73,455 while 11.9% of the population lives at or below the poverty line (United States Census Bureau, 2021). Hispanic Community Population in Prison System The Hispanic population is the second most represented population Jackson County, GA sitting at 9.6% of the population (United States Census Bureau, 2021). In Georgia, the Hispanic community makes up approximately 4% of the prison population (Vera Institute of Justice, 2019). Although Hispanics are overrepresented in the prison system there is a huge discrepancy in race which leads to lower rates of incarceration and misrepresentation of the Hispanic population and higher incarceration rates of the White population (Vera Insitute of Justice, 2019). This means that many Hispanics are misrepresented as White making the reporting inconsistent and patterns of systemic racism hard to measure. Impact of Drinking and Driving Under the Influence for the Hispanic Community In 2017, motor vehicle crashes were the leading cause of death in Hispanic individuals, while 14% of those motor vehicle crashes stemmed from alcohol related fatalities (Responsibility.org, 2017). In 2014 there were 2,345 motor vehicle related fatalities in the Hispanic population, of that 38% of the deaths the driver had a .08% BAC and 78% of deaths the driver had a BAC of .15% or higher (Responsibility.org, 2017). As Hispanics migrate into United States, both legally and illegally, they become assimilated into American culture. Theoretical models suggest that as the Hispanic population assimilates into American culture, the dominate culture tends to influence acculturation at a higher rate (Valentine-Barrow, et al., 2011). The use of alcohol influences acculturation on the Hispanic population and as they assimilate rates of drinking also increase (Castaneda, et al., 2019). Additionally, Hispanic immigrants who have a lower socio-economic status tend to fall into drinking patterns more heavily than those who are of a higher socio-economic status (Castandea, et al., 2019). Risk Factors on the Hispanic Population The Hispanic population is one of the most growing populations in the nation (ValentineBarrow, et al., 2011). Among the nation, Hispanic youth is more likely to develop a substance abuse disorder due to risk factors including but not limited to peer influence, lack of family pride, family substance abuse history, as well as suicide attempts (Valentine-Barrow, et al., 2011). Additionally, lower rates of self-esteem correlated positively with higher rates of alcohol abuse in the Hispanic population (Valentine-Barrow, et al., 2011). Documented immigrants tend to experience more risk factors than protective factors, however, there is limited research on undocumented immigrants and the impact of risk factors on assimilation (Valentine-Barrow, et al., 2011). Lastly, Latino-born Hispanics tend to find substances such as cocaine and marijuana riskier than American-born Hispanics (Valentine-Barrow, et al., 2011). However, more research needs to be conducted on undocumented immigrants. Increasing Cultural Relevance The assets-based community development [ABCD] model helps immigrant families build on their current assets while addressing problems that may lie within the family unit (ValentineBarrow, et al., 2011). The ABCD model provides education and support groups for adapting into American culture while helping to decrease risk factors that can lead to drug and alcohol use (Valentine-Barrow, et al., 2011). Additionally, the ABCD model helps to encourage advocacy for the Hispanic population by listening to the resources needed from the community (ValentineBarrow, et al., 2011). In Jackson County, the Hispanic population is such a small part of the overall population, they are very underrepresented and may not have access to resources they need to reduce risk factors associated with drug and alcohol consumption. As a counselor, it is imperative to understand the resources needed in your community to reduce risk factors and promote protective factors. However, it is important to note that the Hispanic population is incredibly diverse and risk factors for the community may be different based on the region from which they immigrated from (Castandea, et al., 2019). For example, it is important to consider cultural differences in religion, beliefs as it pertains to receiving mental health care and receiving treatment for substance abuse. Ethical Considerations When counseling members of a different cultural background it is imperative for the counselor to be aware of their own personal biases and to create a safe, judgement free zone for their client by following the American Counseling Association [ACA] ethical guidelines. Providing prevention programs to the community can help reduce risk factors, however, these prevention programs must have clear language for the community to understand. Since a large majority of the Hispanic population is bilingual, using clear language that is culturally sensitive and easy to understand follows the ACA ethical guideline A.2.c which mentions developmental and cultural sensitivity (ACA, 2014). This means that when providing prevention programs to the Hispanic population as well as confidentiality limitations, the counselor is using language that is easily understandable. Additionally, it is important for the counselor to ask their client if they understand the program and if they have any questions about the program. Lastly, delivering information in the client’s native language may be a helpful way to reduce confusion and misunderstanding of the prevention program. This may include adding Spanish language to a pamphlet or adding an interpreter into the therapy sessions and prevention programs. Another way counselors should remain ethical while providing prevention programs to the Hispanic population is by following ACA ethical guideline A.7.a, which mentions advocacy for clients by addressing barriers that may hinder growth at the personal, relational, and societal level (ACA, 2014). First, the counselor must be aware of any barriers that exist within the community and address advocacy efforts. An example of a barrier that may exist in Jackson County include lack of accessible resources and education programs such as PARC that are relevant to educating individuals on the risks associated with DUI conviction in native language. Looking to increase advocacy efforts includes increasing protective factors within the Hispanic community while reducing risk factors such as peer pressure and support systems. Additionally, addressing the lack of research and support for the Hispanic population for alcohol and substance abuse, especially undocumented immigrants, can help promote community and societal changes while reducing risk factors. This in turn can help increase the effectiveness of prevention programs. Although the Hispanic population is the second largest population in Jackson County, Georgia, it still does not even make up 10% of Jackson County’s population. There is no data discussing race or ethnicity in DUI convictions. Therefore, there is no way to tell if the Hispanic population or other minority groups are at a higher risk for receiving a DUI conviction than their White counterparts. Additionally, most prevention programs, treatments, and advocacy efforts are geared towards the dominant population, leaving all minority groups underrepresented. It is imperative to consider all ethical considerations when introducing a prevention program for reducing DUI rates in Jackson County, Georgia. PART 5: ADVOCACY DUI Rates in Jackson County, Georgia Multicultural and Social Justice Counseling Competencies Model Part of being a competent counselor means advocating for your clients by helping to reduce the barriers that increase discrimination and marginalization (ACA, 2014). The Multicultural and Social Justice Counseling Competencies [MSJCC] was designed to help include multicultural and social justice initiatives into counseling theories and practice (MSJCC, 2015). The MSJCC model suggests that there are four aspects to promote advocacy efforts within a community which include counselor self-awareness, client worldview, the counseling relationship as well as counseling and advocacy interventions (MSJCC, 2015). Counseling and advocacy interventions include the individual level, the institutional level, the community level, and the public level (MSJCC, 2015). Each level considers individual self-concepts, support groups, society institutions, norms and values that are embedded into society as well as public policy enforcement to promote growth within the community (MSJCC, 2015). Individual Intrapersonal Level: Ignition Interlocks & DUI Risk Reduction Program The intrapersonal level of the MSJCC model focuses on individual characteristics, education, and awareness as well as self-concept (MSJCC, 2015). Ignition interlock systems can be involved in a vehicle and measures the alcohol that is present in the driver’s breath (CDC, 2020). The ignition interlock system primarily is geared towards the individual with the DUI conviction. When the ignition interlock, if the system detects alcohol on an individual’s breath, 0.02% or more, the vehicle will not start (CDC, 2020). Ignition interlock systems can be very successful when it comes to preventing repeat offenders (CDC, 2020). Since the vehicle will not start if alcohol is detected on the driver’s breath, this limits alcohol consumption and prevents further DUI convictions. Georgia also offers a DUI risk reduction program for those convicted of a DUI to help prevent further convictions. The DUI risk reduction program is also known as DUI school and consists of two parts: an assessment and an intervention (Law Offices of Richard S. Lawson, 2022). The assessment consists of a questionnaire designed to measure an individual’s drug and alcohol intake while the intervention consists of counseling and educational groups (Law Offices of Richard S. Lawson, 2022). In Georgia, the DUI risk reduction program must be completed in person and an individual must obtain a completion certification to submit to a judge (Law Offices of Richard S. Lawson, 2022). In some instances, a judge may require an individual to complete additional counseling once the DUI risk reduction program has been completed and the counselor must be selected from a state approved list (Law Offices of Richard S. Lawson, 2022). DUI reduction programs can help individuals manage their drinking while also better understanding the risks associated with additional DUI convictions. Public Policy: Dram Shop Liability Laws & Reduction in Legal Limit At the community level, creating dram shop laws will help reduce excessive drinking thus reducing the rate for DUI convictions (SAMHSA, 2019). Dram shop laws make establishments responsible for any harm that may come from an alcohol impaired accident (SAMHSA, 2019). This means that an establishment may be liable if they continue to serve guests who are clearly intoxicated, or underage should that guest be involved in an accident. In Jackson County, currently, dram shop laws are not in place. However, in surrounding counties, dram shop laws are in place. For example, Gwinnett County requires any person serving liquor to obtain a liquor license through the county. Additionally, there are no happy hour laws and maximum drink limits at certain corporate establishments. Drink limit maximums prevent overserving and potential liabilities that may come from an individual who is driving under the influence of alcohol as well as reductions in DUI convictions. Therefore, by enforcing dram shop laws in Jackson County, the DUI conviction rate may also be reduced since establishments can be held liable for accidents involving individuals who were overserved. Establishments may be required to pay legal fees and may lose their liquor license as a result of overserving or serving guests who are underage. An additional policy requires reducing the legal alcohol limit as well as implementing sobriety checkpoints (SAMHSA, 2019). Reducing the legal limit from .08 to .05 will allow less consumption of alcohol (SAMHSA, 2019). Additionally, sobriety check points will help not only reduce alcohol related accidents but also reduce DUI convictions as well since people may feel less inclined to operate a motor vehicle if there are checkpoints along their route of travel. It is not common for Jackson County to have roadblocks in place, however, during major holidays where alcohol consumption occurs at a higher rate there are police roadblocks in place to prevent drinking while under the influence. REFERENCES American Counseling Association. (2014). 2014 ACA Code of Ethics. Alexandria: VA. Castaneda, S.F., Garcia, M.L., Lopez-Gurrola, M., Stoutenberg, M., Emory, K., Daviglus, M.L., Kaplan, R., Giachello, A.L., Molina, K.M., Perreira, K.M., Youngblood, M. E., Vidot, D. C., & Talavera, G.A. (2019). Alcohol use, acculturation and socioeconomic status among Hispanic/Latino men and women: The Hispanic Community Health Study/ Study of Latinos. PloS ONE, 14(4). 1-12. CDC. (n.d.) The social-ecological model: A framework for violence prevention. Centers for Disease Control and Prevention (CDC). Risk and protective factors. Code of Ordinances Subsection 6. (2021). Retrieved from https://cms2.revize.com/revize/braseltonga/Open%20Container%20Downtown%20Distri ct%202021.pdf. County Health Rankings & Roadmaps. (2018). How healthy is your community? Robert Wood Johnson Foundation. Georgia. Department of Driver Services. (n.d.) DUI Data Reports. Retrieved from https://dds.georgia.gov/dui-data-reports. Gibson, S., Woodford, M., & Czeizinger, T.J., JR. (2018). Avoiding the last ride: Can DUI programming address multiple risk factors to reduce recidivism? Journal of Addictions & Offender Counseling, 39(2), 66-77. GNIS. (n.d.). Jackson County Georgia List of Churches. LaMorte, W. (2022). The Transtheoretical Model (Stages of Change). Boston University School of Public Health. Law Offices of Richard S. Lawson. (2022). Georgia DUI Consequences. Law Offices of Lawson and Berry Justice when you need it most. Retrieved from https://www.dui.info/georgiadui-consequences. Legal Information Institute. (2022). Driving Under the Influence (DUI). Wex Definitions Team. Retrieved from https://www.law.cornell.edu/wex/driving_under_the_influence_(dui). Lietz, C., & Hodge, D. (2014). Incorporating Spirituality Into Substance Abuse Counseling: Examining the Perspectives of Service Recipients and Providers. Journal of Societal Service Research, 39(4), 498-510. Multicultural and Social Justice Counseling Competencies. (2015). Retrieved from https://www.counseling.org/docs/default-source/competencies/multicultural-and-socialjustice-counseling-competencies.pdf?sfvrsn=20 National Highway Traffic and Safety Administration [NHTSA]. (n.d.). Drunk Driving. Retrieved from https://www.nhtsa.gov/risky-driving/drunk-driving. Nelson, S.E., Belkin, K., LaPlante, D.A., Bosworth, L., & Shaffer, H.J. (2015). A prospective study of psychiatric comorbidity and recidivism among repeat DUI offenders. Archives of Scientific Psychology, 3(1), 8-17. Osilla, K.C., Paddock, S.M., McCullough, C.M., Jonsson, L., & Watkins, K.E. (2019). Randomized Clinical Trial Examining Cognitive Behavioral Therapy for Individuals With a First-Time DUI Offense. Alcoholism: Clinical & Experimental Research, 43(10), 2222-2231. Prochaska, J.O. & Velicer, W.F. (1997). The transtheoretical model of health behavior change. AM J Health Promot. 12(1) 38-48. Responsibility.org. (2017). Hispanic Statistics. Retrieved from https://www.responsibility.org/alcohol-statistics/hispanic-statistics/. United States Census Bureau. (n.d.) Quick Facts Jackson County. Retrieved from https://www.census.gov/quickfacts/jacksoncountygeorgia . Saladnio, V., Mosca, O., Petruccelli, F., Hoelzlhammer, L., Lauriola, M., Verrastro, V., & Cabras, C. (2021). The Vicious Cycle: Problematic Family Relations, Substance Abuse, and Crime in Adolescence: A Narrative Review. Frontiers in Psychology, 12. Stautz, K., Frings, D., Albery, I.P., Moss, A.C., & Marteau T.M. (2017). Impact of alcoholpromoting and alcohol-warning advertisements on alcohol consumption, affect, and implicit cognition in heavy-drinking in young adults: A laboratory-based randomized controlled trial. British Journal of Health Psychology, 22(1), 128-150. Valentine-Barrow, M.D., Adcock, K.R., & Jenkins, K.Y. (2011). Substance Abuse Risk Factors Affecting the Hispanic Population in the United States. Journal of Human Behavior in the Social Environment, 21(7), 715-726. Vera Institute of Justice. (2019). Incarceration Trends in Georgia. Retrieved from https://www.vera.org/downloads/pdfdownloads/state-incarceration-trends-georgia.pdf. Wilson, B.R.A. (2021). Transtheoretical model of behavior change. Salem Press Encyclopedia of Health. Zutobi Drivers Ed. (2022). The US DUI Report- The States with the Most and Least Drunk Driving. Retrieved from https://zutobi.com/us/driver-guides/the-us-dui-report. SCHOLARWORKS CONTRIBUTOR AGREEMENT [This section will be completed Week 10. Please read the information below and if desired, sign, date, and provide email address in the highlighted section at the end]. ScholarWorks Publication Consideration ScholarWorks makes the intellectual output of the Walden University community publicly available to the wider world. By highlighting the scholarly and professional activities of our students and faculty, ScholarWorks’ rich repository encourages new ideas, preserves past knowledge, and fosters new connections to improve human and social conditions. If you would like your portfolio from your Counseling 6785 course to be considered for submission to ScholarWorks, please review the ScholarWorks Contributor Agreement below and agree to the terms and conditions. Acceptance of the policies and terms of the ScholarWorks Contributor agreement • will not impact your grade • will not guarantee publication ScholarWorks Contributor Agreement To administer this repository and preserve the contents for future use, ScholarWorks requires certain permissions from you, the contributor. By making a submission to ScholarWorks, you are accepting the terms of this license. However, you do not give up the copyright to your work. You do not give up the right to submit the work to publishers or other repositories. By including an email contact below, you hereby grant Walden a limited license to review the Submission for the purposes of review of scholarly content; to distribute the Submission to the public on the Website; to make and retain copies of the Submission; and to archive the Submission in a publicly accessible collection. You agree to defend, indemnify and hold Walden harmless from and against any and all claims, suits or proceedings, demands, losses, damages, liabilities and costs and expenses (including, without limitation, reasonable attorney’s fees) arising out of or resulting from the actual or alleged infringement of any patent, trademark, copyright, trade secret or any other intellectual property right in connection with any Submission.Walden will not be required to treat any Submission as confidential.For more information, see the Contributor FAQ. By executing this Agreement, you represent and agree that: • You are the author or of the submitted work or you have been authorized by the copyright holder, and the submission is original work. • You hold the copyright to this document and you agree to permit this document to be posted, and made available to the public in any format in perpetuity. • The submission contains no libelous or other unlawful matter and makes no improper invasion of the privacy of any other person. • The submission will be maintained in an open access online digital environment via the ScholarWorks portal. Because works on ScholarWorks are openly available online to anyone with internet access, you do not hold Walden University responsible for third party use of the submission. ScholarWorks (the Website) is owned and maintained by Walden University, LLC (Walden). All content that you upload to this Website (a Submission) will be available to the public. You represent and warrant that you have the right to upload any such Submission and make it available to the public. I have read the Scholarworks agreement above, and I agree to have my COUN 6785 portfolio document considered for inclusion in Scholarworks; I also grant my permission for representatives from Walden University to submit this work on my behalf. By signing again below, I agree to allow my email contact information below to be included in the published document, so that others may contact me about this work. SIGNATURE: DATE: DIRECT EMAIL ADDRESS: COUN 6785: Social Change in Action: Prevention, Consultation, and Advocacy Substance Use Risk and Prevention in LGBTQ Teens Stephanie Bradford Contents Overview Introduction Scope and Consequences Social-ecological Model Theories of Prevention Diversity and Ethical Considerations Advocacy References ScholarWorks Contributor Agreement OVERVIEW Keywords: [include the topic and location of your project here] [Insert title of your social change project here. For example: Teen Alcohol Use in Juneau, Alaska] [Complete this section Week 10, prior to final submission of your portfolio. Complete this section using the headings below as a guide. Please write in full sentences using APA style. This section should be no longer than one page]. Goal Statement: [Your prevention-focused goal statement] Significant Findings: [One paragraph summary of the population, problem, key findings and recommendations. This is like an abstract written for a scholarly research paper. Cite sources as needed] Objectives/Strategies/Interventions/Next Steps: [At least five. Write these to guide professionals in the field. Include specific action items as well as at least one community-based partner agency, for example, the evidenced-based program in the Theories section]. INTRODUCTION Substance Use Risk and Prevention in LGBTQ Teens I currently live in a small town that is approximately 2.5 hours northeast of Atlanta, Georgia. Blairsville, Georgia is a rural community nestled in the southernmost region of the Appalachian mountains. While it is only a few hours away from several more progressive cities including Atlanta, Georgia, Asheville, North Carolina & Chattanooga, Tennessee the conservative belief systems and worldviews here remain unchanged. This collective community mindset leaves those in the LGBTQ+ community without support, acceptance, and all too often feelings of isolation. Rates of suicide and alcohol and drug abuse are high in this area. In fact, this rural community has one of the highest suicide rates in the state ranking 23rd out of 159 counties (CDC, 2022). With limited mental health resources and no LGBTQ+ support and outreach, the LGBTQ+ youth of Blairsville need a place that helps give support and guidance to those who are struggling. PART 1: SCOPE AND CONSEQUENCES Substance Use Risk and Prevention in LGBTQ Teens Scope Rural southern communities have the tendency to hold on to conservative and frequently outdated ideas especially when it comes to opinions regarding homosexuality (Watson, Varjas, Meyers, and Graybill, 2010). While there are several Christian counseling services in the area there are no LGBTQ+-friendly or affirming resources here. I recognize the need for LGBTQ+ mental health services in this rural area and LGBTQ+ teens and young adults are my target population. According to research by the Trevor Project, LGBTQ+ youth are at higher risk than their peers when it comes to substance abuse and suicide (2022). Multiple factors including family rejection, harassment, bullying, and violence cause LGBTQ+ youth to experience more negative health outcomes than their heterosexual peers (Asakura, 2016). Consequences Working to prevent and reduce the prevalence of substance abuse and suicide in LGBTQ+ youth will greatly increase their well-being as they merge into adulthood. Healthy and happy adults can have a greater impact on the community than those who are consumed by addiction and depression. Goal Statement The goal of this project is to create support, education, and prevention services for teens who identify as LGBTQ+ so that rates of alcohol and drug abuse are reduced in my community. PART 2: SOCIAL-ECOLOGICAL MODEL Substance Use Risk and Prevention in LGBTQ Teens Bronfenbrenner’s ecological system theory considers the complex interaction between a person and their environment. A person’s development is influenced by many aspects of their environment from close interactions with family and friends to broader interactions with community and society (Guy-Evans, 2020). Using this model helps us to better understand the mechanisms that place LGBTQ+ teens at greater risk of substance abuse and what can also act as protective factors to prevent this issue (CDC,n.d.). The first level considers a person’s biological and individual history. According to Jones, high school students who identify as LGBTQ+ have a greater frequency of substance use behaviors compared to their heterosexual peers (Jones, et al, 2020). Other risk factors may include a person’s genetic predisposition to addiction or exposure to alcohol prenatally (SAMHSA, n.d.). Protective factors at this level, increase mindsets, opinions, and actions that reduce or prevent alcohol and drug abuse (CDC, n.d.). In-school advocacy programs such as the Gay-Straight Alliance foster opportunities for students to obtain stress management skills, along with coping and problem-solving skills (Watson, Varjas, Meyers, Graybill, 2010). Resiliency training is another protective factor at this level. Many LGBTQ+ teens experience stress related to their sexual identity. Using a model such as The Strengths Perspective in Social Work, students are encouraged to consider their strengths, talents, and resources that can help them cope more effectively with the stress and oftentimes, trauma and cruelty that they experience (Asakura, 2016). The second level of Bronfenbrenner’s ecological system considers how relationships with those closest to a person affect them. This includes family members, friends considered to be in their closest social circle, and familiar peers (CDC, n.d.) Family members have an intense and lasting influence on the development of a child and their existence (Ryan, et al., 2009). Risk factors for this group include parental drug use, abuse or neglect by a parent, or a parent who struggles with mental illness (SAMHSA). When “coming out” to close family members, the potential for rejection or violence is another risk factor at this level. Family rejection is associated with poorer health outcomes for LGBTQ+ persons. Rejection from close family members causes poorer physical and mental health, higher levels of suicide attempts, and a greater chance of abusing alcohol or drugs (Ryan, Huebner, Diaz, and Sanchez, 2009). The third is the community level which encompasses neighborhoods and schools. Interactions with peers, teachers and administrators in school settings is another important layer to this model. Peers at school and the interactions that LGBTQ youth have with them can be either positive and affirming or a source of harassment and bullying that can increase the risk of alcohol and drug abuse (Human Rights Campaign, n.d.). PART 3: THEORIES OF PREVENTION Substance Use Risk and Prevention in LGBTQ Teens Theories are important frameworks or foundations that determine boundaries and offer a greater understanding of what works to solve or diminish a community problem. Theories offer an organized sequence or map to a specific problem, look at ways to institute lasting change, and also offer conclusions for evaluation. (National Cancer Institute, 2005). Theories help to shed light on an issue and offer well-defined pathways to prevention that are based on an understanding of behavior. The use of theories also helps to determine what specific information should be noted and measured during the program evaluation. Prevention programs that apply organized systematic theoretical approaches are more likely to succeed than those that are not developed using a theoretical perspective. Community-level initiatives are key components to change-making policies and programs. When considering theories of prevention for a community problem, it is important to have a complete understanding of the unique attributes of the community (National Cancer Institute, 2005). Resources and knowledge can be gathered from community involvement and action. Community Organizational Models are useful in a variety of communities including schools, businesses, community organizations, and government agencies. When considering the problem of LGBTQ alcohol and drug abuse, Community Organizational Model would be useful in implementing a prevention program. Specific programs such as Gay-Straight Alliance and Mentoring programs similar to those of Big Brothers Big Sisters have shown promising results. Gay-Straight Alliance programs are started in the school setting when a student approaches a teacher to be the sponsor and advocate to begin a GayStraight Alliance club or organization. LGBTQ youth are at much higher risk of than their non-LGBTQ peers to abuse alcohol and drugs. They face unique challenges that are largely attributed to the consequences of predjudice that weaken their support systems and compel them to use alcohol and drugs. They are twice as likely to be bullied or assaulted at school than their heterosexual peers. They also face the possibility of further degradation, persecution, and rejection from their families (Human Rights Campaign, n.d.) There are several protective factors that can greatly diminish the chances of LGBTQ youth using drugs and alcohol as a means of coping. Those factors are increased family support, having relationships with caring adults, and safer school environments (Human Rights Campaign, n.d.). LGBTQ youth who are able to garner support from a parent or caregiver in regard to their identity are better equipped to withstand the other challenges that they face like bullying or harassment at school. Caring and supportive relationships with teachers provide individual support and help to bolster self-esteem. A supportive teacher and also be instrumental in shaping a more positive school environment where harassment and bullying are not tolerated. A safe school environment is another dimension of protective factors that can help to diminish alcohol and drug abuse in LGBTQ youth. PART 4: DIVERSITY AND ETHICAL CONSIDERATIONS Substance Use Risk and Prevention in LGBTQ Teens When considering drug and alcohol abuse in LGBTQ+ youth it is crucial to consider transgender youth and their unique struggles with mental health issues and drug abuse. This group is at particular risk of using substances to cope with verbal harassment, rejection, alienation, and violence encountered by their peers and even sometimes their families. Research has determined that they are as much as 4 times as likely to use alcohol and drugs as their nontransgender peers (Day, Fish, Perez-Brumer, Hatzenbuehler, & Russell, 2019). Transgender youth are particularly vulnerable in the school setting where they are likely to experience hostile treatment which includes biased-based bullying that is centered on actual or perceived sexual identity or gender expression (Day, et al, 2019). With the chances of being bullied at school even greater for this group of students, the chances of them dealing with mental health issues like depression and social ideation are ever greater. These experiences of victimization factor greatly into transgender youth’s higher rates of risky behavior (Sinatra, 2017). When implementing school-based interventions such issues of victimization should be addressed. Advisors or sponsors of Gay-Straight alliance groups should consider addressing antigay language as it is pervasive and the start of other forms of verbal harassment and physical violence. Eighty-five percent of LGBTQ+ teens indicate being victims of verbal harassment (Huebner, Thoma, & Neilands, 2016). When compared to their heterosexual peers, LGBTQ+ youth have a much greater incidence of bullying and fighting at a rate of 25% and 38% compared to 7% and 19% of other adolescents Huebner, et al., 2016). Other efforts should be made to train faculty and staff on the unique needs of transgender youth along with providing information on how to access gender-affirming health services (Sinatra, 2017). In working with this special population, certain ethical considerations should be carefully monitored. It is important that school counselors adhere to the ACA Code of Ethics and hold fast to the standard of confidentiality and consent for both counselor and client (American Counseling Association, 2014). PART 5: ADVOCACY Substance Use Risk and Prevention in LGBTQ Teens Advocacy is such an important part of the counselor’s role. According to Toporek et al, counselors have throughout their history acted as agents of change through advocacy (Toporek et al, 2009). Frequently a client or student’s needs go beyond the services that they receive from hourly counseling sessions. Counselor advocates have a long history of fighting against racism and sexism in the workplace, working to bring hidden family abuse and neglect into the light and eliminating school-based obstacles to equal opportunities for learning (Toporek et el. 2009). The Multicultural and Social Justice Counseling Competencies (MSJCC) was developed to give counselors a framework to implement multicultural and social justice competencies into counseling theories, practices, and research (Multicultural and Social Justice Counseling Competencies, 2015). Advocacy happens on many different levels and affects positive change through several different approaches. Change-making through advocacy occurs through the individual student or client, on an institutional level, in the community or local level, and finally, through public policy or social and political levels. Individual Advocacy When considering the problem of drug and alcohol abuse in LGBTQ+ teens, individual advocacy is a very important piece of helping to improve this issue. This level of advocacy focuses on the client and can be either client/student empowerment or client/student advocacy. (Toporek et al, 2009). Empowering the client/student equips them with skills to advocate for themselves and also provides them with resiliency resources so that they can better manage the feelings and emotions that they experience from barriers and challenges that they experience. According to Sandman et al, it is especially important to offer this type of advocacy to LGBTQ individuals in rural conservative communities where oppression is routinely experienced individually, institutionally, and legislatively (Sandman et al, 2014). Institutional Advocacy The school setting can be especially traumatic for LGBTQ teens where they can feel rejected, disregarded, and isolated from their peers. Resources and support systems are frequently missing or not adequately implemented to assist LGBTQ teens as they navigate the unique challenges they face. These struggles are frequently the impetus that causes them to choose unhealthy coping mechanisms like drug and alcohol abuse. School counselors can advocate on the institutional level by implementing Gay-Straight Alliance groups as a means of support to not only offer LGBTQ teens an avenue of connecting with others who will support and embrace them but also initiate changes in school culture where inclusion, diversity, and acceptance are the norm. Additionally, part of institutional advocacy for LGBTQ teens is to create anti-bullying training and education for both students and staff. Through professional development efforts, school counselors will find other teachers and administrators that will also act as mentors or allies for LGBTQ teens in the school setting. Community Advocacy Community resources are another place where LGBTQ teens will find limited access to support and assistance. In Union county, Georgia there is a significant lack of mental health services. Our local hospital, Union General Hospital, does not have a mental health department and only has one social worker who is responsible for the entire mental health needs of all patients. This leaves the mental health requirements of patients at the hands of medical staff who are not trained to adequately assist with the care of those with mental health issues. According to the CDC’s data on Behavioral Health Service Providers by county, Union county has 1.1 to 3.0 Licensed Social Workers per 10,000 people (CDC, 2022). With a population of around 25,000 in Union county, mental health resources are an overwhelming scarcity. The problem of limited mental health resources in this community is daunting, but outreach to other mental health workers to encourage them to become allies for LGBTQ teens could be a means of helping with this issue. Another possible solution could be to provide outside resources in the surrounding areas of Atlanta metro, Ashville, NC, and Chattanooga, TN. Public Policy According to Multicultural and Social Justice Counseling Competencies, public policy is defined as policies or laws that govern or impact human growth and development on the local, state, and federal levels (Multicultural and Social Justice Counseling Competencies, 2015). Counselors should be aware of local, state, and federal laws and policies that contribute to the continued marginalization of their LGBTQ clients and act as social advocates to change or create new policies or laws that promote equality and social justice. Another important means of advocacy would be to join and collaborate with others on the national, state, and local levels by joining groups like Georgia Equality, Georgia Safe Schools Coalition, GLAAD, or Human Rights Campaign, to name a few. REFERENCES American Counseling Association (2014). 2014 ACA Code of Ethics. Retrieved from https//:www.counseling.org/Resources/aca-code-of-ethics.pdf Asakura, K. (2016). It takes a village: Applying a social ecological framework of resilience in working with LGBTQ youth. Families in Society: The Journal of Contemporary Social Services, 97(1), 15–22. https://doi.org/10.1606/1044-3894.2016.97.4 Campbell-Voytal, K., (2010). The role of theory in clinical prevention research. Family Practice, 27(4), 357–358. https://doi.org/10.1093/fampra/cmq054 Centers for Disease Control and Prevention (CDC). (2022). 10 Leading Causes of Death, United States. Retrieved from https://wisqars.cdc.gov/data/lcd/home Centers for Disease Control and Prevention (CDC). (2022). Behavioral Health Services in Georgia. Retrieved from https://www.cdc.gov/childrensmentalhealth/stateprofilesproviders/georgia/index.html Centers for Disease Control and Prevention (CDC). (n.d.). The social-ecological model: A framework for violence prevention. Retrieved from https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html Day, J. K., Fish, J. N., Perez-Brumer, A., Hatzenbuehler, M. L., & Russell, S. T. (2017). Transgender Youth Substance Use Disparities: Results From a Population-Based Sample. The Journal of adolescent health: official publication of the Society for Adolescent Medicine, 61(6), 729–735. https://doi.org/10.1016/j.jadohealth.2017.06.024 Guy-Evans, O. (2020, Nov 09). Bronfenbrenner’s ecological systems theory. Simply Psychology. http://www.simplypsychology.org/Bronfenbrenner.html Huebner, D. M., Thoma, B. C., & Neilands, T. B. (2015). School victimization and substance use among lesbian, gay, bisexual, and transgender adolescents. Prevention science: the official journal of the Society for Prevention Research, 16(5), 734–743. https://doi.org/10.1007/s11121-014-0507-x Jones, C. M., Clayton, H. B., Deputy, N. P., Roehler, D. R., Ko, J. Y., Esser, M. B., Brookmeyer, K. A., & Hertz, M. F. (2020). Prescription Opioid Misuse and Use of Alcohol and Other Substances Among High School Students – Youth Risk Behavior Survey, United States, 2019. MMWR supplements, 69(1), 38–46. https://doi.org/10.15585/mmwr.su6901a5 Multicultural and Social Justice Counseling Competencies. (2015). Retrieved October 27, 2015, from http://www.counseling.org/docs/default-source/competencies/multicultural-andsocial-justice-counseling-competencies.pdf?sfvrsn=20 National Cancer Institute (2005). Theory at a glance: A guide for health promotion practice. Washington, DC: U.S. Department of Health and Human Services: National Institutes of Health. https://cancercontrol.cancer.gov/sites/default/files/2020-06/theory.pdf Perez-Brumer, A., Day, J. K., Russell, S. T., & Hatzenbuehler, M. L. (2017). Prevalence and Correlates of Suicidal Ideation Among Transgender Youth in California: Findings From a Representative, Population-Based Sample of High School Students. Journal of the American Academy of Child and Adolescent Psychiatry, 56(9), 739–746. https://doi.org/10.1016/j.jaac.2017.06.010 Preventing substance abuse among LGBTQ teens. Human Rights Campaign. (n.d.). Retrieved December 27, 2022, from https://www.hrc.org/resources/preventing-substance-abuseamong-lgbtq-teens Ryan, C., Huebner, D., Diaz, R. M., & Sanchez, J. (2009). Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics, 123(1), 346-352. Sandman, G.R., Frye, M.A., Hoff, D.D., Dinsmore, J.A. (2014). From Awareness to Action: Becoming a LGBT Advocate in a Conservative Rural Community. Vistas Online, 66. https://www.counseling.org/docs/default-source/vistas/article_66.pdf?sfvrsn=4 Sinatra, C. S., (2017, September 25). Victimization of transgender youths linked to Suicidal thoughts, substance abuse. College of Natural Sciences, University of Texas at Austin. Retrieved January 1, 2023, from https://cns.utexas.edu/news/victimization-oftransgender-youths-linked-to-suicidal-thoughts-substance-abuse Substance Abuse and Mental Health Services Administration (SAMHSA): Risk and Protective Factors. Retrieved from https://www.samhsa.gov/sites/default/files/20190718-samhsarisk-protective-factors.pdf Substance use and suicide risk among LGBTQ youth. The Trevor Project. (2022, February 14). Retrieved December 3, 2022, from https://www.thetrevorproject.org/researchbriefs/substance-use-and-suicide-risk-among-lgbtq-youth-jan-2022/ Toporek, R. L., Lewis, J. A., & Crethar, H. C. (2009). Promoting systemic change through ACA advocacy competencies. Journal of Counseling & Development, 87, 260-268. Watson, L. B., Varjas, K., Meyers, J., & Graybill, E. C. (2010). Gay–Straight Alliance Advisors: Negotiating multiple ecological systems when advocating for LGBTQ youth. Journal of LGBT Youth, 7(2), 100–128. https://doi.org/10.1080/19361651003799700 SCHOLARWORKS CONTRIBUTOR AGREEMENT [This section will be completed Week 10. Please read the information below and if desired, sign, date, and provide email address in the highlighted section at the end]. ScholarWorks Publication Consideration ScholarWorks makes the intellectual output of the Walden University community publicly available to the wider world. By highlighting the scholarly and professional activities of our students and faculty, ScholarWorks’ rich repository encourages new ideas, preserves past knowledge, and fosters new connections to improve human and social conditions. If you would like your portfolio from your Counseling 6785 course to be considered for submission to ScholarWorks, please review the ScholarWorks Contributor Agreement below and agree to the terms and conditions. Acceptance of the policies and terms of the ScholarWorks Contributor agreement • will not impact your grade • will not guarantee publication ScholarWorks Contributor Agreement To administer this repository and preserve the contents for future use, ScholarWorks requires certain permissions from you, the contributor. By making a submission to ScholarWorks, you are accepting the terms of this license. However, you do not give up the copyright to your work. You do not give up the right to submit the work to publishers or other repositories. By including an email contact below, you hereby grant Walden a limited license to review the Submission for the purposes of review of scholarly content; to distribute the Submission to the public on the Website; to make and retain copies of the Submission; and to archive the Submission in a publicly accessible collection. You agree to defend, indemnify and hold Walden harmless from and against any and all claims, suits or proceedings, demands, losses, damages, liabilities and costs and expenses (including, without limitation, reasonable attorney’s fees) arising out of or resulting from the actual or alleged infringement of any patent, trademark, copyright, trade secret or any other intellectual property right in connection with any Submission. Walden will not be required to treat any Submission as confidential. For more information, see the Contributor FAQ. By executing this Agreement, you represent and agree that: • You are the author or of the submitted work or you have been authorized by the copyright holder, and the submission is original work. • You hold the copyright to this document and you agree to permit this document to be posted, and made available to the public in any format in perpetuity. • The submission contains no libelous or other unlawful matter and makes no improper invasion of the privacy of any other person. • The submission will be maintained in an open access online digital environment via the ScholarWorks portal. Because works on ScholarWorks are openly available online to anyone with internet access, you do not hold Walden University responsible for third party use of the submission. ScholarWorks (the Website) is owned and maintained by Walden University, LLC (Walden). All content that you upload to this Website (a Submission) will be available to the public. You represent and warrant that you have the right to upload any such Submission and make it available to the public. I have read the Scholarworks agreement above, and I agree to have my COUN 6785 portfolio document considered for inclusion in Scholarworks; I also grant my permission for representatives from Walden University to submit this work on my behalf. By signing again below, I agree to allow my email contact information below to be included in the published document, so that others may contact me about this work. SIGNATURE: Stephanie Bradford DATE: DIRECT EMAIL ADDRESS: