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The Importance of Specialized Treatment Programs for Lesbian and Gay Patients
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1 The Importance of Specialized Treatment Programs for Lesbian and Gay Patients Daniel Hicks, MD SUMMARY. This article describes a dual diagnosis treatment program for the lesbian, gay, bisexual, and transgendered community in Washington, DC called the Lambda Center. By using a case example, the article describes how a specialized treatment program can more effectively treat and return a gay or lesbian patient to full functioning, by addressing specific issues which would be overlooked in a mainstream program. These unique issues include coming out, internalized homophobia, socialization, dating and intimacy for sexual minorities, use of certain recreational drugs, and the role of spirituality. The article also gives examples of failures and difficulties faced by lesbian and gay patients in straight programs. The author calls for further studies to prove the superior efficacy of specialized programs for lesbians and gay men and urges patients and providers demand that third party payers and HMOs authorize gay affirmative treatment programs because they are better for patients and probably more cost effective. [Article copies available for a fee from The Haworth Document Delivery Service: address: Website: < KEYWORDS. Homosexuality, specialized treatment programs, gay and lesbian treatment, substance abuse treatment, recreational drug use, lesbian and gay mental health, internalized homophobia Specialized addiction treatment programs provide a safe place for lesbian and gay persons to talk about all aspects of their lives without fear of criticism or judgement (Skinner and Otis 1992). This is a great relief for many Dr. Daniel Hicks is affiliated with the Georgetown University Medical Center, Department of Psychiatry, 3780 Resevoir Road, Washington, DC [Haworth co-indexing entry note]: The Importance of Specialized Treatment Programs for Lesbian and Gay Patients. Hicks, Daniel. Co-published simultaneously in Journal of Gay & Lesbian Psychotherapy (The Haworth Medical Press, an imprint of The Haworth Press, Inc.) Vol. 3, No. 3/4, 2000, pp ; and: Addictions in the Gay and Lesbian Community (ed: Jeffrey R. Guss, and Jack Drescher) The Haworth Medical Press, an imprint of The Haworth Press, Inc., 2000, pp Single or multiple copies of this article are available from The Haworth Document Delivery Service [ , 9:00 a.m. - 5:00 p.m. (EST). address: 2000 by The Haworth Press, Inc. All rights reserved. 81
2 82 ADDICTIONS IN THE GAY AND LESBIAN COMMUNITY gay people in addiction treatment who have tended to segregate their lives, being in the closet at work or with their families, and only being out of the closet when they are at home or with friends. This can be a liberating experience for persons who are still struggling with acceptance of their identity and have few supports to openly discuss their feelings. It is also important that gay men and women find supportive and affirming groups outside of formal addiction treatment settings, such as lesbian and gay 12 step meetings or openly supportive meetings where it is safe to discuss their gay and lesbian issues without fear. Specialized addiction treatment programs have experience dealing with the specific ways that substances are used in the gay and lesbian community, and which substances are somewhat unique to this community, which may not be understood in many mainstream programs. Specialized programs for gay men and lesbians can help people find alternative ways to socialize and be intimate without drugs or alcohol. They can also focus on safer sex education and responsible behavior, because HIV is so prevalent in the community and inextricably tied to substance use as risk factors. These programs also understand the coming out process, and how the conflicts in coming out often lead to substance abuse. This allows them to help the patient recognize internalized homophobia and find greater balance and self-acceptance. These programs also understand the role of spirituality for gays and lesbians in recovery, sometimes counteracting past damage caused by organized religion and offering an opportunity to open a spiritual path as part of the recovery process. Because of oppression in society, lesbian and gay people are more prone to turn to substances for a variety of reasons. It is the goal of specialized treatment programs to understand these risks, and to be able to help patients not only become sober, but also to move on to greater self-acceptance and maturity. This involves overcoming self-preoccupation and fear caused by internalized homophobia, and shifting the focus to outside goals such as professional and career achievements, family and community, as well as increased political and church involvement. In the last several years, more and more specialized programs offering mental health treatment for lesbian and gay people have emerged, especially those with substance abuse problems. It was recognized that relapse and failure seemed more common for many in the sexual minority community, because they were unable to express themselves openly and integrate the principles of recovery into their lives following treatment in mainstream programs. In many cases, lesbians and gay men were reluctant to enter into treatment because of fear of homophobia and prejudice. This paper will use a case example to demonstrate the effectiveness of a specialized treatment called the Lambda Center, and point out the unique interventions and knowl-
3 Special Populations and Treatment Settings 83 edge which make these programs possibly more effective in reaching the gay or lesbian patient. Michael was a 35-year-old professional gay white man who had recently begun to show signs of social withdrawal, irritability and erratic behavior. Lateness at work, missed appointments, and errors marred his usually excellent work performance. When friends tried to talk with him about these personality changes, he would become defensive and withdrawn. Finally, a group of close personal and professional friends gathered together to confront Michael about their concerns and encourage him to seek help. He finally admitted that his recreational cocaine and crystal methamphetamine use had begun spreading from the weekends into the weekdays, and was beginning to threaten his career. He accepted his friends advice and agreed to seek treatment. Michael had excellent insurance, and could go anywhere for treatment, but he chose a gay affirmative treatment program recommended by his friends. This was crucial to his recovery for several reasons. Many insurance companies would only authorize outpatient treatment for stimulant abuse, feeling that these drugs do not cause serious medical withdrawal, as is seen with alcohol or sedative detoxification, and therefore patients with addiction to stimulants could be safely treated in an outpatient program. These are common drugs of abuse in the gay community, and it is clear that they are intensely addictive. Because of this, the user often must be hospitalized for at least a few days, to break the cycle of use, and also allow the substance to begin clearing from their body. Specialized programs such as the Lambda Center are familiar with drugs endemic to the gay community. The Lambda Center has developed special relationships with third party payers that allow it to successfully obtain reimbursement for this more intensive treatment. During these few days of treatment, dysphoria, restlessness, anxiety, and drug cravings emerged. It became clear that Michael was not only suffering from methamphetamine withdrawal, but also from Major Depressive Disorder, which is often hard to diagnose in the early stages of substance withdrawal. Michael had been in a seven-year relationship during which he occasionally used drugs and alcohol socially but never excessively. His lover had become involved with someone else and left about a year prior to admission. After the breakup, he coped with his depression by increasing his hours of work and isolating himself from many of his friends. This allowed him to move up rapidly in his firm due to his dedication and hard work. In order to relieve stress when he was not working and to cope with his loneliness, he had begun to go out every weekend and party excessively with drugs, dancing, and sex. He regularly traveled to circuit parties at various cities around the country. These consisted of long weekends of dancing and sex, fueled by recreational drugs such as ecstasy, Ketamine, cocaine, and crystal methamphetamine. His
4 84 ADDICTIONS IN THE GAY AND LESBIAN COMMUNITY life consisted of work, going to the gym so he could look good at the parties, and intense dancing and drugs every weekend. There was little room for rest and relaxation, an intolerance for intense affect and an impaired ability for emotional intimacy. Over time, his excessive weekend recreation began to make him more tired and less effective at work, so he started using a little cocaine and amphetamine to increase his energy and performance. This was only a temporary solution, and gradually the drug use increased. He began showing up late and becoming delinquent in meeting deadlines. This led his friends to confront this need for addiction treatment. As he withdrew from the drugs, his sadness, grief and depression over the loss of his relationship became more apparent. He was started on antidepressant medication for treatment of depressive symptoms and to help decrease drug cravings. In many mainstream programs, this depression may have been attributed only to withdrawal and never medicated, because the patient would not have been as open to discussing the losses in his life or their emotional significance. HISTORY OF SPECIALIZED TREATMENT PROGRAMS FOR THE LGBT COMMUNITY Specific treatment programs for gays and lesbians did not exist until 1986 with the formation of the PRIDE Institute (Ratner 1988). Although precise demographics about the lesbian and gay community are difficult to clearly delineate due to the fact that many persons are unwilling to self-identify, most studies do support the idea that there is an increased incidence of substance abuse in the lesbian and gay community (Erwin 1993). Estimates of incidence of addiction in this population range between 28-35%, compared with 10-12% in the heterosexual community (Cabaj 1996). One derogatory explanation is that homosexuality and alcoholism arose through a common pathological psychosexual developmental arrest; fortunately, this theory has been put to rest (Nardi 1982). As studies have inquired into the origins of homosexuality, it has been hypothesized that a gene for alcoholism, which clearly has a strong genetic component, may be in close proximity to a gene for homosexuality, so that a person who is homosexual may also be at higher risk to be alcoholic (Cabaj 1996). More psychological explanations for the increased incidence of addiction in the gay and lesbian community describe addiction as a learned behavior, possibly superimposed upon a genetic predisposition (Ghindia and Kola 1996). For years, the only place to meet other lesbian or gay people safely (or at all) was in bars. This phenomenon still exists for many people today, especially in small towns where there are no gay neighborhoods or other social venues (Kelly 1994). If one spends enough time in an environment that encourages drinking and drug use, some individuals will develop a substance
5 Special Populations and Treatment Settings 85 abuse problem, especially those with a genetic predisposition. For others with social anxieties or discomfort about having sex, drugs and alcohol may be experienced as necessary in order to relax enough to approach strangers, to socialize, or to perform sexually. Another important factor in understanding addiction in the gay and lesbian community is both internalized and societal homophobia (Fleisher and Fillman 1995). Societal homophobia is also called heterosexism (Amico 1997). Homophobia is characterized by self-blame, a negative self-concept, and self directed anger. It is associated at times with self-destructive behaviors such as substance abuse, the development of a sense of victimization, feelings of inadequacy, hopelessness, and despair (Niesen and Sandall 1990). This inner self-hatred due to one s sexual feelings can interfere with psychological development, with drugs and/or alcohol providing escape from these negative feelings (Niesen, 1993). The phenomenon of increased substance abuse is often seen in oppressed communities, especially racial minorities and other socioeconomically oppressed groups. STRUCTURE OF SPECIALIZED PROGRAMS The program at the Lambda Center is a unique partnership between the Psychiatric Institute of Washington (DC) and the Whitman Walker Clinic, one of the nation s largest gay and lesbian health clinics. The Whitman Walker Clinic has become the District of Columbia s largest HIV service provider. The Lambda Center provides inpatient and partial hospitalization for the lesbian, gay, bisexual, and transgender community with psychiatric and/or substance abuse problems. The unit is on a locked ward with 8-10 beds, which also houses the partial hospitalization program for outpatients daily (Monday-Friday) from 10:00 AM to 3:30 PM. The program currently includes a psychoeducational group (Niesen 1997) which focuses on such topics as anger management, stress reduction, depression, medication, grief, safer sex, and HIV. A social worker, pastoral counselor, or nurse clinician leads this group. There is an expressive therapy group, led by an art therapist, in which patients work in a variety of expressive media: art, writing, storytelling, music therapy and sociodrama-type role playing. These therapeutic modalities seek to access emotions not always available through verbal or language based therapy. There is a break for lunch, then traditional process group psychotherapy, which works with current or past issues in a group format. Each day there is an addictions group, led by a Certified Addictions Counselor. These groups deal with such topics as: relapse triggers, relapse prevention, 12 step Meeting participation, relaxation/meditation techniques, the importance of social support for recovery, spirituality, and other issues related to recovery. The psychiatrist sees patients for psychiatric evaluation and treatment. Case management services are offered which provide assis-
6 86 ADDICTIONS IN THE GAY AND LESBIAN COMMUNITY tance with social services, housing, and communication with families and work. Individual, family, and couples therapy may be done when indicated and time allows, but often this is coordinated with outside therapists. There is usually a morning and evening checkout time to support abstinence in the community and to provide planning for the evening and next day s activities. Individuals in treatment are strongly encouraged to attend 12 step or recovery meetings in the evenings and on weekends. Outpatients are encouraged to explore both gay and straight meetings in the community to develop a compatible recovery support system. The staff is multidisciplinary with a psychiatrist as medical director and a program director who is an ordained minister and pastoral counselor. Also on staff are nurses, psychiatric technicians, an art therapist, social worker, and addiction counselor. Some members of the staff are straight and some gay; all staff are asked to be open about their sexual orientation and relationship status with patients. This is because honesty and openness are felt to be important for optimal health and recovery, and should be modeled by the staff whenever possible. The non-gay staff is gay-affirmative, and all staff participate in regular in-service education about lesbian and gay issues, such as dating, safer sex and intimacy, gay male couples and lesbian couples, treatment of HIV disease, grief and loss, discrimination in the community, political advocacy, gay families and parenting, and other issues that emerge in the course of treatment. There are also plans to offer evening and weekend components of the treatment program in order to provide greater continuity and safety for inpatients and outpatients. These treatment times are important also for potential patients who work during the day, but need an Intensive Outpatient Program. As demonstrated in the case example, patients may begin their treatment as inpatients for detoxification, safety and establishment of abstinence. They then move to the partial hospitalization program, living at home and coming to the Center for groups each day. If their living environment is unsafe due to strong relapse potential, they are encouraged to go into recovery housing, either through Whitman Walker Clinic or in the community. This increases the chances of successful recovery. Those who cannot access safe housing or who relapse repeatedly despite maximal treatment efforts are often referred to more restrictive long-term treatment programs in the community where patients are closely monitored and supervised for several months until their recovery is more stable. Offering a continuum of treatment intensity ranging from inpatient to partial hospitalization also gives a much greater opportunity for monitoring of early abstinence and psychotropic medication effectiveness. Once patients mood and recovery are more stable, their treatment session frequency is decreased, allowing them to return to work or other community activities.
7 Special Populations and Treatment Settings 87 Alternatively, the patient is referred to the intensive outpatient program, and may be seen on 2-5 days/week. This frequency is often helpful for further stabilization, and helps the patient remain focused on his or her recovery goals. In addition to options for housing for addictions and for HIV, our affiliation with Whitman Walker Clinic also gives access to a two day/week intensive evening addiction program that lasts for several months. Once the patient is functioning adequately, and in stable recovery, they may be referred for further treatment in their community, often including individual therapy and 12 step meetings. As in the case with Michael, the community program lasted several months, allowing him to have support as he came out at work and to his family. Whitman Walker Clinic and Lambda Center also have access to a community-wide network of mental health providers who are willing to see patients for individual, couples, family, or group therapy. These gay affirmative practitioners are in private practice settings, and offer a broad spectrum of treatment expertise. Some offer a sliding scale fee. The Lambda Center offers monthly educational programs for providers in the community on various mental health topics including substance abuse, transgender issues, employment discrimination, domestic violence, gay and lesbian youth, trauma survivors, couples and family therapy, psychopharmacology and other issues pertinent to the community. TREATMENT OPTIONS Individuals are often limited in their choice of addiction treatment settings by their HMO or insurance company. Such restrictions may also limit the effectiveness of treatment if the program does not address the patient s specific needs (Garnets et al. 1997). One patient at the Lambda Center sought addiction treatment at several programs in his small town in Alabama. He had found them interesting and helpful, but he found himself listening to others and never really sharing his own life story: coming out after being married with children, and his difficulties in meeting and socializing without using alcohol. In a gay affirmative program, he was able to open up and talk about his life, and for the first time felt like he had really begun to recover. Another patient, who had been diagnosed with AIDS and was forced to retire soon after his initial HIV test, developed cocaine addiction to cope with his depression, illness, and drastic change in lifestyle. He entered the same treatment program on two occasions; he was very open about his sexuality and health status and even had his family involved in treatment. However, the patient continued to relapse and went from powder to crack cocaine, because the full weight of his depression in the face of AIDS was not recognized and treated in this mainstream treatment program. When he entered a specialized pro-
8 88 ADDICTIONS IN THE GAY AND LESBIAN COMMUNITY gram, he was able to grieve the loss of his lover, his job, and his past professional achievements. He was able to work through family issues and become closer to his supportive family. He also began to explore his spirituality and worked toward finding a new level of satisfaction in life without drugs or a highly-paid career. Some treatment programs, and some 12-step meetings have actually encouraged people not to talk about their homosexuality (Lewis and Jordan 1989) or their HIV disease. There was concern that it might cause too much disturbance to the other people in the group, or that it was not relevant to their addiction treatment (Green and Faltz 1991). Other programs may claim to be sensitive to gay and lesbian issues, but may not really understand the coming out process and the special issues faced by lesbian and gay people. Some openly gay people go to treatment programs and have no trouble being fully out of the closet and even may present as free of internalized homophobia. They may say to their therapists, You don t understand what it s like in the gay community; everyone drinks, or everyone gets high or you have to do this to fit in. The therapists and the treatment program need to identify and confront this common presentation of denial and avoidance of therapeutic interventions. One clinician, a well-known specialist in addictions treatment, became very upset when it was suggested that two of his patients who were referred for a mainstream chemical dependency program for cocaine addiction, might be better served in a gay and lesbian dual diagnosis program. Both of the patients were openly gay men with HIV Disease who had much more in common with the other patients in the lesbian and gay program. This clinician insisted that addiction is addiction and that he had treated many lesbian and gay people as well as HIV positive persons in his addiction program and they had done well. There continues to be a common misperception by many clinicians and psychiatrists that all addiction treatment is equal, so that any standard treatment program should be equally effective, without looking at complicating co-morbid factors (Ubell and Sumberg 1992). To gain access to gay and lesbian affirmative treatment, it is necessary for patients and clinicians to speak up to the insurance companies. Patients are encouraged to ask their HMOs and insurance companies for access to specialized programs and gay affirmative therapists. Many patients who have been in other treatment settings realize the importance of being able to integrate all aspects of their life in their treatment. The law of supply and demand will eventually encourage insurance companies to recognize the importance of gay and lesbian treatment for both inpatient and outpatient therapy, and so they will hopefully include gay specific programs and gay-identified therapists in their panels.
9 Special Populations and Treatment Settings 89 COMING OUT AND HOMOPHOBIA Michael seemed to be fairly open and out. He had had a long-term committed relationship, and most of his socialization was within the gay community. However, he had never integrated his personal, emotional life with his family of origin, nor had he really come out at work except to a few close, trusted friends. This compartmentalization of his life set up a state of tension and secrecy. He could not really talk about his personal life or relationship at work, and lived in some fear of what would happen if he were found out. He also avoided many interactions with his family except for periodic dutiful holiday visits home, which he enjoyed. He was warmly received by his family and friends, but never included his lover in his visits. When at home, he did not reveal much about his personal life in the city. These secrets led to a constant underlying state of anxiety, which eventually resulted in depression and turning to substances for relief. As Michael s mood lifted in treatment and he felt better about himself, he began to realize the cost of keeping his life so segregated. He began to explore the idea of coming out more, both at work and with his family. Over time, he began to self-identify as gay at work where he was accepted and supported. His visibility and his efforts led his company to offer domestic partner benefits for gay and lesbian employees. He was also allowed to do pro bono work for his firm in the lesbian and gay community. With this success, he also came out to his family, first to a trusted sister, then to other siblings and then to his parents. With the help of his therapist and the work he had done in the groups, he was prepared for the emotional reactions of his family. He was able to provide them information and materials to help them understand homosexuality, and to answer their questions about his health and counter some of their religious arguments. He also told them about PFLAG (Parents, Friends and Families of Lesbians and Gays), and they became involved with their local chapter for further understanding. His visits home became easier, and his communication with them was much more open and fulfilling. The process of coming out and coming to self-acceptance is a unique journey for lesbian and gay people. Society tends to negate and condemn persons with different sexual orientation, and these negative feelings become integrated into the psyches of lesbian and gay people. Recognizing and coming to terms with these sexual/emotional feelings creates a cognitive dissonance, and usually leads to some pain and distress. Some gay men and lesbians are able to confront and accept these feelings and move to acceptance without professional help; others become extremely depressed, even suicidal, or turn to drugs and alcohol for relief. Coming out is a non-linear, often lifetime process of coming to full acceptance of one s sexuality. Some gay men such as Michael, feel they are out,
10 90 ADDICTIONS IN THE GAY AND LESBIAN COMMUNITY and seem to live a fairly open life, but still avoid certain painful or sensitive areas. That is why many lesbian and gay people move to gay ghettoes, where they can experience affirmation from other gay people, and avoid censure by family or close friends during the coming out process. Adolescents struggling with their sexuality are at increased risk of suicide, or they turn to drugs and alcohol to escape (Schneider and Farberow 1989). Many lesbian and gay people become overly dependent on drugs and alcohol to ease their anxiety in the coming out process, to aid in socializing and early sexual experimentation (Kus 1988). They sometimes become dependent on alcohol or drugs to function sexually and socially. For others, like Michael, they may turn to drugs or alcohol to fit in with their social circle, or when they encounter losses and disappointments later in life. A mainstream program may not have been as able to help Michael recognize that his coming out process had been halted, similar to an early developmental arrest due to some life trauma. For him to continue to grow and develop, it was essential to be able to help him continue his coming out process and so achieve a greater degree of self-realization and self-acceptance. SOCIAL ISSUES IN RECOVERY For years, the main social and gathering place for lesbians and gay men have been bars even when they were not safe and subject to police harassment. In many small towns and communities, bars continue to be the main social outlet for the lesbian and gay community. Since the development of alcohol dependence is thought to have a strong genetic component, and many gay and lesbian people still tend to associate in bars, a certain percentage of these people will develop substance abuse problems. Many lesbians and gay men have marked anxiety about their sexual interest and behavior, and alcohol becomes a way to lessen that anxiety and help people perform sexually; for some this leads to abuse or dependence. Others have a great deal of social anxiety and fear, having never learned how to date. Once again, alcohol or drugs become a social lubricant, lowering anxiety and inhibitions. For some, this becomes the only means of socializing comfortably (McKirnan and Peterson 1989). Another major issue in the gay male community is the marked emphasis on sexuality and physicality. One can see pictures of perfect bodies advertising bars, phone lines, bathhouses, classified ads, etc. This gives the impression that the majority of gay men are predominantly interested in the sexual aspects of being gay and the key to self-acceptance and contentment is to be highly physically attractive. Most gay men and lesbians are capable of having wonderful relationships and sex without dwelling excessively on physical beauty, which tends to evaporate with time. The focus on physicality is exemplified by the circuit party a series of weekend gatherings in various
11 Special Populations and Treatment Settings 91 cities throughout the year, which draw thousands of mostly affluent gay men who dance and have sex all weekend under the influence of a variety of alcohol and drugs. These began as a way to raise money for AIDS organizations, but developed into a tribal ritual. They are justified as a legitimate fund-raising venue, and as a well-earned outlet and reward for a community which has survived a plague. But this environment provides a new avenue for drugs into the community. These parties are settings which support the heavy use of drugs of abuse that are somewhat unique to the gay community: ecstasy, Ketamine, GHB, crystal methamphetamine and poppers, as well as the ubiquitous alcohol, marijuana and cocaine. The emphasis on perfect bodies and the use of steroids first for wasting, decreased libido, and depression in HIV disease, and then for cosmetic reasons can generate increased sexual acting out, frequently with lowered regard for safety due to the influence of drugs. Because of the attractiveness and visibility of this segment of the gay male community, many others are undoubtedly being influenced to use party drugs and practice unsafe behavior, leading to further HIV transmission as well as substance abuse. This certainly drew in Michael, who began using to escape his work tensions and loneliness, to find relief and sexual gratification, but who became dependent on the drugs due to his depression and his underlying predisposition. Another important risk factor for substance abuse among gays and lesbians is the shame and guilt around sexual behavior. Many people grow up with inhibitions about sex due to religious backgrounds or social upbringing. This is compounded further for lesbians and gay men who lack affirmations for their sexuality. Alcohol or drugs become a way to desensitize a person to the anxiety surrounding sexuality. For a percentage of people, this becomes the only way to be sexually active, and thus sets up the pattern of substance abuse or addiction. SPIRITUALITY AND HOMOSEXUALITY AA is still considered one of the most successful methods for overcoming alcoholism; other 12 step groups use similar approaches to address other addictions. AA began as a religious approach to recovery (Kominars 1987). Most 12-step programs are essentially spiritual paths. For many people in the lesbian and gay community, organized religion tends to be a difficult area, because mainstream religions have tended to reject and condemn homosexuality. For many gay and lesbian people, this rejection creates an insurmountable problem, so they are reluctant to pursue 12 step programs that appear religious in nature. It is essential that treatment programs recognize that some lesbian and gay people come from very religious or spiritual backgrounds, but after coming out, found that their church rejected them. Due to this cognitive dissonance between their church and their sexuality, these gay
12 92 ADDICTIONS IN THE GAY AND LESBIAN COMMUNITY people choose to walk away from organized religion, and often harbor bitterness. This is reinforced by the fact that fundamentalist religions continue to be the strongest spokespersons against gay people. Many lesbian and gay people are very spiritual, despite the damage done to them by the church. There are many gay clergy, and many churches are openly embracing lesbian and gay people in their congregations and their leadership, especially in choir and music. But many people with substance abuse problems are estranged from their religion and oppose any discussion of spirituality. They often resist attending 12 step meetings because there is talk about God, and some meetings are experienced as judgmental and condemning of gays and lesbians. Specialized treatment programs are aware of these conflicts, but also know the importance of spiritual repair in recovery. To address this, the program needs to help patients expand their concept of God, religion, faith, and spirituality. It is valuable in recovery to support the process of being open to exploring various religions, and entering one s own journey to find a power or force greater than one s self. This is the basis of spirituality; some people can find these answers in organized religion, but others need to find their own spiritual path. CONCLUSION Specialized treatment programs for lesbians and gay men are a relatively recent phenomenon. Although there are not enough controlled studies to demonstrate effectiveness, it is clear to many who work in these programs that they seem to be more powerful in helping patients achieve recovery and healing. Specialized treatment programs provide a safe space for sexual minority persons with substance abuse and emotional problems to talk about their lives freely. The issues discussed may have little or nothing to do with their sexual orientation, but the groups provide a sense of acceptance and support. The issues discussed may have little or nothing to do with their sexual orientation, but the groups provide a sense of acceptance and support, which may be a new experience for these patients. This nurturing environment allows patients to share secrets and pain they have often kept hidden. In being able to look at these issues, many personas can face painful issues and reach some resolution and healing so that they become stronger and more likely to stay sober when faced with new problems. The strength of the specialized programs seems to be in providing a safe space for gay men and lesbians to confront problems in a community of support. A gay-affirming and supportive treatment program can help people resolve past issues such as incest and abuse, as well as foster the coming out process and self-acceptance. These programs offer the opportunity to address socialization skills, dating and intimacy issues, as well as HIV, grief and loss.
13 Special Populations and Treatment Settings 93 Specialized programs are sensitive to the damage experienced by many gays and lesbians within organized religion, and aid patients in finding their spiritual center. Because of the special issues that the lesbian and gay community faces, it is important to fight for specialized programs and affirmative treatments. Hospitals, insurance carriers and third party payers should be requested to provide access to these programs. Further research needs to be done to prove their effectiveness, so that payers will realize they should be funded. REFERENCES Amico, J.M., & Niesen, J. (1997), Sharing the secret: the need for gay-specific treatment, The Counselor, May/June. Cabaj, R.P. (1996), Substance abuse in gay men, lesbians, and bisexuals, Textbook of Homosexuality and Mental Health, Cabaj and Stein, Eds., Chap. 47, , APPI Press. Erwin, K. (1993), Interpreting the evidence: competing paradigms and the emergence of lesbian and gay suicide as a social fact, International Journal of Health Services, 23(3): Fleisher, J., & Fillman, J. (1995), Lesbian and gay youth: treatment issues, The Counselor, Jan-Feb, Garnets, L., & Hancock, K.A. (1991), Issues in psychotherapy with lesbians and gay men: a survey of psychologists, American Psychologist, 46(9): Ghindia, D.J., & Kola, L.A. (1996), Co-factors affecting substance abuse among homosexual men, Drug and Alcohol Dependence, 41(3): Green, D., & Faltz, B. (1991), Chemical dependency and relapse in gay men with HIV infection, Counseling Chemically Dependent People with HIV Illness, The Haworth Press, Inc., Kelly, J. (1994), Preventing alcohol and other drug problems in the lesbian and gay community, California Department of Alcohol and Drug Programs, Sacramento, March. Kominars, S.B. (1989), Accepting ourselves: the 12 step journey of recovery for gay men and lesbians, New York: Harper and Row. Kus, R.J. (1988), Alcoholism and non-acceptance of gay self: the critical link, Journal of Homosexuality, 15(1-2): Kus, R.J. (1992), Spirituality in everyday life: experiences of gay men of alcoholics anonymous, Journal of Chemical Dependency Treatment, 5(1): Lewis, G.R., & Jordan, S.M. (1989), Treatment of the gay or lesbian alcoholic, Alcoholism and Substance Abuse in Special Populations, Lawson and Lawson, Eds., Aspen Publishers, Rockville, MD. McKirnan, D.J., & Peterson, P.L. (1989), Psychosocial and cultural issues in alcohol and drug abuse: an analysis of a homosexual community, Addiction Behaviors, 14(5): Nardi, P. (1982), Alcoholism and homosexuality: a theoretical perspective, Journal of Homosexuality, 7(1): 9-25.
14 94 ADDICTIONS IN THE GAY AND LESBIAN COMMUNITY Niesen, J., & Sandall, H. (1990), Alcohol and other drug abuse in a gay/lesbian population: related to victimization? Journal of Psychology & Human Sexuality, 3(1): Niesen, J. (1993), Healing from cultural victimization: recovery from shame due to heterosexism, Journal of Gay & Lesbian Psychotherapy, 2(1): Niesen, J. (1997), An inpatient psychoeducational model for gay men and lesbians with alcohol and drug abuse problems, Chemical Dependency Treatment: Innovative Group Approaches, L.D. McVinney, Binghamton, The Haworth Press, Inc Ratner, E. (1988), Model for the treatment of lesbian and gay alcohol abusers, Alcoholism Treatment Quarterly, 5(1/2): Schneider, S.G., & Farberow, N.L. et al., (1989), Suicidal behavior in adolescent and young adult gay men, Suicide and Life-Threatening Behavior, 19(4): Skinner, W., & Skinner, O. (1992), Drug use among lesbian and gay people: findings, research, design, insights, and policy issues from the trilogy project, The Research Symposium on Alcohol and Other Drug Problem Prevention Among Lesbians and Gay Men: Proceedings, October. Ubell, V., & Sumberg D. (1992), Heterosexual therapists treating homosexual addicted clients, Journal of Chemical Dependency Treatment, 5(1):19-33.
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text:
Thomas Doll to sign
Today afternoon the two parties came to agreement and decided to put their signature on Thomas Doll's contract. We can now proclaim that Thomas Doll is going to lead our football team in the future.
Name Card
Name: Thomas Jens Uwe Doll
Place and Date of Birth: 1966. április 9., Malchin (GDR)
Club career: Hansa Rostock (1983-86), BFC Dynamo (1986-90), HSV Hamburg (1990-91), Lazio (1991-93), Eintracht Frankfurt (1993-96), Bari (1996-98), HSV Hamburg (1998-2001)
National Team career: GDR Olympic team(1986-88), GDR (1986-90), Germany (1991-93)
Successes: East German champion (BFC Dynamo, 1987, 1988), East German Cup winner (1988, 1989), European Championship Silver-medal (Germany 1992), DFV Super Cup-winner (BFC Dynamo 1989)
Coaching Career: HSV Hamburg U19 (2001-02), HSV Hamburg II (2002-04), HSV Hamburg (2004-07), Borussia Dortmund (2007-08), Genclerbirligi (2009-10), Al-Hilal (2011-12)
Successes: Intertoto Cup winner (HSV Hamburg 2005), UEFA Cup Round of 16 Matches (HSV Hamburg, 2005/06), Man of the year at Kicker (2005), Bundesliga Bronze (HSV Hamburg 2006), Champions League – Main Round (HSV Hamburg, 2006/07)
Thomas Doll began his professional career at the German first-division member Hansa Rostock and at the age of 20 signed to BFC Dynamo where he won the East German Championship title two times, first in 1987 and then in 1988.
After the reunification of Germany, Doll became one of the most sought-after German players; and finally, the attacking midfielder joined Hamburg.
However, Doll did not remain in Germany for long; he decided to move to Italian side Lazio for a then record fee of 15 million Deutsche Mark.
Doll participated with the German national team on the 1992 European Championship, where the team finished as runners-up.
In 1994 Doll signed to Eintracht Frankfurt, then in '96 to Bari where he spent two seasons before returning to Haburg.
Doll played 29 matches in GDR and 18 in total in Germany's national side.
Following his retirement Doll remained part of Hamburg's coaching staff and started to manage the reserve team. Two years later he's been appointed as head coach in Hamburg.
In his first season he saved his team from relegation, what's more, won Intertoto Cup. Thanks to this triumph the team qualified itself into UEFA Cup where they defeated the Danish Copenhagen in the first round. This season Doll reached the Round of 16 Teams with Hamburg.
The following season brought an improved success: the team finished in the third place and earned a Champions League berth. During the qualification period Hamburg said farewell to the Spanish Osasuna and reached the Group Round.
In 2008 Doll managed Borussia Dortmund, and then worked also at Genclerbirligi and Al-Hilal.
Doll is considered not only in his home country Germany as a recognized manager, who took a leading role in the renaissance of the German football around the millennium.
In 2005 Kicker magazine chose him as the 'Man of the year' for the impressing improvement and successful period with Budesliga-member Hamburg.

subset: commoncrawl


text:
|Photo courtesy
Shelby comes from Michael Lee West's novel, Mermaids in the Basement.
|Photo courtesy
If you haven't read either of these books, you ought to. With summer fast approaching, these books would be ideal to add to a summer reading list. Then, go on and read the rest of West's books. You'll be glad you did.


text:
Fan Gets Billy Idol to Perform at His Birthday Party [VIDEO]
Well, how cool is this! A couple of years ago Michael Henrichsen of Seattle decided it would be great if Billy Idol would play at his 26th birthday party.
Michael put a website together and started getting video of celebrities supporting his cause. He received support from celebrities including Rick Springfield, Mike Love from the Beach Boys, Kevin Nealon, Fabio, Eddie Money and more! It worked! Billy Idol will perform at Michael's 26th birthday this Friday night.
Below is Billy Idol's video response!
You can check out Michael's website at PlayMyBirthdayBillyIdol.com
If you had the chance to have any artist perform at your birthday party, who would it be?


text:
On Moon Festival I have to barbecue with my family and I eat the moon cake.
I feel barbecue is great because I am happy.
Do you have the barbecue with your friends or family?
What are you doing on the Moon Festival?
Moon Festival
This forum combines the former Food & Drink and Health & Fitness forums. Post your ideas here!
Moderators: Krisi, Vega, EC, Dixie
Post Reply
1 post • Page 1 of 1
- Member
- Posts: 7
- Joined: Mon Sep 18, 2017 8:21 am
- Status: English Learner
Post Reply
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text:
F. Walsingham (F・ウオルシンガム, F. Uorushingamu) is a student of Oxford Academy, member of the Chancellor's Board and Student Council, the TRUMPS and a female automaton. She is ranked #2 in the Oxford TRUMPS.
An absolute master at gravity manipulation and a professional at intelligence. Expressionless, always speaks in English. Her inherited name is the one for the head of the Intelligence Agency (諜報機関, Chōhō Kikan) and a member of the Disciplinary Committee (風紀委, Fūki-i), responsible of thwarting the supposed Elizabeth assasination plan by Mary Stuart.
F. Walsingham is a girl with long wine-red hair and dark blue eyes. She wears the blue-and-red uniform of Oxford Academy, although she does not wear the lower part of the uniform.
Another detail in F. Walsingham's features are her detached arms and two large cross-like objects floating behind her. Due to extensive repairs done to her body, the specific part of her body that allows her to control gravity were relocated to the two cross-shaped accessories, which also keep her forearms close to her body. These accessories resembles the paddles used to control a marionette and, by extension, give F. Walsingham the appearance of a life-sized female puppet.
It is implied that F. Walsingham sustained extensive damage on her body in the past, and she underwent repairs that changed her body to her current state. However, although Walsingham's gravity manipulation ability stayed intact, her vocal cords were no longer replaced. Because of this, she can only communicate using Sign Frames.
In the anime version, Walsingham can speak normally without the usage of Sign Frames, but only in English and communicating with short and simple sentences, making her still unable to perform a normal conversation.
Musashi on EnglandEdit
May 19, 1648 - Testament EraEdit
May 29, 1648 - Testament EraEdit
Mary Rescue AssaultEdit
June 5, 1648 - Testament EraEdit
Walsingham fighting style can be described as extremely versatile. As an automaton, she can use her gravitational manipulation in combination with her War of the Roses and her own detached extremities, making her a fighter that can change her own tactics very fast even in the middle of intense combat.
- Racial Ability: Gravity Manipulation (重力制御, Jūryoku Seigyo) - Ability to control gravitational forces. TRUMP #2 is an absolute master at this racial ability. As she is a model with full gravitational control, Walsingham is capable to manipulate the gravity on her own body and weapons with the utmost efficience, in both offense and evade.
- Weapon: Wars of the Roses (千本薔薇十字, Senbon Bara Juji, lit., "One Thousand Rose Crosses") - A pair of cross-shaped swords. F. Walsingham's weapon of choice. Can dismantle itself into 128 smaller knife-like blades. She can either control them using gravity manipulation or fire them through four iron tubes which are also considered as part of Wars of the Roses. The versatility of this weapon is an effective tool in surprising a foe by allowing changes of tactics on the fly, making it a difficult weapon to fight against. Apart from the flying blades, it got a Mode: Counter Attack in which both blades react to enemy attacks by deflecting them and a Burst Mode with both edges combining into a polearm-like weapon that can shoot powerful ether beams.
Inherited NamesEdit
Francis Walsingham (1532 - 1590)Edit
Francis Walsingham (c. 1532 – 6 April 1590) was a famous Statesman, Politician and Spymaster in the Elizabethan Times. Son of a prosperous London merchant, was born in Chislehurst, Kent, in about 1530. He studied at Cambridge University where he became a strong supporter of Protestantism. He is suspected of being involved in the plot to make Lady Jane Grey Queen of England. He escaped to Europe and studied law at Padua. During his exile, he became an accomplished linguist and student of human nature.
After Elizabeth I became Queen Walsingham returned to England. Soon afterwards William Cecil arranged for Walsingham to obtain a seat in the House of Commons. In 1570 Walsingham was appointed Ambassador to France. Over the next two years his house became a refuge for Huguenots being persecuted by Catholics. On his return to England in 1573 Walsingham he became Principal Secretary. Specializing in foreign affairs he advocated an aggressive policy in favour of Protestants in Europe.
Walsingham played an important role in protecting Elizabeth from Catholic plots. Using a network of agents and informers, he exposed plots led by Robert Di Ridolfi (1570) and Francis Throckmorton (1584). In December 1585, Gilbert Clifford was arrested in Sussex. While being interviewed, Clifford confessed that he had been involved in a Catholic plot to overthrow Elizabeth I. Walsingham offered to release Clifford if he was willing to work as a double-agent.
Gilbert Clifford agreed to this plan and went to his contact in the French embassy telling him that he knew how to smuggle letters to and from Mary Stuart. He explained that every week a barrel of beer was sent from Burton to where Mary was imprisoned. Clifford arranged to have letters placed in a waterproof package inside the stopper of the barrel.
Another double-agent, Thomas Philips, who was inside the prison, told Mary how she would be receiving letters in her beer barrel. However, before they were placed inside the beer barrel, they were read by Walsingham. More importantly, Walsingham was also able to read the letters that Mary sent to her Catholic friends in France and Spain. In these letters Mary explained how she wanted France and Spain to help her become Queen by invading England.
Walsingham allowed the letters to continue to be sent because he wanted to discover who else was involved in this plot to overthrow Elizabeth. Eventually, on 25 June 1586, Mary wrote a letter to Anthony Babington. In his reply, Babington told Mary that he and a group of six friends were planning to murder Elizabeth. Walsingham was now ready to act. Babington was arrested and his home was searched for documents that would provide evidence against him. When interviewed, Babington made a confession in which he admitted that Mary had written a letter supporting the plot.
Anthony Babington and six others were executed for high treason on 18 September, 1586. An attempt to kill the monarch was the most serious crime in England and the punishment was to be hung, drawn and quartered. The men were tied face downwards on a hurdle drawn by horses. They were then dragged through the streets of London. At Tyburn they were hung for a short period. After that the men had their intestines cut out.
Another of his succeses was in 1587 he obtained details of the planned Spanish Armada, giving England the upper-hand in the coming battles against the Spain of Felipe II.
Walsingham died deeply in debt on April 6, 1590. Since 1579 he had lived mainly at Barn Elms, Barnes, maintaining an adequate establishment; but his salary did not cover his expenses, he was burdened with his son-in-law Sir Philip Sidney's debts, and he obtained few of those perquisites which Elizabeth lavished on her favourites. He had little of the courtier about him; his sombre temperament and directness of speech irritated the queen, and it says something for both of them that he retained her confidence and his office until the end of his life.
- Natsuko Kuwatani replaced Yuko Goto as F. Walsingham's voice actor following the latter's temporary hiatus on voice acting due to her health condition.[1]


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"The Medicare program, as it's currently constituted, needs reform," said Jacob Hacker, co-director of the University of California-Berkeley School of Law's Center on Health, Economic and Family Security. "But I argue that a new public plan could embody many reforms and in doing so, could set a high standard for private plans."
Medicare sets a good example for such a plan because it controls costs better than any of its competitors, has produced quality improvements in service through cooperation with organizations such as the Veterans Health Administration and would set strong benchmarks for private health insurance providers, Hacker said in a briefing paper. He released the report in coordination with the Institute for America's Future, the think tank associated with the liberal advocacy group Campaign for America's Future; and Rep. Pete Stark, D-Calif., who chairs the House Ways and Means Health subcommittee.
FEHBP often has been held up as a standard-bearer for health insurance. During the Democratic presidential primary, Sen. Hillary Rodham Clinton, D-N.Y., proposed allowing uninsured Americans to purchase health insurance through the program as part of her plan for health care reform. At the time, Hacker said if such a strategy were implemented, it would require separate risk pools for federal employees and the general public to keep premiums from fluctuating.
But Hacker said on Wednesday that he had concluded Medicare does a better job of controlling costs than FEHBP. In the report, he noted that the Congressional Budget Office has pegged administrative costs of the public Medicare plan at less than 2 percent. In comparison, the plans in Medicare Advantage, which allows people to purchase private insurance through Medicare, have administrative costs of 11 percent. Preferred provider organization plans in FEHBP have overhead costs of 7 percent and health maintenance organization plans in the federal employee program devote between 10 percent and 12 percent of total expenditures to administrative costs.
FEHBP spending per participant also has increased faster than Medicare spending per enrollee, Hacker wrote. Between 1985 and 2002, spending per participant rose 7.3 percent annually in FEHBP, versus 5.8 percent in Medicare. Private health insurance spending grew 7.4 percent annually per enrollee during the same time period.
"The Federal Employees Health Benefits Program has frequently been invoked as a model for national reform, and indeed it provides one template for a national insurance exchange offering competing private plans," Hacker wrote. "It is not, however, a model of cost restraint when compared with Medicare."


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Revelation 20.11->
Then I saw a great white throne, and him who sat upon it--From his presence earth and sky fled away, and no place was found for them.
And I saw the dead--great and small--standing before the throne, and books were opened. Also another book was opened, which is the book of life.
And the dead were judged by what was written in the books, by what they had done.
And the sea gave up the dead in it. Death and Hades gave up the dead in them, and all were judged by what they had done.
Then Death and Hades were thrown into the lake of fire.
This is the second death--the lake of fire--And if any one's name was not found written in the book of life he was thrown into the lake of fire.


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NSA Spying on Vatican.Vatican Says "Whatever."
Catholic Culture reports:
An Italian magazine has reported that the US National Security Agency (NSA) monitored the phone conversations of Vatican officials. But the director of the Vatican press office has told reporters that "we have nothing to worry about."The aims of the Church are stated plainly and clearly. No secret aims.
"There are no concerns on this matter," said Father Federico Lombardi, in a statement released to reporters after the magazine Panorama reported that the NSA had eavesdropped on conversations at the Vatican. The magazine claimed that the NSA monitoring included the conversations of cardinals who gathered in Rome in March for the conclave that elected Pope Francis.
It's pretty hilarious that the Church in many popular novels and movies is portrayed as the most secretive and ruthless of all world organizations. But in real life, they say about being spied on, "we have nothing to worry about."
Now, of course, you may think the Vatican thinks they have nothing to worry about because they are so confident in their subterfuge, the capabilities of their albino monk assassin squads, and their ruthless nunjas and their nocturnal apostolic visitation, if you know what I mean. But I'm pretty sure that's not the case. Or is it?


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This year the car show is on June 27th, the last Saturday of the month, as always, from 8 am to 4 pm.
While the salon will probably be open for at least part of the day, we wanted to remind you that the street (Greenwood) will be closed off to regular traffic from 67th to 87th, including (of course) in front of the salon. You can cross at NW 80th and NW 85th, but that's it. Parking will likely be a little more challenging than usual. Also, the street gets closed off early in the morning (4 am) for the show cars to come in and park, and doesn't re-open until 6 or 7 pm, as the show cars need time to drive out.
Some stylists work part of the day on car show day, but check with your stylist – some of us will take the day off!
We hope you will take the time to enjoy this event – in addition to all the cool cars, there are food vendors and various types of events and activities.


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Today Summer of Indie spoke with Carol Tibaldi, author of the historical mystery novel Willow Pond. For those already familiar with the book, author Carol Tibaldi has stated that she is currently working on a sequel. Tying in with the historical setting of the novel, author Carol Tibaldi said that she was a history buff with a special affinity for the prohibition era and the Civil War. Intrigued by the premise of a historical mystery novel, Summer of Indie asked Carol Tibaldi to give us a more detailed look at her book.
Willow Pond
The Roaring Twenties crumble into the Great Depression, but Virginia Kingsley, New York's toughest and most successful speakeasy owner, is doing just fine. Now that the world is falling apart, bootlegging is a flourishing business, and she's queen of that castle.
Then her infant nephew is kidnapped. Her niece, Laura, and Laura's philandering movie star husband, are devastated. The police have few leads, and speculation and rumors abound in the media circus that follows the celebrity abduction.
Only one reporter, Erich Muller, seems to care enough about the child's welfare and the parents' feelings to report the case responsibly. Over the course of the investigation, Erich Muller and Laura fall in love, but their relationship is doomed to failure since he suspects her beloved aunt Virginia is behind the kidnapping. Laura, jaded when it comes to men, sides with Virginia.
But Virginia has figured out the truth, and she can't tell anyone for fear of losing her niece's affections and having the police ransack her life. So she pursues her own investigation, shaking down, threatening, and killing one petty crook after another during her search.
Little Todd's absence shapes everyone's lives. When he is finally found, the discovery will bring disaster for some and revelation for others.
Available in both print and Kindle at:
After hearing more about Willow Pond, we asked author Carol Tibaldi to give us some details about them.
Carol Tibaldi stated that "I was born and raised in Bayside, New York and attended Queens College of the City University of New York. I love to travel and have lived in London and Los Angeles. For twenty five years I worked as a newspaper reporter and covered the crime beat. I am a history buff and love to research different time periods, and have a special affinity for the prohibition era and the Civil War. Willow Pond is my first novel and I am hard at work on the sequel.
You can find author Carol Tibaldi online at:
Their website: http://www.caroltibaldi.com/
Twitter: https://twitter.com/#!/cat5149
Or on Amazon: http://amzn.to/AthqHg


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Don't DDOS people and you won't have those same people threatening you. It's a pretty simple concept.
completely agree, but if i did ddos him id admit and and wouldnt bitch out of it :')
I've heard you talk about DDOSing people before. Don't lie about it now ya little shit


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The revered beauty vlogger and Youtube sensation who teased the trends to ditch topic on Instagram recorded over 4,000 (four thousand comments) immediately with people talking trends they want gone!
ALSO READ:Jackie Aina dishes on the perfect way to stop foundation creasing
Superficial highlight takes centrestage as ladies especially are over the overly-shiny 'fleeking' highlights some Instagram artists have turned into something else. 'Freckles' (done with makeup) also make the list of trends to totally ditch (this was way overdone in 2016 and were seriously not cute!).
ALSO READ:Jackie Aina's list of the WORST brands for dark skin
Clear/PVC shoes make a fashion trend to ditch; made popular by Kim Kardashian for husband Kanye West's Yeezy brand, the shoe trend is billed to be trashed for 2017. Overly done face, products and more made Jackie Aina's list, do you agree? Whats on your 'ditch list' as 2017 beckons?


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Haiti's Children Left Vulnerable to Trafficking in Earthquake Aftermath
As a result of Haiti's recent earthquake, there are many obvious threats survivors must face in the aftermath, such as malnutrition, dehydration, lack of shelter, and rampant disease.But there is another enemy less obvious to the naked eye far that's far more sinister than these afflictions – human trafficking. In the wake of natural disasters, the breakdown of rule of law, extreme poverty, and increased vulnerability all contribute to a surge in human trafficking, especially targeted towards young children who are the most vulnerable of the population.
Haiti is no exception. Haitian Prime Minister Jean-Max Bellerive told CNN in an interview that child trafficking is one of the country's most significant problems, even without the added stresses caused by the earthquake. It is estimated that every year a quarter million children are reported trafficked within the country.
Now, as the country struggles to rebuild, children face an even greater risk of being sold for sex, slave labor, or their organs. Prime Minister Bellerive says many culprits pose as organizations falsely claiming to want to save children from the streets and send them to the United States. He is working to register displaced children in Haiti so that the government can account for the children and return them to their relatives if they have any or place them with new families. Trafficking dangers are another reason why Haiti is
thoroughly verifying adoption papers before orphans leave the country.
The Salvation Army has been named the lead agency of some 20,000 homeless Haitians living in make-shift shelters and tents near our main compound in Port-au-Prince. As a part of serving as lead agency, we are registering individuals and families settled in this area, in part, to help battle the exploitation of children and vulnerable individuals. The Salvation Army is also rapidly dispensing food, water, supplies, and medical treatment; re-opening schools closed by the earthquake; and offering church-related activities and services in a safe setting in efforts to rebuild and secure the devastated communities.
For more information on how The Salvation Army is working specifically to eradicate human trafficking, visit our national website at www.salvationarmyusa.org/trafficking y


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Also using one of the newest A Way With Words dies on the inside by Elizabeth Craft Designs "Noel" also available on Quietfire Design HERE
And I'm using a sentiment stamp from Quietfire Design "Let It Snow...large"
I side folded my white card (5.5"w x 4.25"h). Cut a piece of glossy paper a bit larger than my card and created the sky by applying dots of blue alcohol inks on a felt pad and then just swiping it across the sky area. Dribbled a bit of blending solution. Adhered to card front and trimmed down.
Die cut a bunch of the pine trees from white cardstock, sponged Distress "Pine Needles" all over then hit them direct to paper with the pine needles and "Forest Moss".
Tore a piece of paper to give me a contoured line to sponge some "Pumice Stone" and "Weathered Wood" to create shadow areas.
Adhered my pine trees. Spattered white gesso all over.
punched out a 3/4" circle and sponged a bit of the pumice and adhered to card - my moon...
Stamped the sentiment using Versafine Black Onyx and clear embossed.
On the inside stamped the trees (Deep Red "Winter Pines") using the moss all over and then the pine needles here and there.
Die cut the "Noel" from blue cardstock, inked with Versamark and embossed with Emerald Creek "Blue Sparkle" embossing powder.
Click on any image to enlarge. Enjoy
And it fits for these challenges:
Tuesday Throwdown #309 CAS
Moving Along with the Times #27 CAS
JW Scrapshack #153 dies/punches (2nd entry)
Hiding In My Craft Room #264 any holiday
Sweet Stampin Challenge no DP


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After the Cundall's Hole adventure, the party had some downtime. The days had been turning colder for some time now, and now at the end of the second month of autumn, an icy wind blew off the Moonsea, indicating winter was nearly here.
During his time off Minimus went on a bit of a bender and got into some trouble with those who police Elventree. It was nothing serious but he did have to pay a 40 gold piece fine (Elanil told him sternly that if they had a jail he would have been put there for a few days). During his time he scandalised the community by having a very public, romantic fling with a feisty, dusky skinned human female named Shaniqua, who was a known "party animal", and who was not in the least bit intimidated by Minimus' reputation. Many said it was she who led the renown hero astray and into trouble, but the party knew better. Minimus himself said his behaviour was a "one off" and he had been just letting off steam. Even after he sobered up, he retained his association with Shaniqua and they were often seen together at the Tree Spirits tavern.
Marie and Cundall travelled to Hillsfar together. Marie went to visit the Mages' Guild, and use their magical workshop there, creating a set of gauntlets of ogre power for Minimus.
Cundall's stay in Hillsfar was much shorter than Marie's. He visited the priests of Chauntea at Lastholme and found them overrun with orphan babies, an indication of how far the madness had affected the lust of many of the folk of the town. He helped out a little, but was mainly there as a safe place to cast a locate object spell. He was looking for a specific magic item called The Deck of Many Things. Cundall had wanted this legendary magic item as soon as he had heard about it in stories. He had cast this spell before – in fact as soon as he gained the ability to do so – but never had a positive result. This time however, the spell indicated a positive reading which led him to a shop in the wealthier district of Hillsfar. He came to an antiques shop, and entered. He found that the owner of the shop appreciated Cundall's straightforward approach and he acknowledged that he did have in his possession the rare magic item the Deck of Many Things. There was some negotiating, but really Cundall knew immediately the owner was no pushover and had a price he wouldn't budge from, which was higher than Cundall could afford. The only thing in Cundall's favour was that it was often difficult to find a buyer who could afford such an item. When the druid had counted out all his valuables – and many of the party's valuables as well – from the bag of holding it wasn't enough to purchase the item. It was then he offered the dagger of Lolth, the magic dagger of banishing they had found in the Fane of Lolth in Szith Morcane (see Szith Morcane Rescue – Part 4). They settled on a price of a thousand gold pieces, plus the dagger, for the Deck of Many Things. Cundall left Hillsfar elated.
While at the Mage's Guild Marie was spoken to by the Master of the Mages' Guild Nash Sorinius about taking on an apprentice. Initially she was reluctant because of her time spent adventuring, but eventually she agreed and returned to Elventree with an apprentice named Jerrard, a pock-marked and broody youth, the middle son of a merchant who was likely to get no inheritance. He did have a keen mind though, and good attention to detail.
"You can bring him along on our next adventure," said Cundall, shaking Jerrard's hand. "We need someone to open trapped doors."
"He's joking," said Marie to Jerrard, noting her apprentice's uncertain expression. "Mostly."
Jerrard was housed in The Swaying Bough inn where Marie gave him some study to be going on with when she wasn't around. He was a young man who seemed to take everything seriously and with an intense wonder.
"Has he actually ever been outside of Hillsfar before?" asked Zelda, watching Jerrard looking at the sky, and then the trees and tree houses of Elventree.
"He has, but not for any length of time," said Marie. "I'm not entirely sure what I'm going to do with him. I might get him to copy spells when he gets a bit better at it."
"There's a big party for the Feast of the Moon in the Hall of the Unicorn tomorrow night," said Minimus. "Elanil is going to perform. Have you heard her play? She's amazing."
"Everyone in Elventree will be there," said Cundall. "It's always a huge party."
"Let's go get a drink," said Minimus. "I'm freezing my arse off out here. No above ground adventuring until winter is over!"
"We'll go wherever we're needed," replied Zelda. "The needs of the people come before our personal discomfort." She winked. "But hopefully the needs of the people will not stretch to snowy adventures!"
To be continued…