School of Social Work, Columbia University, New York, USA.
Cult Health Sex. 2011 Apr;13(4):399-413. doi: 10.1080/13691058.2010.550322.
Integrating HIV prevention into substance abuse counselling is recommended to ameliorate the health outcomes of men who have sex with men. However, culture-based countertransferences (CBCs) may hamper this effort. Using a case illustration, this paper will explain the manifestation of CBCs held among substance abuse counsellors and how they hinder counsellors' work with men who have sex with men. The following CBCs will be explored: distancing, topic avoidance, heteronormativity, assumptions and denying client strengths. These CBCs allow counsellors to avoid discussions about sexual practices and curtail HIV prevention counselling, while undermining the counsellor-client relationship. Based on the empirical literature on HIV and substance abuse prevention with men who have sex with men, we provide recommendations to help counsellors overcome CBCs and integrate HIV prevention consistently with men who are in treatment for substance abuse.
将艾滋病毒预防措施纳入物质滥用咨询中，以改善男男性行为者的健康结果，这是被推荐的做法。然而，基于文化的反向移情（countertransference，CBC）可能会对此造成阻碍。本文将通过案例说明，解释物质滥用咨询师中存在的反向移情表现形式，以及它们如何阻碍咨询师与男男性行为者的工作。我们将探讨以下几种反向移情：疏远、回避话题、异性恋规范、假设和否认客户的优势。这些反向移情使咨询师能够避免讨论性实践，并限制艾滋病毒预防咨询，同时破坏咨询师与客户的关系。基于男男性行为者艾滋病毒和物质滥用预防方面的实证文献，我们提供了一些建议，以帮助咨询师克服反向移情，并与接受物质滥用治疗的男男性行为者一致地进行艾滋病毒预防。
