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During the last several decades, psychologists have placed emphasis on multicultural competence as an essential aspect of training and practice. However, despite this emphasis, empirical data on the effects of multicultural training and practice are generally limited to variables such as race and ethnicity, with very little research on sexual minorities. However, a framework for understanding competent practice with sexual minorities does exist in the form of the concept of gay affirmative practice (GAP), which has been successfully operationalized by Crisp (2006b). Using the GAP measure and scores of empathy, the authors examined students and practitioners in the helping profession to explore the relationship between empathy and level of gay affirmative work. Findings indicated that levels of empathy predicted overall levels of GAP. The authors discuss the clinical implications of these findings and explore how the findings fit within the literature surrounding empathic understanding.Keywords: affirmative practice, LGBTQ, therapy, multicultural counseling Durante las últimas décadas, los psicólogos han puesto un énfasis especial en la competencia multicultural como un aspecto esencial en la formación y la práctica. Sin embargo, a pesar de este énfasis, los datos empíricos sobre los efectos de la formación multicultural y su práctica están generalmente limitados a variables como raza y etnicidad, con escasas investigaciones realizadas sobre minorías sexuales. Aun así, existe un marco teórico para comprender la práctica competente con minorías sexuales denominado terapia afirmativa gay (GAP, por sus siglas en inglés), que fue operacionalizado con éxito por Crisp (2006b). Usando las medidas GAP y puntuaciones de empatía, los autores examinaron a estudiantes y profesionales del campo de la consejería para explorar la relación entre empatía y el nivel de trabajo afirmativo con la comunidad gay. Los resultados indicaron que los niveles de empatía pronosticaron niveles totales de GAP. Los autores discuten las implicaciones clínicas de estos resultados y exploran cómo estos encajan con la literatura sobre comprensión empática.

Current epidemiological data indicate increases in the prevalence of prescription opioid analgesic abuse. Recent findings suggest that these increases have been more rapid in rural areas. A growing body of research supports the notion that rural opioid abuse involves different risk factors, protective factors, and prevalence rates than opioid abuse in urban areas. Building upon cross-sectional studies that raise the question of whether rural opioid abusers are using injection as a method of administration more frequently, this study used longitudinal data from a national survey dataset to investigate whether a sample of individuals who have used prescription opioids have increased their use of injection between 1994 and 2008. A multilevel modeling procedure found that multiple measures of injection use increased in the combined sample of rural and nonrural participants, and that rural participants increased in their lifetime use of injection. However, residence in a rural community did not significantly predict any form of injection use. Rural residence also did not predict prescription opioid use by any route of injection, although prescription opioid use increased in the combined sample. These findings challenge existing theories that regard rural opioid use as a distinct phenomenon.