This document seeks to inform administrators and clinicians about appropriate diagnosis and treatment approaches that will help ensure the development or enhancement of effective lesbian-, gay-, bisexual-, and transgender (LGBT)-sensitive programs. Serving as both a reference tool and program guide, it provides statistical and demographic information, prevalence data, case examples and suggested interventions, treatment guidelines and approaches, and organizational policies and procedures. Section one provides an introduction and includes information on sexual orientation, legal issues, and treatment approaches and modalities from a lesbian, gay, bisexual, and transgender standpoint. Section two, written for the practicing clinician, offers further information on clinical issues of LGBT clients; an introduction to strategies and methods for improving current services to LGBT individuals; and steps for starting LGBT-sensitive programs. Section three, developed for program administrators, provides an overview of the issues that need to be addressed when developing a LGBT program or when expanding current services for LGBT clients. It offers the data needed to build a strong foundation for a program, including an organizational mission and policies and procedures. Also provided are resources and strategies for working with managed care organizations and building alliances and cooperative arrangements to coordinate efforts on behalf of LGBT individuals. Appended are: Glossary of Terms; Acronyms; and Studies on LGBT Substance Abuse. (Contains 260 references.) (GCP)