Women and Addiction Treatment

Specific Treatment Tracks for Women Addicts and Alcoholics

The study of gender specific treatment programs is still in its infancy. Research has revealed differentiations between women and men in their using patterns, their responses to treatment and to relapse prevention approaches. The primary goal of women's addiction treatment is to provide a safe and comfortable haven to focus on recovery. Traditional co-ed treatment programs are designed for both men and women. But, some women do not feel emotionally and/or physically comfortable in this setting.

There are a number of factors that lead women to use alcohol and drugs: genetic factors, environmental variabilities, cultural contexts, domestic violence, weaknesses of primary relationships (family of origin, or current primary relationship with spouse or significant other), mental health disorders, and other factors.

Healthy, Role Models in Treatment and Recovery

Research indicates that the manner in which gender specific issues are addressed and/or the philosophical approach to treatment has a direct correlation to outcome rates.

Numerous studies have illustrated that connections are a core component to a woman’s world perspective. Any “disconnect” within a woman’s primary relationship will have a profound impact upon her psyche. “Lower self-esteem, feelings of powerlessness, and a lack of assertiveness” are more than likely to occur when a disconnect occurs. (source: SAMHSA TIPS 51, p. 143)

Therefore, it is not surprising that a 2006 study found that women in treatment looked for trustworthiness, warmth, and non-authoritarian approaches from counselors and therapists. Often, these qualities were experienced with the female counselors and therapists. Male therapists often project gender stereotypes on to their female patients causing discord within this new relationship.

The collaborative approach to treatment is when patient works in conjunction with the treatment therapist in a non-confrontational manner. This method has been more successful for women in addiction programs and is used to develop trust and a mutually acceptable treatment plan. Traditional therapeutic models are based upon confrontation and the concept of rebuilding the patient after breaking through denial. The dangers implicit in this confrontational approach, especially when done by a male therapist, are grounded in re-victimization and re-traumatization of the female patient. Women tend not to be in as much denial about their addiction as men, but are inclined to suffer from intense guilt and shame instead. Although in some cases, the need for such confrontation may in fact be therapeutically appropriate. Often, it is unnecessary. It should be noted that many women addicts and alcoholics lack positive male role models in their lives. A male therapist attuned to gender issues can serve to fill this void.

Research also demonstrates that nearly 45 percent of the women who enter addiction treatment programs have at one time suffered some type of abuse. This fact makes women's addiction treatment tracks important. If such challenges to “self” occur within a mixed gender group, a woman may feel threatened and unable to address intensely personal issues. Such feeling can instigate the need to leave treatment against medical advice.

A long term study (1986-1996) examining retention rates for women in outpatient treatment, found that there was a greater than 3 month retention rate for women in “women only programs” compared to those in a mixed gender program.
(source: PubMed.gov, http://www.ncbi.nlm.nih.gov/pubmed/14677784)

Mixed gender groupings also provide an environment for “treatment romances” . Women who develop new romantic relationships in treatment are less likely to complete treatment especially if the male partner leaves treatment. Such relationships are always a distraction from, and a hindrance to, the early recovery process.

Benefits of Women Centered Addiction Programs

Relationships are central to women’s lives and help form a sense of self-esteem. Many times relationships are the context for decision making and life choices. Positive female relationships are a support for daily living and personal growth. (source: TIPS 51, p. 143)

For women in addiction treatment, relationships formed with female treatment staff and peers are perhaps the first, healthy, female relationships that many women patients experience. “A collaborative supportive approach … encourages [the female patient] to use her strengths, and increases her confidence in her ability to identify and resolve problems.” (source: TIPS 51, p. 140)

In women's addiction treatment programs, women battling addictions can bond with each other in a way rarely experienced in a conventional mixed gender treatment program. These bonds provide women struggling with alcohol and addiction with:

A sense of community and understanding
Feelings of trust, compassion and honesty
The ability to speak freely about women centered issues
Understanding that the woman is not alone or unique in her feelings
The formation of life-long friendships
Diminishes inappropriate treatment romances

Examining Gender Specific Topics

Often gender specific topics are at the core of a woman’s ability to confront her addiction issues. These topics are not easily discussed in mixed gender groups and include:

Body Image
Cultural Context of defining womanhood
Pregnancy and drug and alcohol abuse
Parenting – Good mother, Bad mother
Victimization
History of Abuse
Leisure Activities
Sexual Behavior –manipulation
Sexual Identity
Mental Health Disorders
Criminal Behavior

A Canadian government study found:
“Women often describe their substance use as having a sudden and heavy onset, often following a traumatic event. Women may use substances to numb emotional pain from abuse, grief over the death of loved ones, or guilt over injury to loved ones, especially children. Relational issues are intricately connected with the onset and progression of substance use problems in women. Families can either help or hinder treatment seeking, but they rarely have a neutral impact. Women with children may forgo or postpone treatment entry because they do not have someone they trust to care for their children in their absence.”
(source: Early intervention Guide, Canada, http://www.hc-sc.gc.ca/hc-ps/alt_formats/hecs-sesc/pdf/pubs/adp-apd/early-intervention-precoce/early-intervention-precoce-eng.pdf

Because of the array of problems listed above and how each woman responds to them, an appropriate, safe, warm, trusting environment is necessary.

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