Over recent years, numerous studies have been conducted to examine various kinds of drug and alcohol rehabilitation, including women's recovery.  It has been found that women tend to heal very differently than men, which was no real surpirse, giving way to gender specific drug and alcohol treatment.  Women's recovery tends to happen more smoothl and comfortably when it is done among other women, increasing the trust and commonality within the group.  This article explains the scientific data behind these studies into women's recovery as well as more information about some of the drug and alcohol rehabilitation options within geneder specific guidelines.

Women's Recovery

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Women's Drug and Alcohol Treatment Programs and Methods of Treatment

Residential drug treatment centers offering "gender-specific" programs for women, women's rehab, and women's addiction recovery and rehabilitation services provide a multidisciplinary approach to facilitate recovery from addiction and alcoholism. Comprehensive chemical dependency treatment services provide a structured therapeutic environment that may begin with the detoxification/withdrawal and continue through to aftercare planning following residential drug and alcohol treatment. Women with drug addiction, alcoholism, eating disorders, sex addiction and co-occurring disorders benefit from gender-specific treatment programs because substance abuse in women has a distinctive etiology, disease progression and specific treatment needs. A growing body of research shows that substance abuse among women and the issues surrounding their abuse differs from that of men, requiring a specialized set of treatment services. Women's treatment programs are specifically designed to meet the needs of women seeking recovery from alcoholism and drug addiction.

Women in Recovery Drug Treatment Program Methods

The past few decades of research on women substance abusers identify certain addiction consequences that are substantially different from their male counterparts including low self-esteem, lack of traditional job skills, depression, eating disorders, social isolation and, by far the most important, lack of a social support network and a strong value system. Women's drug and alcohol treatment centers take into account all of these characteristics when analyzing the appropriate treatment modalities and therapies for a female drug addict or alcoholic in a gender specific drug rehabilitation program setting. Treatment programs for women may include the following:

• Therapeutic intervention - include individual or group counseling and psychotherapy, and most rely on cognitive-based therapy addressing irrational thinking and attempts to restructure thought processes.
• Group Therapy - designed to "connect" and provide a "social network of support" for women in recovery.
• Drug and Alcohol Detoxification - detox programs are treatment programs of planned withdrawal which may or may not include medication.
• Anger Management Treatment - cognitive behavioral therapy that teaches anger management techniques in a group setting through a 12-week cognitive behavioral intervention. The treatment addresses the anger cycle, conflict resolution, assertiveness skills, and anger control plans.
• Trauma Therapy  - counselor or therapist guided exploration of past traumas and possible contributing factors to addiction problems. The assistance is designed to provide a safe, yet challenging experience permitting women to connect with their genuine feelings.
• Psychodrama - an interactive method of therapy that uses group interaction and role play to help delve into and investigate inner and outer worlds and experiences. Psychodrama is action-oriented and also helps women practice new behaviors in all areas of their lives.
• Equine Therapy - working with horses consists of grooming, leading and guiding the horse through obstacles and occasional riding. Working with horses elicits reactions from people ranging from joy to fear. Horses, with their intuitive and sensitive nature, mirror what they receive from people, providing powerful insights and learning experiences in a therapeutic setting. Through one's relationship with the horse and the use of metaphors, equine therapists will facilitate the process of awareness and change for each individual.
• Family Treatment Services - family and partner involvement is essential in treating this disease and is an integral part of the recovery program. Weekly family and multi-family group sessions are offered that include education and therapy as well as private family sessions.
• Children's Services - family, individual and play therapy, Mother and child bonding time, and rooms/beds for women with children.  Education about alcoholism and addition as a family disease is provided.  Parenting education and greater parent-child communication. School age children are afforded the opportunity to enroll in local schools while younger children and infants attend on-site or off-site daycare programs.
• Meditation, Yoga,  and Spirituality - an integrated system of education for the body, mind, and inner spirit. The practice of yoga in women's drug and alcohol treatment and recovery can be invaluable in the recovery process for many women.
• Exercise - Physical fitness programs personalized training with a certified personal trainer and may offer a well-equipped gym, allowing women to continue with the fitness programs they learn.
• Spa Service - Salons and day spas to provide extracurricular amenities such as facials, massages and days at the beauty salon for haircuts, styling and fun.
• Challenge and Adventure - programs offering a wide range of different opportunities such as rock climbing, hiking and equine therapy that challenge personal limits and provide experiential activities leading to healing and growth.
• Art Therapy - a creative way to express trauma, abuse, partner related issues, and life experiences associated with drug addiction and alcoholism.
• Individualized Treatment Programs and Treatment Plans - effective treatment programs vary from one individual to the next depending on many factors (e.g. type of drug, background, length of abuse, motivation for treatment, environment and social support). It’s important to receive one on one treatment with a trained certified counselor or therapist as well as group and education treatment when receiving alcohol or drug treatment.
• Co-occuring Disorders and Medical Issues - psychological or psychiatric and medical assessments and care which may or may not include a regimen of pharmacological treatment (e.g. depression, ADHD, ADD, PTSD, and bipolar disorders), and general health and well-being.

Unique trajectories of Addiction, Treatment, and Recovery in Women

Overview

Substance abuse is a significant public health and child welfare problem that extends to all demographic groups. For many individuals, addiction is a chronic impairment; the recovery process may take a long time and include frequent relapses. Thus, it is important to understand the psychosocial factors that interfere with or sustain long-term recovery in addicts in order to help prevent or minimize the frequency and severity of relapse. Despite the fact that alcohol and other drug (AOD) problems affect women and men of all age groups, historically, the etiology, course, and treatment of AOD addiction have been understood from a predominantly male perspective. Research and policies that aim to understand the specific issues pertaining to female addicts, however, have been emerging for the last several decades. Some of these issues include:

• Women recover in connection, not isolation.
• Trauma is extremely prevalent among female AOD users and can be caused by sexual abuse, physical abuse, emotional abuse, domestic violence, witnessing abuse/violence, and/or stigmatization of incarcerated women, women of color, poor women, lesbians, and women with mental illness. As a result, internalizing disorders (e.g., post-traumatic stress disorder, depression, and anxiety) and poor interpersonal skills and attributes (e.g., low self-esteem, avoidant coping skills, shame, and guilt) frequently co-occur with AOD problems in women.
• Because addiction, trauma, and psychopathology are interrelated among women, programs must be developed comprehensively to address all of these issues.
• The confluence of trauma, psychopathology, and, often resulting, poor interpersonal skills affects substance abusing women’s relationships with others.
• Partners often play a large role in women’s introduction to alcohol or other drugs, and in their motivation and/or ability to access treatment and remain clean and sober.
• Treatment programs need to be sensitive to the unique needs of lesbians, specifically issues related to discrimination and homophobia, sexual identity issues, isolation, and possible shame.

An ever-increasing number of programs offer “gender-specific” services to better address some of these issues unique to women’s recovery. Moreover, recognizing the large number of parenting women substance users, more and more programs are becoming “family-focused” in order to meet the needs of women and their children. Although these changes reflect tremendous progress in the substance abuse treatment field, most programs for women fail to actively engage women’s partners or provide any concrete services for them, despite general awareness of the role that they play in women's recovery....

Gender-specific approaches to treatment

Women need a gender specific approach to substance abuse treatment because the substance abuse experience for women is totally different than the experience for men. There are certain predisposing psychological, family, and social risk factors that are more common in the substance-abusing woman. The psychological factors are disorders of mood such as depression, anxiety, negative self-identity, low self-esteem, poor self-conflict, lack of adequate coping skills, and poor social support systems. In the family risk factors, women are more likely to have experienced childhood abuse, especially sexual, greater incidence of parental addiction, parental mental illness, and parental deprivation or rejection, early separation from parents through divorce or death, and greater incidence of family violence. In the social risk factors, women are more likely to have been socially isolated as children, come from low-income households, have experienced discrimination as adults, and be caring for their children alone.

The strongest impetus for women seeking treatment is problems in their relationships, especially with their children or partner. Women do not typically seek treatment for substance abuse for a variety of reasons, including potential out-of-home child placements, the perception that women are society’s moral gatekeepers, and the societal stigma generally associated with substance abuse. Treatment is effective and improves the overall condition of women’s lives.

Women and mental health

Women face mental health risks and confront barriers in receiving treatment that are different than those experienced by men. In the 1999 “Mental Health: Report of the Surgeon General,” emphasis is placed on the concept that mind and body are inseparable. Mental health is inseparable from physical health. It is important that physicians be aware of prevalence rates and contributing factors as well as the barriers in mental health care that women may face in seeking to lead healthy lives.

Comparative United States prevalence rates for mental health disorders

• Nearly twice as many women then men are affected by a depressive disorder each year.
• Women report attempting suicide about twice as often as men.
• 20 to 40 percent of women may experience Premenstrual Syndrome. An estimated 3 to 5 percent have symptoms severe enough to be classified as Premenstrual Dysphoric Disorder.
• Postpartum depression can disable some women and may also be preceded by undetected depression.
• Women are nearly twice as likely as men are to suffer from anxiety disorders.
• Female risk of developing PostTraumatic Stress Disorder (PTSD) following trauma has been shown to be two times that of males. They are also more likely to develop long-term PTSD and have higher rates of co-occurring medical and psychiatric problems than do males with the disorder.
• More than 90 percent of people in the U.S. who have eating disorders are young women.
• Despite similarities in schizophrenia rates for men and women, there are differences in age of onset, pattern of symptoms, and treatment responses. In addition, a significant proportion of women with schizophrenia experience increased symptoms during pregnancy and postpartum.

Some contributing factors to gender differences in prevalence rates/greater vulnerability of women

• Hormonal factors.
• Multiple roles in the home and at work.
• Increased risk of raising children alone.
• Increased likelihood of women to be poor: women and children represent 75 percent of the U.S. population considered poor. Low economic status brings with it many stresses, including isolation, uncertainty, frequent negative events and poor access to helpful resources, including health insurance. Low-income women and children have been shown to be at elevated risk of severe victimization and violence.
• Increased risk for violence and abuse: Far more women than men are sexually abused as children. Women molested as children are more likely to have mental health problems than those with no such history. Women who experience other forms of abuse such as physical abuse, domestic violence and sexual harassment also may experience higher rates of depression. Studies also have shown a higher incidence of depression among women who have been raped as adolescents or adults.

Some cultural considerations

• Possible differences in coping styles or symptom presentation may affect the way mental health concerns are recognized and diagnosed among minorities (e.g., depression may be diagnosed less frequently in African American women and slightly more frequently in Hispanic women than in Caucasian women).
• Racial and ethnic minorities are less likely than Caucasians to have access to treatment, and those who do often receive a lesser quality of care.
• Cultural differences in care-seeking behavior and the perception of stigma affect access to treatment.
• Minorities in vulnerable populations, such as African Americans who are homeless, have been shown to have a higher prevalence of mental disorders than Caucasians.

Some barriers women face in receiving appropriate diagnosis/treatment

• Masked symptoms of mental health problems, such as gastrointestinal symptoms, especially in older women or in women who have experienced abuse or violence.
• Lack of recognition of co-occurring disorders, e.g., additional mental illness or substance abuse; medical practitioners who may focus on substance abuse and delay or omit mental health referrals.
• Low self-esteem, passiveness or concerns about stigma that strain care seeking.
• Obligations to children, family and work that impede seeking and obtaining treatment.
• Access to health insurance or insurance that provides mental health benefits.
• Women experiencing mental illness face many additional risks and challenges, including victimization, abusive relationships, financial and sexual exploitation, substance abuse, sexually transmitted diseases, unexpected pregnancies and significant problems with parenting.

Addiction in Women

The etiology of addiction in women is vastly different than it is in men. Addiction recovery programs designed specifically for women are necessary and are offered by many treatment centers around the country.  Women recover in "connection" rather than in "isolation."  By definition, addiction is an addicts' experience of powerlessness over a compulsive behavior, resulting in their lives becoming unmanageable.  The addict is out of control and experiences tremendous shame, pain and self-loathing. The addict may wish to stop and is unable to do so.  The un-manageability of the addicts' life can be seen in the consequences (s)he suffers by the loss of close relationships, difficulties with work, arrests, financial troubles, low self-esteem and despair, and a loss of interest in things not directly related to their addiction.

References

Unique Trajectories of Addiction, Treatment, and Recovery in Women, excerpt from PARTNERS' INFLUENCE ON WOMEN’S ADDICTION AND RECOVERY: The Connection between Substance Abuse, Trauma, and Intimate Relationships National Abandoned Infants Assistance Resource Center University of California at Berkeley —2002— (http://aia.berkeley.edu/) "The views expressed herein are solely those of the authors and TEG members and do not necessarily represent the views or policy of the U.S. Department of Health and Human Services or treatment-centers.net. For a full copy in .pdf format contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Women-Specific Alcohol and Other Drug Abuse (AODA) and Women and Mental Health (MH) - www.dhfs.wisconsin.gov

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