Women with Addictions: Music Therapy Clinical Postures and Interventions

Abstract

Each year, the Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services conducts the National Survey on Drug Use and Health (NSDUH). This survey gleans data pertaining to the nationwide prevalence and incidence of alcohol, tobacco, and illicit drug use, abuse, and dependence among people aged 12 years and older. NSDUH 2010 revealed that nearly 9% of the respondents were classified with substance use disorders (SUDs) during the year prior to the survey (SAMHSA, 2011).SUDs are characterized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) by dependence or abuse of alcohol and/or illicit drugs (American Psychiatric Associ- ation, 2013). Dependence involves physical tolerance to the substance and withdrawal upon cessation, increased time spent seeking, using, and recovering from use, and failed attempts to stop. Abuse refers to a maladaptive pattern of use that negatively impacts work, school, home, or interpersonal relationships and/or that results in hazardous situations or legal troubles for the user.1Like men, women have been using alcohol and drugs since ancient times; yet we are just beginning to uncover important information about women's unique trajectory to and through addiction. (For a detailed historical view of women and addiction, the reader is referred to Straussner and Brown [2002].) We know-recognizing, of course, that the informa- tion we obtain from self-report measures is inherently limited and biased-that the prevalence of addictions has been and continues to be generally higher among men (11.6%) than women (5.9%), but that among 12- to 17-year-olds, this gap appears to be narrowing (SAMHSA, 2011). Straussner and Brown write, There is little or no denial left today: women can be and are addicts at alarming rates'' (2002, p. 34).Thanks to efforts of institutions such as the United Nations Office of Drugs and Crime and the National Institute on Drug Abuse (NIDA), which advance multifaceted research agendas pertaining to sex differences and addictions, we are learning about the biological and psychosocial factors that idiosyn- cratically impact the etiology and progression of women's use and abuse. Research projects initiated and supported by these types of organizations also enable us to identify women's unique needs regarding prevention and treatment (NIDA, 2011).Although less than 4% of the members of the American Music Therapy Association (AMTA) reportedly work in drug/ alcohol treatment settings, close to 15% report working with clients who have addictions (AMTA, 2011). Sex-specific statistics are not available, but it is certain that some of these members work with women who struggle with addictions, and it seems feasible that some would work predominantly or exclusively with women. Yet, few treatises exist to inform music therapy clinical practice with this clientele. With the present report, we hope to expand the knowledge base in this important area of clinical practice.We first present statistics and other research findings pertaining to women with addictions. Then, based on our collective experiences with women who have alcohol and drug addictions, we present postures and interventions for ethical, effective, and meaningful music therapy clinical practice. The primary author (SG) has provided intermittent group music therapy services for 6 years with women, ages 17 to 65, who reside in a 20-bed, 30-day treatment program in Ohio. Another author (MC) has extensive experience with this clientele. As an independent contractor, she provides expres- sive arts therapy (including music therapy, art, & writing) to clients in both residential and outpatient treatment programs and an affiliated halfway house in Pennsylvania. The remaining authors (JJ, AL) are students who completed a music therapy practicum in the Ohio residential program, working with a women's group twice a week for 4 months under the direct supervision of the primary author. …