Drug Treatment Program For Women Research Articles

The relative effectiveness of women-only and mixed-gender treatment for substance-abusing women

Following research indicating that the treatment needs of women are different from those of men, researchers and clinicians have argued that drug treatment programs for women should be designed to take their needs into account. Such programs tend to admit only women and incorporate philosophies and activities that are based on a social, peer-based model that is responsive to women's needs. To assess the relative effectiveness of women-only (WO) outpatient programs compared with mixed-gender (MG) outpatient programs, 291 study volunteers were recruited (152 WO, 139 MG), and a 1-year follow-up was completed with 259 women (135 WO, 124 MG). Using bivariate, logistic regression, and generalized estimating equation analysis, the following four outcomes were examined: drug and alcohol use, criminal activity, arrests, and employment. In both groups, women showed improvement in the four outcome measures. Comparison of the groups on outcomes yielded mixed results; women who participated in the WO treatment reported significantly less substance use and criminal activity than women in the MG treatment, but there were no differences in arrest or employment status at follow-up compared with those in the MG treatment.

Rethinking parenting interventions for drug-dependent mothers: From behavior management to fostering emotional bonds

Mothers who are physically and/or psychologically dependent upon alcohol and illicit drugs are at risk for a wide range of parenting deficits beginning when their children are infants and continuing as their children move through school-age and adolescent years. Behavioral parent training programs for drug-dependent mothers have had limited success in improving parent-child relationships or children’s psychological adjustment. One reason behavioral parenting programs may have had limited success is the lack of attention to the emotional quality of the parent-child relationship. Research on attachment suggests that the emotional quality of mother-child relationships is an important predictor of children’s psychological development through school-age and adolescent years. In this paper, we present a rationale and approach for developing attachment-based parenting interventions for drug-dependent mothers and report preliminary data on the feasibility of offering an attachment-based parenting intervention in an outpatient drug treatment program for women.

Smoking stage of change is associated with retention in a smoke-free residential drug treatment program for women

Prochaska and DiClemente's Transtheoretical Model predicts dropout from substance-abuse treatment. However, it is not known whether readiness to quit smoking is associated with attrition from drug treatment programs with smoking restrictions. This study examined the relationship between smoking characteristics, smoking stage of change, and both length of stay (LOS) and discharge type among 75 perinatal substance abusers attending a smoke-free residential treatment program. URICA scores predicted LOS ( P=.0004) and discharge type ( P=.01). Women in action and maintenance remained in treatment longer and were more likely to complete treatment compared to those in precontemplation. Findings were not accounted for by addiction severity. Women with little interest in quitting smoking may have difficulty adhering to smoking restrictions during treatment for other drug problems, resulting in increased attrition. Alternatively, smoking stage of change may be a “proxy” for overall readiness to change in this population.

Psychopathology Is Associated with Completion of Residential Treatment in Drug Dependent Women

This study characterized drug dependent women based on current psychopathology (MCMI-III) and then examined the relationship between psychopathology and treatment retention. Participants included 97 pregnant (88%), African-American (78%), single (90%) 30-year old women enrolled in a 6-month residential drug treatment program for women and children. Clustering on personality test scores using Ward's technique identified three subgroups with mild (24%), moderate (59%) and severe (18%) psychopathology. Treatment completion rates varied by group (66%, 45% and 29%), with half of the high severity group leaving against medical advice (AMA) within 60 days. Although the majority of low severity women completed the program as scheduled, they may also have done well in a less intensive treatment modality. Conversely, it appears that women with severe psychopathology may require a more flexible, psychiatrically-oriented approach than is found in most residential settings including greater emphasis on psychiatric issues, individual psychotherapy, and pharmacotherapy.

Where are the Children? An Examination of Children's Living Arrangements When Mothers Enter Residential Drug Treatment

Although providing child care and family residency options has become central to substance abuse treatment for women with dependent children, research documenting status of child coresidence prior to, during, and following treatment is currently unavailable. The purpose of this study is to examine the degree to which mothers are successful in maintaining or reestablishing their role as parents during the course of treatment. The sample included 152 female clients admitted to a residential drug treatment program for women with dependent children. Findings document an increase in child coresidency from admission to follow-up. Women who entered treatment with all children or who were reunited with children previously in others' care at admission were over five times more likely to coreside with all children at follow-up. At follow-up, mothers who reported complete coresidence were more likely to be 30 years old or younger, live independently, and have fewer than two parenting challenges.

Effects of women-sensitive, long-term residential treatment on psychological functioning of diverse populations of women

A number of studies have found that women who abuse substances enter treatment with greater psychological problems and more vulnerabilities than men. This article reports on a 5-year study of clients in a comprehensive, residential drug treatment program for women and their children. Psychological assessments on 362 women included the Basic Personality Inventory (BPI), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Luria-Nebraska Neuropsychological Battery, Screening Test (LNNB-ST). Early in the course of treatment, the typical client tends to experience a great deal of distress, as evidenced by scores on the CES-D. Other assessments indicate she is relatively alienated, mistrustful of others, and resentful of rules imposed on her by others. Repeated assessments show that these psychological indicators improve significantly as the client progresses through the treatment program. Additional studies are needed to focus on long-term treatment outcomes of women in programs designed specifically for them.

PREDICTORS OF PROGRAM COMPLETION FOR WOMEN IN RESIDENTIAL SUBSTANCE ABUSE TREATMENT*

Although there is increasing emphasis on providing drug treatment programs for women that address their specific needs (including parenting and childcare), some women still fail to complete treatment. Because of the limited information about the barriers involved, this study examines pretreatment characteristics as predictors of program completion for 87 women who were pregnant or who entered residential treatment with their children. By using a multivariate prediction model, three significant predictors of treatment completion were identified: education level, recent arrests, and peer deviance. Women who completed program requirements were more likely to have a high school degree or equivalent, no arrests in the 6 months before admission, and friends who were less deviant. These findings support the need for specialized education and services that address social deviancy of pregnant and/or parenting women. Other predictors that approached significance and deserve further study include marital status, number of children in treatment, child welfare involvement, cocaine use, and psychological depression.

Using focus groups to evaluate client satisfaction in an alcohol and drug treatment program.

Often in studies of the program effectiveness of alcohol and drug treatment programs, behavioral outcomes are the only focus. While important, behavioral outcomes do not explore the viewpoint of the client about the success of the program, and evaluators are now recognizing the importance of measuring the performance of addictions treatment programs in terms of client satisfaction. The primary purpose of this article is to describe the experience of evaluators in their attempts to assess client satisfaction through the use of focus groups at a comprehensive drug treatment program for women and their children. The results of these focus groups are shared, and the appropriateness of the focus group methodology in assessing client satisfaction with comprehensive drug treatment services for women is discussed.

Mothers and Children, Drugs and Crack:

This paper discusses the criminalization of pregnancy. Prosecutors have charged drug-using pregnant women with drug trafficking and child abuse. However health care providers, bound to report suspected cases of drug use among pregnant women, have brought far more women into family court where they risk forfeiting their children to congregate or foster care. The paper reviews the lack of drug treatment programs for women and concludes by recommending community-based drug treatment that keeps families together and provides full range of social services.

Public Issues and Private Problems: Women and Drug Use

Despite the conventional wisdom that defining a problem is an essential step in determining a solution, social problem definitions often obscure strategies for ameliorating problems. A review of social research designed to illuminate our definition of substance abuse reveals the way in which historical and political factors have modified the definition of substance abuse problems over time. Treatment and prevention strategies based on these problem definitions are vulnerable to the same influences. A review of explanations of substance abuse among women shows that they have been limited by the same narrow prescriptions that have been applied to women's behavior more generally. This means, for example, that drug treatment programs have focused on improving vocational skills for men and social skills for women. This paper suggests an alternative starting point for the design of effective services. It is suggested that successive, limited comparisons of actual intervention efforts—particularly those designed with the participation of clients or ex‐clients—is a superior method for determining appropriate services for drug‐using women. Based on findings from evaluations of special drug treatment programs for women, three strategies are discussed for implementing this evaluation feedback approach to program design.

The goal-oriented approach to evaluation: Critique and case study from drug abuse treatment

The specification and measurement of program goals remains central to most evaluation research strategies, yet procedures for implementing this approach are not well-articulated. It is the purpose of this discussion to describe a stepwise procedure for programmatic goal setting and monitoring used in a demonstration drug treatment program for women. Three implementation steps are described: (a) goal setting, (b) checking for consistency, (c) monitoring and feedback. The advantages and limitations of this approach are discussed and useful complementary measurement strategies are suggested.