Women's Recovery Group Research Articles

Women's and men's experiences in group therapy for substance use disorders: A qualitative analysis.

This thematic analysis of qualitative interviews from participants in Stage II randomized controlled trial examined women's and men's experiences in group therapy for substance use disorders (SUDs). Interviews were conducted with 77 women and 38 men after completion of either the gender-specific Women's Recovery Group (WRG) or mixed-gender Group Drug Counseling (GDC). Interviews were coded for themes using a deductive approach with a coding scheme modified from the Stage I trial. Satisfaction was measured quantitatively posttreatment. Participants had high satisfaction scores with no significant differences between groups. Women in GDC rated group gender composition as less helpful than those in WRG. In the GDC group, women more frequently discussed the theme of self-perception (e.g., feelings of comfort, safety, shame) compared with men. Men overwhelmingly expressed the benefits of having women in the group, whereas women expressed advantages and disadvantages of mixed-gender groups and preference for single-gender groups. Guilt and shame were discussed by women and men; however, only women discussed stigma and its important role in their addiction and recovery. Men more frequently endorsed the helpfulness of mixed-gender groups than did women while women appreciated the enhanced support in single-gender SUD groups. Issues of stigma are especially salient for women. Men and women express differences in their experiences of SUD group therapy. Only women endorse stigma as an obstacle to their treatment and recovery. Tailoring treatment to meet women's and men's needs may enhance engagement, retention, and clinical outcomes.

Group therapy for women with substance use disorders: In-session affiliation predicts women's substance use treatment outcomes

In-session affiliation among members is a hypothesized mechanism of action of group therapy for women with substance use disorders (SUDs). We evaluated group affiliation as an independent predictor of SUD treatment outcome in women (n = 100), 18 years or older diagnosed with substance dependence, who were randomized to the single-gender Women's Recovery Group (WRG) or mixed-gender group therapy (Group Drug Counseling; GDC). Affiliative statements made by members in both groups were measured for 39 women in each treatment arm. We studied the relationship between frequency of affiliative statements categorized in quintiles and the trajectory of days of any drug use during 3 months treatment and 6 months post-treatment using a Poisson regression model with estimation via generalized estimating equations. Furthermore, we investigated whether the effect of affiliation on substance use was moderated by group therapy type. The relationship between amount of affiliation and substance use reduction was non-linear. At the end of the treatment phase (3 months), women who experienced the highest level of affiliation (>65 affiliative statements on average) were found to reduce substance use by about 1.75 days more (p-value = 0.02) than women who experienced the lowest level of affiliation (<26). The effects of affiliation persisted 6 months post-treatment and were moderated by therapy group, whereby women enrolled in the single-gender WRG appeared to benefit more from affiliation post-treatment. Training therapists to facilitate verbal affiliation may provide added therapeutic benefit to group therapy for women with SUDs.

Treating Women with Substance Use Disorders: The Women's Recovery Group ManualShelly F.Greenfield New York, USA: Guilford Publications, 2016 ISBN 978‐1‐4625‐2576‐8 324 pp. Paperback. Price: $74.00. Available to purchase in Australia and New Zealand from Footprint Books.

Drug and Alcohol ReviewVolume 36, Issue 3 p. 433-434 Critique Treating Women with Substance Use Disorders: The Women's Recovery Group Manual , Shelly F. Greenfield , New York, USA: Guilford Publications, 2016 ISBN 978-1-4625-2576-8 324 pp. Paperback. Price: $74.00. Available to purchase in Australia and New Zealand from Footprint Books. Juliet Ardren, Juliet Ardren Women's Alcohol and Drug Advisory Centre Incorporated, Trading as Jarrah House, Sydney, AustraliaSearch for more papers by this author Juliet Ardren, Juliet Ardren Women's Alcohol and Drug Advisory Centre Incorporated, Trading as Jarrah House, Sydney, AustraliaSearch for more papers by this author First published: 12 April 2017 https://doi.org/10.1111/dar.12515Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume36, Issue3May 2017Pages 433-434 RelatedInformation

Treating Women With Substance Use Disorders: The Women's Recovery Group Manual by Shelly F. Greenfield (review)

Treating Women With Substance Use Disorders: The Women's Recovery Group Manual by Shelly F. Greenfield (review)

Feasibility and satisfaction of the women's recovery group for patients with co-occurring substance use and eating disorders

Feasibility and satisfaction of the women's recovery group for patients with co-occurring substance use and eating disorders

Comorbidity and functioning of substance-dependent women with sexual abuse history in the stage II women's recovery group therapy trial

Comorbidity and functioning of substance-dependent women with sexual abuse history in the stage II women's recovery group therapy trial

Ancillary treatment use in the stage ii community-based women's recovery group therapy trial

Ancillary treatment use in the stage ii community-based women's recovery group therapy trial

Group therapy for women with substance use disorders: Results from the Women's Recovery Group Study

BackgroundThis Stage II trial builds on a Stage I trial comparing the single-gender Women's Recovery Group (WRG) to mixed-gender Group Drug Counseling (GDC) that demonstrated preliminary support for the WRG in treating women with substance use disorders. The Stage II trial aims were to (1) investigate effectiveness of the WRG relative to GDC in a sample of women heterogeneous with respect to substance of abuse and co-occurring psychiatric disorders, and (2) demonstrate the feasibility of implementing WRG in an open-enrollment group format at two sites. MethodIn this randomized clinical trial, participants were included if they were substance dependent and had used substances within the past 60 days (n=158). Women were randomized to WRG (n=52) or GDC (n=48); men were assigned to GDC (n=58). Substance use outcomes were assessed at months 1–6 and 9. ResultsWomen in both the WRG and GDC had reductions in mean number of substance use days during treatment (12.7 vs 13.7 day reductions for WRG and GDC, respectively) and 6 months post-treatment (10.3 vs 12.7 day reductions); however, there were no significant differences between groups. ConclusionsThe WRG demonstrated comparable effectiveness to standard mixed-gender treatment (i.e., GDC) and is feasibly delivered in an open-group format typical of community treatment. It provides a manual-based group therapy with women-focused content that can be implemented in a variety of clinical settings for women who are heterogeneous with respect to their substance of abuse, other co-occurring psychiatric disorders, and life-stage.

The women's recovery group: Outcomes from a stage II trial

The women's recovery group: Outcomes from a stage II trial

Implementing substance abuse group therapy clinical trials in real-world settings: challenges and strategies for participant recruitment and therapist training in the Women's Recovery Group Study.

Open-enrollment group therapy research is challenged by the participant recruitment necessary to ensure continuous group enrollment. We present successful strategies to overcome the following barriers during the Women's Recovery Group (WRG) two-site clinical trial (N = 158): maintenance of sample size and balanced gender randomization during continuous enrollment, maintenance of group attendance, and training and retention of therapists over the 24-month continuous group enrollment. To increase recruitment, we targeted referral sources yielding the highest enrollment conversion at each site. Group sessions were consistently held regardless of group size. Therapists were trained in two teams allowing for coverage and uninterrupted treatment over 24 months. At both sites recruitment and enrollment increased with each successive quarter. Sample size and end date targets were met without disruptions in treatment. Group therapists reported high satisfaction with their training and treatment experiences. These strategies supported targeted enrollment and study duration, stability of open-enrollment group therapy frame, and therapist retention and satisfaction. Applying these strategies can aid in providing evidence-based group therapy in both clinical and research settings.

Group Process in the Single-Gender Women's Recovery Group Compared With Mixed-Gender Group Drug Counseling

Enhanced affiliation among members is thought to provide increased support for women in single-gender compared with mixed-gender group therapy for substance use disorders (SUDs) and to provide a potential mechanism of action for its efficacy. In a Stage I trial of single-gender versus mixed-gender group therapy for SUDs we examined affiliative statements made by members in two group treatments, single-gender Women's Recovery Group (WRG) and mixed-gender Group Drug Counseling (GDC). Twenty-eight WRG and 17 GDC group therapy tapes were coded and compared for five types of affiliative statements. Three types of affiliative statements (agreement, supportive, and completing a thought) were highly correlated and were more frequent in WRG than GDC (D=0.882, p=0.27). In GDC, women were more likely to provide an affiliative statement to a male group member than any other combination of directionality (p<0.01). Compared with mixed-gender, single-gender group therapy for SUDs may enhance support through greater frequency of affiliative statements.

Implementing substance abuse group therapy clinical trials in real-world settings: Challenges and strategies for participant recruitment and therapist training in the Women's Recovery Group Study

Background and Objectives Open-enrollment group therapy research is challenged by the participant recruitment necessary to ensure continuous group enrollment. We present successful strategies to overcome the following barriers during the Women's Recovery Group (WRG) two-site clinical trial (N = 158): maintenance of sample size and balanced gender randomization during continuous enrollment, maintenance of group attendance, and training and retention of therapists over the 24-month continuous group enrollment. Methods To increase recruitment, we targeted referral sources yielding the highest enrollment conversion at each site. Group sessions were consistently held regardless of group size. Therapists were trained in two teams allowing for coverage and uninterrupted treatment over 24 months. Results At both sites recruitment and enrollment increased with each successive quarter. Sample size and end date targets were met without disruptions in treatment. Group therapists reported high satisfaction with their training and treatment experiences. Discussion and Conclusions These strategies supported targeted enrollment and study duration, stability of open-enrollment group therapy frame, and therapist retention and satisfaction. Scientific Significance Applying these strategies can aid in providing evidence-based group therapy in both clinical and research settings. (Am J Addict 2014;23:197–204)

A Qualitative Analysis of Women's Experiences in Single-Gender Versus Mixed-Gender Substance Abuse Group Therapy

The present study of women with substance use disorders used grounded theory to examine women's experiences in both the Women's Recovery Group (WRG) and a mixed-gender Group Drug Counseling (GDC). Semi-structured interviews were completed in 2005 by 28 women in a U.S. metropolitan area. Compared to GDC, women in WRG more frequently endorsed feeling safe, embracing all aspects of one's self, having their needs met, feeling intimacy, empathy, and honesty. In addition, group cohesion and support allowed women to focus on gender-relevant topics supporting their recovery. These advantages of single-gender group therapy can increase treatment satisfaction and improve treatment outcomes.

Changes in Coping Moderate Substance Abuse Outcomes Differentially across Behavioral Treatment Modality

In this secondary data analytic study, we examined whether the relationship between changes in coping and treatment outcome differed between women enrolled in either the Women's Recovery Group (WRG) (n = 29), a new manualized group treatment for women with substance use disorders, or Group Drug Counseling (GDC) (n = 7), an empirically supported mixed-gender group treatment. We examined subscales of the Ways of Coping Questionnaire and found that while changes in coping did not differ significantly across treatment groups, the association between changes in coping and substance abuse outcome was related to treatment condition. Increases in problem-focused coping were associated with decreased drinking days in WRG, but paradoxically with increased drinking days in GDC. For both groups, increases in wishful thinking were associated with increases in substance use, and increases in social support coping associated with decreases in use, but these associations were greater in GDC. Our results highlight the importance of examining the impact of treatment modality on coping, as well as contextual factors that may help to explain the specific pattern of results.

Self-Efficacy and Substance Use Outcomes for Women in Single-Gender Versus Mixed-Gender Group Treatment

OBJECTIVE: This study examined baseline self-efficacy as a moderator of outcomes comparing women receiving either the Women's Recovery Group (WRG), a new manualized group treatment for substance use disorders combining single-gender group composition and women-focused content, or Group Drug Counseling (GDC), an empirically supported mixed-gender group treatment. METHODS: To understand the relationship of baseline scores of abstinence self-efficacy measured by the Drug-Taking Confidence Questionnaire (DTCQ) to outcome, we included the interaction of group by phase by continuous DTCQ scores in the outcome analyses. Women were split into groups of high versus low abstinence self-efficacy based on the clinical cutoff score of 80 on DTCQ. RESULTS: We found a significant 3-way interaction effect of treatment condition, time, and baseline DTCQ scores on drinking days and days of any substance use per month. Women in WRG had greater reduction in substance use from baseline to post-treatment than women in GDC, and women in WRG with low self-efficacy had the best outcomes overall. CONCLUSION: The findings suggest that women with low self-efficacy may have enhanced treatment outcomes in a single-gender substance use treatment group.

Psychiatric Symptom Improvement in Women Following Group Substance Abuse Treatment: Results from the Women's Recovery Group Study.

The Women's Recovery Group study was a Stage I randomized clinical trial comparing a new manual-based group treatment for women with substance use disorders with Group Drug Counseling. Data from this study were examined to determine whether co-occurring symptoms of depression and anxiety would improve with treatment and whether these improvements would demonstrate durability over the follow-up period. The sample consisted of 36 women (29 WRG, 7 GDC) who were administered self-report and clinician-rated measures of anxiety, depression, and general psychiatric symptoms. Although there were no group differences in psychiatric symptom improvement, analyses demonstrated significant within-subject improvement in depression, anxiety, and general psychiatric symptoms. Symptom reduction was not mediated by changes in substance use. This study demonstrated significant psychiatric symptom reduction that remained durable through 6 month follow-up for women receiving group therapy focused on substance abuse relapse prevention. Reduction in psychiatric symptoms may be an additional benefit of substance abuse group therapy for women.

High Psychiatric Symptom Severity Is a Moderator of Substance Abuse Treatment Outcomes Among Women in Single vs. Mixed Gender Group Treatment

Objective: This exploratory study examined psychiatric symptom severity as a moderator of outcomes among women receiving either the Women's Recovery Group (WRG), a new manualized group treatment for substance use disorders combining single-gender group composition and women-focused content, or Group Drug Counseling (GDC), an empirically supported mixed-gender group treatment. Methods: We used a mixed model analysis of variance. Results: We found a significant 3-way interaction effect of treatment condition, time, and baseline Brief Symptom Inventory scores as well as Beck Depression Inventory scores. Conclusion: Single-gender group treatment may confer added benefit for women with substance abuse and high psychiatric symptom severity than mixed-gender treatment.

The Women's Recovery Group Study: A Stage I trial of women-focused group therapy for substance use disorders versus mixed-gender group drug counseling

The aim of this Stage I Behavioral Development Trial was to develop a manual-based 12-session Women's Recovery Group (WRG) and to pilot test this new treatment in a randomized controlled trial against a mixed-gender Group Drug Counseling (GDC), an effective manual-based treatment for substance use disorders. After initial manual development, two pre-pilot groups of WRG were conducted to determine feasibility and initial acceptability of the treatment among subjects and therapists. In the pilot stage, women were randomized to either WRG or GDC. No significant differences in substance use outcomes were found between WRG and GDC during the 12-week group treatment. However, during the 6-month post-treatment follow-up, WRG members demonstrated a pattern of continued reductions in substance use while GDC women did not. In addition, pilot WRG women with alcohol dependence had significantly greater reductions in average drinks/drinking day than GDC women 6 months post-treatment ( p < .03, effect size = 0.81). While satisfaction with both groups was high, women were significantly more satisfied with WRG than GDC ( p < .009, effect size = 1.11). In this study, the newly developed 12-session women-focused WRG was feasible with high satisfaction among participants. It was equally effective as mixed-gender GDC in reducing substance use during the 12-week in-treatment phase, but demonstrated significantly greater improvement in reductions in drug and alcohol use over the post-treatment follow-up phase compared with GDC. A women-focused single-gender group treatment may enhance longer-term clinical outcomes among women with substance use disorders.