Preface

 

In early 1992, the Center for Substance Abuse Treatment (CSAT) Division of Clinical Programs (the Division) determined that as part of its effort to expand the availability of quality treatment services for women, it would be necessary to make available to substance abuse treatment providers a comprehensive document on substance abuse treatment of women. To that end, CSAT initiated preparation of the document under the leadership of Maggie Wilmore, Chief of the Women and Children's Branch (the Branch). She established and involved in this process a Women's Treatment Task Force comprising 18 individuals specializing in the treatment of women for problems with alcohol and other drugs. This Task Force identified issues related to treatment of women as well as strategies that can be used by programs serving this population.

 

Given the paucity of published materials available on substance abuse among women and on the relative effectiveness of treatment modalities for female clients, development of the document was designed to utilize the knowledge and expertise of experts in the field insofar as possible, as well as published and unpublished documents. The involvement of experts knowledgeable about and experienced in treatment of women in general as well as specific populations of women enriched and expanded the document, which included not only basic epidemiological data, but strategies that address the specific needs of a number of populations of women. In late 1993, the first complete draft of the manual in its present form was prepared by Policy Research Incorporated and disseminated to experts in the field, including members of the Task Force and CSAT, for review and comment. Revisions were made, and the manual was again reviewed by CSAT staff, members of the Task F;orce, and others knowledgeable about substance abuse treatment for women. In all, more than 50 women and men of diverse cultures, viewpoints, training, and experience contributed to the preparation of this manual.


We believe that this document can contribute to improving the quality of treatment services for women. It is part of the larger effort of the Division and its Women and Children's Branch to expand quality services. These other activities include, for example, expanding services through two grant programs (the Residential Women and Children's Treatment Program and the Residential Pregnant and Postpartum Women's Program) and sponsoring preparation of a Comprehensive Treatment Model for Women to be used by substance abuse treatment providers. The manual will be disseminated to treatment programs whose client population includes women. In the future, it will be used as a basis for developing and implementing training programs for staff and for preparation of learner-centered materials that can be readily used by practitioners in the field.

We appreciate the dedication of the Chief of the Women and Children's Branch, Maggie Wilmore, who contributed to the conceptual development of the manual and who reviewed and commented extensively on each draft. Without her, this document would not have been a reality.

Warren W. Hewitt, Jr.
Acting Director
Division of Clinical Programs

Foreword

 

The Congressional legislation which established the Center for Substance Abuse Treatment (CSAT) provided an overall mandate to expand the availability of effective treatment and recovery services for (those with) alcohol and other drug problems. This legislation specifically called for expanding treatment and recovery services for women. The Division of Clinical Programs (the Division) Women and Children's Branch of CSAT is committed to increasing service availability (access to care) for women and to ensuring that comprehensive treatment services for women are provided that empower and sustain their recovery.

 

This CSAT-sponsored publication, Practical Approaches in the Treatment of Women Who Abuse Alcohol and Other Drugs, is one of several activities carried out by the Division's Women and Children's Branch to help treatment program staff plan and deliver quality treatment services for women. It is our hope that the manual will truly make a difference-that it will inspire and activate increased concern for and attention to women's issues on the part of all substance abuse treatment providers as well as those involved in formulating substance abuse policy. The manual includes summaries of current knowledge regarding substance abuse treatment modalities for women, the epidemiology of women and substance abuse, and factors related to substance abuse among women. Equally if not more important, it provides practical information on how to design, develop, and implement effective substance abuse outreach and treatment programs for women. As the field of substance abuse treatment for women changes and grows, CSAT will revise this publication as necessary.

 

Acknowledgments

 

The experience and knowledge of many experts in the field of substance abuse treatment for women has been synthesized in this manual. More than 35 experts participated in its development. Many of them devoted considerable time and effort as volunteers. I would particularly


like to express my gratitude to Doris Amaya, Barbara Aranda-Naranjo, Naya Arbiter, Andrea Barthwell, Debbie Barsell, Virginia Borrok, Vivian Brown, Carol Casey, Stephanie Covington, Mary Patricia Donegan, Barbara Eisenstadt, Susan Galbraith, Barbara Gibson, Cora (Skip) Gordon, Annette Green, Irene Jillson, Robin LaDue, Mari Ono, Helen RodriguezTrias, Paula Roth, Brenda Smith, Brenda Underhill, and Marilyn Vranas. These individuals either wrote a chapter or contributed substantively to one or more of the chapters. The names and affiliations of everyone who contributed to the manual are listed alphabetically on the following pages. On behalf of CSAT, I wish to express my deep appreciation for their dedication to improving substance abuse treatment for women.

Maggie Wilmore
Chief
Women and Children's Branch
Division of Clinical Programs

Experts Contributing to the Development of the Substance Abuse Treatment Manual for Women

Doris Amaya Stephanie Covington Linda Herman
Doris Amaya and Associates Consultant to the Betty Ford Center The Flowering Tree Project
Coral Gables, Florida Women's Program Oglala Sioux Tribe
LaJolla, California Pine Ridge, South Dakota
Barbara Aranda-Naranjo
The University of Texas Mary Patricia Donegan Val Jackson
Health Center at San Antonio Psychological and Counseling The Village
San Antonio, Texas Center, Inc. Miami, Florida
Pittsburgh, Pennsylvania
Naya Arbiter Jackie Jenkins-Scott
Amity Hope Ewing Dimock Community Health Center
Tucson, Arizona Born Free Project Roxbury, Massachusetts
Maratinez, California
Debbie Barsell Irene Jillson
Technical Resources Incorporated Francine C. Feinberg Policy Research Incorporated
Rockville, Maryland Our Home Foundation, Inc. Bethesda, Maryland
Milwaukee, Wisconsin
Andrea Barthwell Karol Kaltenback
Interventions Norma Finkelstein Thomas Jefferson University
Chicago, Illinois Coalition on Addiction, Pregnancy Philadelphia, Pennsylvania
and Parenting
Lorrainne Bilodeau Cambridge, Massachusetts Robin LaDue
Florence County Commission on Clinical Psychologist
Alcohol and Drug Abuse Susan Galbraith Renton, Washington
Florence, South Carolina Legal Action Center
Washington, DC Davene B. McCarthy-White
Virginia Borrok Howard University Hospital
Gateway Community Services, Inc. Barbara Gibson Washington, DC
Jacksonville, Florida Urban Resource Institute
Brooklyn, New York Lorraine Montenegro
Aurelia Brooks United Bronx Parents, Inc.
House of the Crossroads Skip Gordon Bronx, New York
Pittsburgh, Pennsylvania Policy Research Incorporated
Bethesda, Maryland Christine Olsen
Vivian Brown Colorado Department of Health
PROTOTYPES Annette Green Denver, Colorado
Culver City, California Allegheny County Mental Health,
Mental Retardation, Drug and Mari Ono
Claire Callahan Alcohol Program Hawaii State Hospital
Consultant Pittsburgh, Pennsylvania Kaneohe, Hawaii
Bethesda, Maryland
Cheryl Grills Kattie Portis
Carol Casey Loyola Marymont University Women Incorporated
The Columbia Recovery Center, Inc. Los Angeles, California Boston, Massachusetts
Washington, DC
Nancy Hamilton
Operation Par
St. Petersburg, Florida
Beth Glover Reed Rita Sullivan
University of Michigan Ontrack, Inc.
Ann Arbor, Michigan Medford, Oregon
Helen Rodriguez-Trias Sushma D. Taylor
Consultant in Health Programming Center Point, Inc.
Brookdale, California San Rafael, California
Paula Roth Brenda Underhill
Consultant Policy Research Incorporated
New York, New York Bethesda, Maryland
Beatrice Rouse Marilyn Vranas
Office of Applied Studies Center for Substance
SAMHSA Abuse Treatment
Rockville, Maryland Rockville, Maryland
Harilyn Rousso John Wilbur
Disabilities Unlimited Maehnowesekiyah Treatment
Consulting Services Center's Residential Treatment for
New York, New York Pregnant and Postpartum Women
Keshena, Wisconsin
Maryanne Schretzman
Women In Need, Inc. Dooley Worth
New York, New York Research Consultant
New York, New York
Bettina Scott
Office of Alcohol Prevention Joan Ellen Zweben
and Treatment Policy East Bay Community
SAMHSA Recovery Project
Rockville, Maryland Oakland, California

Albert M. Senella
Tarzana Treatment Center, Inc.
Tarzana, California

Brenda Smith
National Women's Law Center
Washington, DC

Iris E. Smith
Gapp Family Recovery Center
Atlanta, Georgia

John W.Stauder
Prince Georges County
Health Department
Landover, Maryland

Chapter 1 Introduction

 

The compilation and presentation of the information in this manual serves as a guide to develop and implement effective substance abuse treatment services for women.