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published and unpublished documents.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
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
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
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.
