This manual is designed to help treatment program personnel meet
the specific needs of women with substance abuse problems. It is for substance
abuse treatment staff who work in programs that serve both men and women and
for staff who serve women only. Although written for a wide audience, the
manual is most relevant to federally-funded programs that mainly serve
low-income populations. The manual is presented in eight chapters, including
this introductory chapter. Chapters 2 through 8 are presented as follows:
· Chapter 2 "Women and Alcohol and Other Drugs: An
Overview" presents a summary of the current epidemiology
of substance abuse among women, and data and informa
tion concerning factors related to substance abuse among
women.
· Chapter 3 "Treatment of Alcohol and Other Drug Abuse:
An Introduction" presents approaches to the treatment of
substance abuse.
· Chapter 4 "Outreach to and Identification of
Women"
presents a discussion of barriers to engaging women
in treatment and outreach strategies to deal with those
barriers.
· Chapter 5 "Comprehensive Treatment for Women"
pre
sents approaches to comprehensive care in each stage of the
treatment process (e.g., intake, treatment, discharge).
· Chapter 6 "Continuing Care and Follow Up" is a sum
mary of approaches to continuing care.
· Chapter 7 "Program Management Issues" presents an
overview of program management issues.
· Chapter 8 "Reflections" includes thoughts and
reflections
on the issues raised in the manual.
4 Introduction
Unless otherwise stated,
the discussion of treatment issues and strategies relates to women in substance
abuse treatment in general; that is, the information applies across
ethnic/racial groups and socioeconomic groups. Factors specifically related to
different populations of women (age groups, ethnic/racial groups, and other
populations) are addressed in chapters 2, 4, and 5. For example, in chapter 2,
comparative information is presented by age and/or race where appropriate, but
information regarding several populations is also summarized at the end of the
chapter. Because of the critical importance of the cultural competency of staff
in engaging and retaining women in treatment and the importance of the factors
of culture, gender, and class in designing and delivering effective substance
abuse treatment services, extensive discussions of issues unique to different
population groups are presented in chapters 4 and 5. Those who are
knowledgeable about the current epidemiology of substance abuse in women may
wish to refer directly to chapters that present specific strategies concerning
one of the phases of care (e.g., outreach, continuing care). Others may choose
to read chapter 2 thoroughly before reading the other chapters or may wish to
use chapter 2 as a quick reference for epidemiologic information.
There is no large body of research on which to base the design and
implementation of strategies for women's substance abuse treatment, as chapter
2 will make clear, and many of the national data sets that might be useful do
not have-or do not present-information separately for men and women. Those who
manage treatment services for women or who are counselors in women's treatment
programs do describe their programs and conduct at least informal assessments
in the course of program management (e.g., completing required reports for
funding or sponsoring agencies) and fund raising (e.g., preparing proposals).
However, program managers often do not have the resources or the opportunity to
conduct systematic evaluations or assessments of their programs or to compare
their services with those of other treatment programs. Thus, program staff
usually rely on
experiential
knowledge or the "oral tradition" in designing, developing, and implementing
substance abuse treatment services for women.
This manual is based on the knowledge of experts in the field of substance
abuse treatment for women as well as on published and unpublished research.
Both of these information sources contribute to the knowledge base of substance
abuse treatment. 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. This manual also serves as a guidepost for
research by helping to make evident the gaps in current knowledge. As this
process continues, it will provide relevant and current information to help
those in the field of substance abuse treatment implement effective substance
abuse treatment services for women.
Across all program components in the continuum of care for women, the mandate
of providers is to do the following:
En eg nder hope and empowerment in their clients,
Ensure safe, secure, and supportive environments,
Establish trusting relationships between women clients and staff,
Provide advocacy in accessing all services needed,
Promote self responsibility, self sufficiency, and interdependence,
Strive for gender specific and culturally relevant clientdriven services,
Eliminate labeling of women and their children in all respects, and
- Build the effective linkages and networking required for
model women's programs.
The effects of alcohol and other drug abuse on women's health are clear.
