Do women with complex alcohol and other drug use histories want women‐only residential treatment?

Abstract

BackgroundWomen‐only addiction services tend to be provided on a poorly evidenced assumption that women want single‐sex treatment. We draw upon women's expectations and experiences of women‐only residential rehabilitation to stimulate debate on this issue.MethodsSemi‐structured interviews were undertaken with 19 women aged 25–44 years [currently in treatment (n = 9), successfully completed treatment (n = 5), left treatment prematurely (n = 5)]. All had histories of physical or sexual abuse, and relapses linked to relationships with men. Interviews were audio‐recorded, transcribed verbatim, coded and analysed inductively following Iterative Categorization.FindingsWomen reported routinely that they had been concerned, anxious or scared about entering women‐only treatment. They attributed these feelings to previous poor relationships with women, being more accustomed to male company and negative experiences of other women‐only residential settings. Few women said that they had wanted women‐only treatment, although many became more positive after entering the women‐only service. Once in treatment, women often explained that they felt safe, supported, relaxed, understood and able to open up and develop relationships with other female residents. However, they also described tensions, conflicts, mistrust and social distancing that undermined their treatment experiences.ConclusionsWomen who have complex histories of alcohol and other drug use do not necessarily want or perceive benefit in women‐only residential treatment.

What do women want? Women want services tailored to their needs

“…is a question asked by philosophers and pundits over the ages and raised again by Neale et al [1]. In raising the question, they seek to stimulate the debate around the 'common' assumption that women with complex alcohol and other drug use histories want women-only treatment.…”

What do women with substance use disorders want?

“…The question posed in the paper by Neale et al [1] of whether women in treatment for substance use disorders (SUD) prefer to be in women-only programs is deceptively simple. However, implicit in this question is another: do women with SUD necessarily know what is the best type of treatment for them?…”

“…We would like to thank Professors Elizabeth Ettorre [1], Christine Grella [2] and Jeanne Marsh [3] for their thoughtful commentaries on our Addiction Debate article [4]. The question we posed ('Do women with complex alcohol and other drug use histories want women-only residential treatment?')…”

The need for more research and considered debate regarding women‐only treatment services: a comment on Neale et al. (2018)

“…This both undermines the research presented and qualitative research more generally [5]. As internationally acknowledged experts in their field, the authors are no doubt aware that qualitative research can provide rich and detailed insight into the experience of research participants, but it is rarely generalizable beyond the cases to the extent the authors suggest [1]. Although these limitations were identified in the Discussion, the authors failed to couch their conclusions within the context of these limitations.…”

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We were surprised to read Neale and colleagues' conclusions in their recent work on women-only services, which stated: 'Women who have complex histories of alcohol and other drug use do not necessarily want or perceive benefit in women-only residential treatment' (Abstract conclusion, p. 989) [1] and that women were 'routinely fearful and negative about entering women-only treatment ' (p. 994) [1]. These conclusions and interpretations appear to misrepresent the findings based on the data presented and are at odds with the study's qualitative methodology.

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