The relative effectiveness of women-only and mixed-gender treatment for substance-abusing women

Abstract

Following research indicating that the treatment needs of women are different from those of men, researchers and clinicians have argued that drug treatment programs for women should be designed to take their needs into account. Such programs tend to admit only women and incorporate philosophies and activities that are based on a social, peer-based model that is responsive to their needs. To assess the relative effectiveness of women-only (WO) outpatient programs compared to mixed-gender (MG) outpatient programs, 291 study volunteers were recruited (152 WO, 139 MG), and a 1-year follow-up was completed with 259 women (135 WO, 124 MG). Using bivariate, logistic regression, and generalized estimating equation analysis, the following four outcomes were examined: drug and alcohol use, criminal activity, arrests, and employment. In both groups, women showed improvement in the four outcome measures. Comparison of the groups on outcomes yielded mixed results; women who participated in WO treatment reported significantly less substance use and criminal activity than women in MG treatment, but there were no differences in arrest or employment status at follow up compared with those in MG treatment.

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

“…Although we have no literature on user preferences for services organized by gender, we have evidence showing that in non-residential settings women-only treatment is as effective or more effective than mixed-sex treatments at reducing substance use and crime (e.g. [3,4]). In residential programs, women-only programs are associated with longer stays, higher completion rates and increased post-treatment after-care [5].…”

“…On the other hand, assuming that women may prefer the type of treatment that is 'best' for them is complicated by the nature of SUD, which often manifests in impaired decision-making [3,4]. Evaluating the benefits of women-only treatment programs is complicated further when their substance use is embedded in relationships and part of a nexus of trauma history, intimate partner violence and sexual risk behaviors [5][6][7][8].…”

Identifying possible reasons why female street sex workers have poor drug treatment outcomes: a qualitative study

“…35 36 Women-only trauma-informed programmes designed to reduce levels of drug use have had inconclusive results,46 47 though some have suggested that certain subgroups48 49 such as sex workers,50 may benefit from this approach. Our findings are in keeping with theory suggesting that drug use is a strategy to avoid traumatic symptoms 51.…”

What do women with substance use disorders want?

“…Moreover, women in women-only programs often have more severe problems than those in mixed-gender programs [11,12], suggesting that women with greater needs may self-select into these programs-or are more apt to be referred to them. Despite the greater severity of their patients' problems, women-only programs are associated with more favorable outcomes regarding drug use [13], treatment retention [14], criminal behavior [15], incarceration [16,17] and family reunification [18].…”