Treatment Interventions for Women With Alcohol Use Disorder

Abstract

Women with alcohol use disorder (AUD) experience more barriers to AUD treatment and are less likely to access treatment than men with AUD. A literature review identified several barriers to women seeking help: low perception of a need for treatment; guilt and shame; co-occurring disorders; employment, economic, and health insurance disparities; childcare responsibilities; and fear of child protective services. Women entering treatment present with more severe AUD and more complex psychological, social, and service needs than men. Treatment program elements that may reduce barriers to AUD treatment include provision of childcare, prenatal care, treatment for co-occurring psychological problems, and supplemental social services. Research has suggested that outcomes for women are best when treatment is provided in women-only programs that include female-specific content. To date, research on treatments tailored to the individual needs of women is limited, but research on mechanisms of change has suggested the importance of targeting anxiety and depression, affiliative statements in treatment, abstinence self-efficacy, coping skills, autonomy, and social support for abstinence. Future research should focus on early interventions, linkages between primary care or mental health clinics and AUD treatment settings, and integrated treatments for co-occurring AUD and other disorders. Further research should also explore novel treatment delivery approaches such as digital platforms and peer support groups.

Sex and Gender Effects in Recovery from Alcohol Use Disorder

“… 38 , 39 There are several female-specific barriers to accessing AUD treatment, such as external and internalized stigma, lack of childcare, and systemic barriers. 6 Women are more likely than men to believe their alcohol problem will resolve on its own. 6 Additionally, women who are of minority racial or ethnic groups, of different sexual orientations, in the criminal justice system, living in rural areas, and/or of older age and women who speak languages other than English represent intersectional identities that add barriers to treatment entry.…”

“… 4 , 5 These U.S. national policies and strategic plans have had a profound impact on treatment development for alcohol use disorder (AUD) by accelerating attention to sex and gender differences in research, resulting in increased awareness of gender-specific treatment needs. Currently, evidence-based, female-specific AUD treatments are emerging; 6 however, there is still insufficient research (or reporting of research results) on gender differences in all areas of research on AUD treatment and its implementation.…”

From the Editors

“…“Treatment Interventions for Women With Alcohol Use Disorder” examines women’s barriers to treatment seeking and referral, program services to address these barriers, and efficacy of women-specific services relative to traditional mixed-gender care. 21 Importantly, McCrady, Epstein, and Fokas address mechanisms of change, which often are overlooked but highly relevant to successful development of strategies to tailor treatment to women more effectively. 21 Finally, the article considers the effects of women-specific substance abuse services on a breadth of outcomes, ranging from the primary targets of alcohol and drug use to secondary outcomes such as psychosocial well-being, psychiatric health, pregnancy outcomes, and HIV risk reduction.…”

“… 21 Importantly, McCrady, Epstein, and Fokas address mechanisms of change, which often are overlooked but highly relevant to successful development of strategies to tailor treatment to women more effectively. 21 Finally, the article considers the effects of women-specific substance abuse services on a breadth of outcomes, ranging from the primary targets of alcohol and drug use to secondary outcomes such as psychosocial well-being, psychiatric health, pregnancy outcomes, and HIV risk reduction. 21 …”

“… 21 Finally, the article considers the effects of women-specific substance abuse services on a breadth of outcomes, ranging from the primary targets of alcohol and drug use to secondary outcomes such as psychosocial well-being, psychiatric health, pregnancy outcomes, and HIV risk reduction. 21 …”