Gender-Responsive Treatment Helps Women and Men in Recovery
Men and women are different. It seems obvious, but it’s a fact medical research and treatment recommendations often ignore. Until quite recently, major health studies on common conditions such as heart disease, diabetes and aging as well as most randomized clinical trials of new pharmaceuticals included no women.
In clinical practice, it turns out those differences matter: The amount of the sleeping aid Ambien initially approved for all adults is twice as much as a woman can safely take.1 Low-dose aspirin reduces heart attack risk in men, but stroke risk in women. Women have entirely different symptoms for heart attacks than men; as a result, they are consistently misdiagnosed and more likely to be fatal.
How women and men use and respond to illicit drugs varies as well. Women typically use smaller amounts of opioids, cannabis and alcohol for shorter periods before they become addicted.2 Hormones, pregnancy and breastfeeding affect women’s drug use. They tend to experience more damage to their cardiovascular system with substance use and are more likely to suffer from comorbid depression, anxiety, post-traumatic stress disorder and eating disorders. Women are twice as likely to receive a prescription for tranquilizers and more likely to develop an addiction to them. They tend to enter substance abuse programs with more medical, behavioral, psychological and social problems, even if they have not been using as long.
Gender-responsive treatment that recognizes that women and men do not have the same needs, methods of processing, coping skills and ability to engage in therapy produce better results. Women in such programs are more likely to be employed a year after treatment admission than those in traditional, coed programs, according to the National Institute of Drug Abuse.
At Malibu Beach Recovery Center, we provide care for women, exclusively by women. The environment sets the stage for healing. The low-stimulation environment of dim lighting, uncluttered walls and quiet soothes women recovering from significant trauma, which most women in treatment have experienced. A calming room with tactile balls, soft blankets, relaxing music and aromatherapy provides a safe place for women struggling to learn how to self-regulate emotions or trying to work through a difficult therapy session. Chefs prepare lighter fare women prefer generally. For women with co-occurring eating disorders, staff members team with Rosewood of California to treat both issues simultaneously.
The program recognizes the unique roles women play as daughters, wives and mothers, while also providing them a framework for valuing time and energy spent tending to themselves rather than always caring for others. It addresses family roles and the need to affect positive changes within the family to support recovery. Family issues may include a husband who uses, domestic abuse or other stress in the marriage. To provide a stronger foundation, patients work on relational models to learn how to form healthy, balanced relationships with themselves and others.
Women work together and share in group therapy. They help each other by truly hearing what other women have to say and supporting one another in their journey.
The approach works. Women in most treatment programs do not stay as long as men because they rush back home to resume their responsibilities. Teaching women that they must care for themselves before they can care for others keeps them engaged and helps women see themselves as important people in their own and others’ lives.
The step-down women’s center continues the supportive and structured environment necessary for individuals in early stages of recovery, with random drug tests and breath tests, curfews and limited guests. The single-sex approach enables women to learn life skills from resident role models who teach them how to function in the community without using drugs or drinking. In contrast, women in coed programs tend to care for the men in the group or sexually act out, both activities that divert them from attending to their own issues and recovery.
The gender-responsive treatment structure works better for men as well. Men are generally socialized to not share their feelings openly, to not cry or discuss their issues. In coed programs, most men take a long time to stop internalizing and women try to help them through the process, which delays recovery for both groups.
Men need to learn to recognize and name emotions in ways women seldom do. They often do not know the difference between sad and angry. Men use the calming room to deescalate from being angry, more as a self-imposed time out. They struggle to overcome decades of training in a matter of weeks.
For men, therapists spend the first 30-45 days guiding them through withdrawal, educating them about the disease of addiction and start to acknowledge their issues. It’s not until men arrive at the intensive outpatient level that they build trust and recognize that they are no less a man for communicating what hurts inside. In group sessions, therapists engage men in friendly competition to support their recovery, and spend less time on family relationships as fewer men are in relationships when they enter treatment.
The gender-responsive approach creates an environment in which women and men receive treatment in a culture and setting that best meets their needs and harnesses their strengths to support recovery.