Women healing from alcoholism: a qualitative study:

High relapse rates in treated alcoholics and a lack of adequate research studies with recovering alcoholics suggest we need to know much more about the actual recovery process from alcoholism with both males and females (Leukefeld & Tims, 1989; Fuller, 1989; Langton, 1991). This study describes selected aspects of the recovery process as experienced, understood, and articulated by a group of women in various stages of healing from the effects of alcoholism. The study offers phenomenological evidence on the issues of how recovery is initiated, the role of the social support system, the impact of economics on recovery (and vice versa), the use of all-women AA groups, and the influence of shame. Although recent studies have included women in their samples, historically the data base comes from predominantly male treatment studies (Catalano, Howard, Hawkins & Wells, 1988). Questions have been raised as to what extent these and other conclusions apply to women (Duckert, 1987). Recent alcohol treatment research has defined women as a "special population group"; that is (like older adults and ethnic minorities), a group with unique biological and sociocultural characteristics that require culturally sensitive intervention (Institute of Medicine, 1990). There is some recognition that traditional treatment programs and research studies have not adequately addressed the needs of these "special populations," and that improved access to treatment and inclusion in more research are needed (NIAAA, Eighth Special Report to the U.S. Congress on Alcohol and Health, 1993). It is the intention of this study to contribute to increasing the knowledge and understanding of women alcoholics and their recovery process. Recent literature on women suggests several important differences between men and women, once serious drinking is initiated. Women develop alcoholism more quickly, experience alcohol-related problems such as liver disease more rapidly, and present for treatment sooner than men (Hill, 1982; Roman, 1988; Institute of Medicine, 1990; Schmidt et al., 1990). Lack of family and social support networks may cause greater conflicts for women substance abusers than their male counterparts (Beckman & Amaro, 1986; Schilit & Gomberg, 1987; Davis & DiNitto, 1996). In the psychological sphere, women alcoholics are more likely to be depressed (Conte et al., 1991), have lower self-esteem (Roman, 1988), attempt suicide more frequently (Corrigan, 1985), and report a high degree of sexual trauma and physical violence (Covington, 1982; Miller et al., 1989). Although there is increasing evidence to suggest gender differences among alcoholics and consequently the need for gender-specific treatment strategies, few controlled studies are available that support specialized services to women in treatment (see Dahlgren & Willander, 1989). The question of "what works" with women is still developing. Studies using qualitative methods have been helpful in "fleshing out the bones" on these and other findings about the recovery process of alcoholic women (for example, Lundy, 1985; Maracle, 1989; Holmila, 1991); Woodhouse, 1992; Kaskutas, 1994). These methods are particularly appropriate with special populations about which less is known (Stahler, Cohen, Shipley & Bartelt, 1993; Akins & Beschner, 1980). Women in recovery have been characterized as a "discredited group" who suffer from the double whammy of societal bias against alcoholics and against women (Kagle, 1987; Holmila, 1991; Leigh, 1995). Such negative social attitudes result in a "shame factor" that can act as a barrier to accessing information about their lives. Feminist qualitative research recognizes the impact of gender as central to the female experience and aims at correcting the invisibility of and distortions about women's lives (Swindells, 1989; Harding, 1987). This recognition has only recently been evident in the research on women's recovery from alcoholism (Davis & DiNitto, 1994). …