Single-gender treatment of substance abuse: Effect on treatment retention and completion

Increasing emphasis has been placed on the development of gender-specific treatment programs to address the unique needs of women substance abusers. Some authors have suggested that this task can be accomplished by simply providing single-gender programs; yet others have argued that simply segregating substance abuse clients by gender has no effect on outcomes. The latter have suggested that in addition to providing women-only programs, different treatment approaches must be adopted. The purpose of the study described in this article was to investigate the effect of one agency's change from mixed-gender to single-gender treatment on client retention and treatment completion. Data were collected on 305 men and 102 women who were treated in either mixed-gender or single-gender settings. Results indicate that substance abuse treatment provided in single-gender settings does not significantly increase treatment retention and completion. These findings lend support to the contention that to improve treatment outcomes for women substance abusers, gender-specific treatment must do more than provide traditional treatment in a single-gender environment. Key words: gender; retention; substance abuse treatment ********** Although women have struggled with chemical dependency for centuries, society has generally viewed substance abuse as a male problem (Blumenthal, 1998; Goldberg, 1995). Not until feminist theory and the women's liberation movement questioned male-dominated societal norms did addicted women begin to receive attention in their own right (Kandall, 1998). Because women have been underrepresented in research studies and treatment groups, the effects of and treatment for drug abuse among women are less understood than for men (Mondanaro, 1989; Wilke, 1994). Recognition of this fact has led to an increasing emphasis on the development of treatment programs that address the unique needs of women substance abusers. Despite a number of articles describing gender-specific treatment programs (Burman, 1992; Coletti et al., 1995; Finkelstein, 1993; Finkelstein, Kennedy, Thomas, & Kearns, 1997; LaFave & Echols, 1999; Schliebner, 1994; Wald, Harvey, & Hibbard, 1995; Yaffe, Jenson, & Howard, 1995; Zankowski, 1987), few studies have examined the outcomes of these programs (Beckman, 1994; Hodgins, el-Guebaly, & Addington, 1997; Wallen, 1998). LITERATURE REVIEW It has become accepted generally that the patterns, consequences, and reasons for substance abuse are different among women and men (Lex, 1994). Studies comparing men and women in chemical dependency treatment have found that women report more psychiatric symptoms than men, more depression and anxiety, lower self-esteem, and higher rates of childhood sexual abuse (Wallen, 1992). Also, chemically dependent women differ from men in patterns, psychosocial characteristics, and physiological consequences of drug use (Nelson-Zlupko, Kauffman, & Dore, 1995). Rates of treatment entry, retention, and completion are significantly lower for women than for men, and current substance abuse treatment models are less effective for women than for men (Beckman & Amaro, 1984; Blume, 1990; Reed, 1985; Stevens, Arbiter, & Glider, 1989). Because of these differences, it is not surprising that treatment strategies designed for men fail to adequately address the needs of female substance abusers (Schliebner, 1994), thus preventing treatment programs from attracting and retaining female substance abusers (Wells & Jackson, 1992). Gender-Specific Treatment Blumenthal (1998) noted that to increase retention of women in substance abuse treatment, treatment approaches must address gender differences in the etiology and treatment of addictive disorders and respond to the unique needs of women. Gender-specific programming gives women an opportunity to concentrate on their needs and desires away from their traditional concerns of social approval and the welfare of others (Copeland, Hall, Didcott, & Biggs, 1993). …