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Gender factors matter in the treatment setting

May 15, 2013
by Gary A. Enos, Editor
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The “Mars and Venus” syndrome related to the genders certainly seems to apply to the addiction treatment and recovery milieu. As CLARE Foundation director of clinical services Matthew Healy says, “The old joke is that if a man in recovery gets a job and a flat-screen TV, he can make it in the world.” That simple recipe likely wouldn’t work for a woman.

The Santa Monica, Calif.-based residential and outpatient treatment facility learned a great deal about the need for gender-focused services two years ago when it examined results of a program evaluation for federally funded services at the agency. While men and women as a group both had shown significant improvement on illness domains such as hostility, anxiety and depression, women in much greater numbers were reporting low satisfaction with their quality of life post-treatment. It was widely speculated that this was happening because women were returning to personal relationships that were not improved and therefore were not conducive to a lasting recovery.

These evaluation results helped to sharpen CLARE Foundation’s focus on gender-specific treatment approaches in its programming, and this week Healy and colleague Jennifer Musselman will present a session titled “Mars & Venus in Addiction: The Dangers of Ignoring Gender Differences in Substance Abuse Treatment” at the annual conference of the California Association of Marriage and Family Therapists.

Looking back on what her agency was seeing in outcomes a couple of years ago, Musselman says, “Women who came to treatment tended to leave treatment earlier and in greater numbers.”

As part of its response, an agency that once had embraced gender-separate therapy groups and then had switched to mixed-gender groups decided to turn back to the gender-separate mode once again.

“When we went to the single-gender groups, we expected a lot of complaints from the men,” says Healy. “But the men actually became more responsive. They found it less distracting, and they didn’t talk in group to promote themselves.”

Similarly, women in single-gender groups were seen as less reluctant to bring up highly personal topics related to sex, pregnancy or menopause. “This can be embarrassing, and the women don’t think a man can relate to the discussion,” says Musselman, who is program director of the Conscious Recovery by CLARE initiative.

Still, a major goal of treatment at CLARE Foundation involves giving clients in single-gender groups some tools that they can apply to life in the mixed-gender world to which they will be returning after treatment.

Training clinicians

Even with the need to consider gender factors broadly in treatment, Musselman and Healy urge clinicians to look at each client as an individual. They say that in their May 17 presentation at the California Association of Marriage and Family Therapists’ 49th annual conference in Sacramento, they will ask audience members to consider their own personal stereotypes about what it means to be a man or a woman, and how those notions might affect the way they deliver services.

They also plan to discuss in their presentation some of the differences in clinical approach that could be beneficial, such as with differences in men’s and women’s willingness to open up about feelings.

Healy says the results of the Substance Abuse and Mental Health Services Administration (SAMHSA) program evaluation have helped to transform clinical care at his organization. CLARE Foundation has found as of late that women as a group are not leaving treatment to the extent they were in the past, and there are fewer differences in medical outcomes between the genders as well.

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