Gender-sensitive treatment services for women can lead to better employment outcomes, even when vocational training and guidance is not included as a defined component of the substance use treatment program. This encouraging conclusion resulted from a federally supported study involving 13 intensive inpatient facilities in Washington state, published online last month in the Journal of Drug Issues.
What makes the study results even more striking is that the study period spanned four years in the mid-2000s, when a national economic downturn had dimmed many individuals' job prospects. “I think it's pretty impressive that any result was found,” says Wendy Kissin, lead author of the study and a psychologist at Westat, a Rockville, Md.-based social sciences and statistical analysis firm.
For this phase of a National Institute on Drug Abuse (NIDA)-funded study that previously reported encouraging criminal justice outcomes for women after gender-sensitive treatment, the research team had hypothesized that women receiving services in more gender-sensitive programs would be more likely to be employed over a two-year period following treatment.
In order to analyze treatment programs' gender sensitivity, researchers visited treatment sites and interviewed administrators and clinicians. They evaluated the programs, all of which provided 30-day inpatient services in Washington state, utilizing a quantitative measure based on domains used in a model established by Christine Grella, PhD, a professor at UCLA Integrated Substance Abuse Programs: orientation and staff training, women's and general services, and physical environment.
Women's and general services, covering numerous areas such as life skills, assertiveness training, counselor availability, and establishment of a post-treatment housing plan, were weighted more heavily in the analysis, says Kissin. “That's actually what comes out in the application of a gender-sensitive approach,” she says in reference to services.
The evaluated programs received gender sensitivity ratings of low (three programs), moderately low (three programs), moderately high (four programs), or high (three programs). “This is only 13 programs, but they really did vary,” says Kissin.
The study sample included more than 5,100 women in the mixed-gender inpatient programs; their average age was just over 34 and 76% were Caucasian. Alcohol and methamphetamine were the most prevalent substances used in the past 30 days among the group, and more than half of the women reported experiencing a recent and troubling mental health problem. These women were eligible to receive publicly supported treatment services in these programs.
The researchers also evaluated men's employment outcomes in these treatment programs, in order to control for confounding based on overall quality differences among the programs.
Researchers found that women who received services in the more gender-sensitive programs were more likely to be employed after 12 months, but this effect dissipated over the course of the second year and was not apparent at 24 months. Still, Kissin believes the effect remains noteworthy in that it occurred during a recessionary period, as well as from treatment stays lasting only 30 days (as opposed to a long-term residential program).
“An intensive 30-day program is basically just intended to get you on to the next step [in recovery],” she says.
Moreover, the journal article states that “few of the participating [intensive inpatient] programs reported offering vocational services to women such as vocational planning (n=5), vocational training (n=1), or help finding paid employment (n=1). It may be that as the recovery process begins and substance use decreases, employment-related activities can begin.”
Kissin believes the findings of this analysis speak to what can be accomplished for women in programs that are mixed-gender but also gender-sensitive. This constitutes an important finding because most women's treatment services are delivered in mixed-gender settings, not gender-separate ones.