Effective Treatment for Women with Substance Use Problems

Aurora Centre’s approach

Gail Malmo, MA, MSW

Reprinted from "Women's" issue of Visions Journal, 2004, 2 (4), p. 43-45

Background

The Aurora Centre has been providing treatment to women with substance use problems for over 30 years. Throughout these years we have worked with over 6,000 women from all regions of the province, from all walks of life, and they have all shared the same problem: serious addiction to alcohol and/or other drugs

The growth and development of the Aurora program to some extent mirrors that of the substance use field generally. In our early days, in the ’70s, we were a grassroots organization, with volunteers and good intentions as the dominant treatment modality. As knowledge of effective substance use treatment practices developed, Aurora refined and changed its practices and approaches. Today, we offer a highly professional treatment program based on ‘best practices’ and ongoing evaluation of client outcomes and client satisfaction.

In addition to research and best practice literature, we rely on the women we serve and what they tell us about what has helped them most. Underlying our approach is an abiding belief in the ability of our clients to reclaim what they have lost during their addiction and to uncover and discover their real, beautiful selves as the mothers, daughters, sisters and partners that they are.

What does treatment at Aurora Centre look like?

We know that the process of addiction, treatment and recovery is different for men and women. It is therefore crucial that women have the option of a women specific treatment facility. At Aurora, women find a physically and emotionally safe and supportive environment in which to address their substance dependency. The centre offers both residential and day program treatment options.

Many-issues approach

Our approach is based on the belief that effective treatment includes helping women understand and address the many issues underlying their use of substances. Issues common to women experiencing substance use problems include:

  • Previous history of trauma

  • Mental health problems, with depression being one of the most common

  • Issues of guilt and poor self-esteem

  • Relational issues—with spouses, partners, families and children

  • Poverty, discrimination and lack of power and control over their lives

Using a biopsychosociospiritual model, the Aurora program assists women in treatment to understand the connection between the above issues and their use of substances. The women come to realize how they may have used substances to cope with, and numb, the pain they are experiencing in their lives. We help them make the connection between their substance use histories and issues such as grief and loss, unhealthy relationships, family patterns, and sense of self. As they begin to understand these connections, the women are able to better identify their potential relapse triggers and to develop a solid plan for long-term recovery.

One of the most important gains our clients make is the connection with other women. Isolation is common in the process of addiction, and being able to establish deep bonds with other women is a significant factor in women’s recovery.

Residential treatment

Our residential program is six weeks long. Using a combination of group therapy, education sessions, videos and individual counselling, we help our clients set goals and work toward improving their emotional, physical, mental and spiritual lives. Women are supported in taking healthy risks to change their behaviour, improve communication skills and develop greater self-aware ness and understanding of their patterns of use. In keeping with our holistic approach, clients also participate in regular fitness programs, yoga and meditation, and music and art therapy. In the last week of treatment, clients focus on preparing to return to their lives outside Aurora Centre. This includes developing a relapse prevention plan.

Day treatment

Aurora offers day treatment to women who live within commuting distance of Vancouver. Women may choose our five-week intensive program or a two-week program designed for women in early recovery. Day treatment is ideally suited to women who have stable home lives and who do not require the structure and support of a residential environment. Our day programs are similar in approach to our residential program.

Barriers to getting help

Treatment works. We see evidence of this every day at Aurora. But the process is not always smooth, and women often encounter numerous barriers to receiving the help they need.

The field of substance abuse treatment is beginning to recognize that important differences exist between men and women’s risk factors for use, patterns of use, and their treatment needs. While the rate of women’s substance use is lower than men’s, women are more vulnerable than men to some serious health consequences. For example, because of the way women absorb and metabolize alcohol, they are more vulnerable to organ-related damage than are men.1 That women may experience more serious consequences from substance use despite overall lower levels of use than men, suggests that seeking and receiving treatment early is of vital importance.

Unfortunately, women tend to face more barriers to accessing treatment than men do. Some of these barriers are external (e.g., lack of family support, lack of accessible treatment resources) and some are internal (e.g., the woman’s own perception of her problem, her self-worth).

A study done by our research consultant Nancy Poole found that the two biggest barriers to treatment identified by women interviewed were shame (internal barrier) and fear of losing their children (external barrier).2 The issue of stigma continues to be an important factor for women who misuse substances, and it is compounded by their role as primary caregivers of children. Women tend to internalize this stigma, which results in feelings of severe worthlessness and shame. This often prevents them from reaching out for help. And it is not difficult to see how the fear of losing their children —a very real, and very terrifying concern for many women—prevents them from stepping forward and admitting to serious addiction problems.

It is exceedingly important that human service and health care professionals working with women understand these barrier dynamics, and that they provide both non-judgemental support to help women acknowledge harmful substance use and to guide them in identifying appropriate treatment resources.

Measuring Success

Measuring success in addiction treatment isn’t easy. It is not enough to simply measure abstinence rates, for there are many other elements in a woman’s life that need to change if she is to sustain the gains made in treatment. In addition to abstinence rates, Aurora measures how well women who have completed treatment are doing in the following:

  • Overall improvement in physical health, emotional health, spiritual life, vocational status and legal status

  • Improvements in relationships with partners, families and children

  • Continued participation in alcohol/drug counselling, self-help groups or other support groups/counselling

Success in managing substance use appears to correlate with improvements in the above areas. In 2003, an average of 88% of both day and residential treatment clients reached reported either abstinence, or a brief relapse followed by a return to abstinence, at three months post-treatment. At the time of discharge from Aurora, the vast majority of these women had shown marked improvement in their self-esteem and depression levels, as well as their sense of hope for the future.

While a successful treatment outcome for women with substance dependency problems is not always straightforward or guaranteed, we do know that treatment readiness and client motivation are two factors which have a great impact upon treatment outcomes. The Aurora Centre relies on professionals working with women prior to admission to assess these factors, and as much as possible, to ensure that a referral to Aurora is the right treatment at the right time.

We know too, that, as has often been said, treatment is a journey, not a place. Our clients leave Aurora with an array of new skills, and renewed self-confidence in their ability to live a full and satisfying life free from the harms of addiction. Above all, they take with them the sense that they are worthy of a better life.

But treatment is only one step on the journey to full recovery. We know that the women who complete our treatment programs need ongoing practical and emotional support as they rebuild their lives in their respective communities. It is our hope that they find this support where and when they need it. With the right combination of effective treatment, together with an array of aftercare services, women can and do recover from the harms caused by addiction.

 
About the Author

Gail is Program Director at Aurora Centre in Vancouver

Notes

For further information about Aurora Centre programs, or to refer a woman to Aurora, email aurora@cw.bc.ca, or call (604) 875-2032

Footnotes
  1. National Institute on Alcohol Abuse and Alcoholism. (1999). Are women more vulnerable to alcohol’s effects? Alcohol Alert, 46. Retrieved November 15, 2004, from www.niaaa.nih.gov/publications/aa46.htm

  2. Poole, N. & Isaac, B. (2001). Apprehensions: Barriers to Treatment for Substance-Using Mothers. Vancouver, BC: British Columbia Centre of Excellence for Women’s Health.

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