Experiences of Drug Use and Parenting among Women in Substance Abuse Treatment: An Exploratory Study

The purpose of this exploratory study was to explore the multiple contexts of vulnerability, drug use and parenting for women in substance abuse treatment. Nineteen purposively sampled women provided qualitative data through semi-structured interviews. Findings revealed that adverse childhood experiences and intimate partners were important pathways into drug use initiation. Identities as mothers emerged as a key finding, intimately linked to women's motivation to seek and complete treatment. Understanding the challenges to recovery among mothers in treatment is an important priority for social workers. This study highlights the complexity of women's experiences and suggests implications for future practice and research.     

Creating a Family Centered Wellness Team: Lessons learned in creating an integrated continuum of care for families facing homelessness,addiction, and trauma recovery.

Abstract

Homelessness is often experienced by women and children, and recent evidence suggests that women and children are the fastest growing segments of the homeless population. Homelessness is often accompanied by mental illness, substance abuse, and histories of violence, for both women and their children. While trauma informed care has been incorporated into women's treatment systems there has not been widespread application of this knowledge to family centered work with homeless families. This paper explores the need for family strengthening approaches and identifies one model currently being evaluated that seeks to decrease service fragmentation, increase positive family interaction, and deepen the family's connections with each other and with the community.     

Assessing Social Work's Contribution to Controlled Studies of Adolescent Substance Abuse Treatment

ABSTRACT

Findings from a review of social work's contribution to the adolescent substance abuse treatment outcome literature between 1990 and 2001 are presented. Social work involvement in adolescent substance abuse treatment was evaluated through a computerized bibliographic search of medical and social science databases and by a manual search of 13 core social work journals. Results indicate that social work has contributed little to knowledge development in adolescent chemical dependency treatment. Investigators affiliated with a department or school of social work accounted for three of 15 controlled treatment outcome studies. Only one report was published in a core social work journal. Efforts to develop clinical guidelines in this important practice domain will founder until a sufficiently directive body of practice-relevant research accumulates to guide evidence-based substance abuse treatment for adolescents.     

Culturally Competent Substance Abuse Treatment for Asian/Pacific Islander Women

Summary

In response to the urgent need for substance abuse treatment among pregnant and postpartum Asian/Pacific Islander (A/PI) women, heath care and social service providers in a rural community of Hawaii established a culturally based, women-centered residential treatment program. The program was designed to address barriers that often prevent A/PI women from engaging and completing treatment. Treatment included Hawaiian healing practices or deep cultural therapy, provision for newborns to live with their mothers, infant health-care services, parent education, and infant-mother bonding guided by kupu-na (elders) of the community.

Analysis of twenty-one in-depth interviews revealed factors that A/ PI women participants found vital to their treatment process: having their children with them in a non-punitive, mutually respectful treatment milieu; working with consistent, competent residential staff and culturally-sensitive interdisciplinary professionals; and involvement in a range of substance abuse interventions, including cultural healing practices.

Findings underscore the importance of learning about and affirming women's lived-experiences and cultural contexts in the development of culturally competent practice models, interventions, research procedures, and policies that focus on the complex needs of chemically dependent pregnant and parenting women (Brindis & Theidon, 1997).     

Predictors of employment among sheltered homeless women

The effect of homelessness on the psychological and physical health of women is damaging and long lasting. Understanding of the personal factors that enable homeless women to secure employment and re-enter mainstream society is of utmost importance. A sample of homeless women residing in a US Midwestern nonprofit treatment and transitional living shelter for homeless women and their children were surveyed regarding the extent to which life satisfaction, social self-efficacy, and hopeful thinking predicted women's expected capabilities to obtain employment above and beyond social support provisions, while controlling for participants' age, ethnicity, and education level. Findings failed to reveal that social psychological (i.e., life satisfaction and social self-efficacy) and intrapersonal (i.e., hope) variables predicted homeless women's job procurement self-efficacy above and beyond perceived social support. The social support provision of social integration and younger age significantly predicted women's self-efficacy to secure employment. Implications of results for social justice initiatives and interventions are discussed.     

Women's Spirituality: A Proposed Practice Model

SUMMARY

The values and spirituality of clients are an important area for social workers, counselors, and other mental, health professionals to consider in their work. This article addresses the need for professionals to be sensitive to this aspect of growth and development for all clients. Noting that until recently, religious writings have tended to reflect a male-centered bias and patriarchal values, issues related to women's spirituality are identified, implications for therapeutic interventions are discussed, and a model for understanding and facilitating women's spirituality is proposed.     

Violence Against Homeless Women: Safety and Social Policy

Abstract

Over the past 20 years there has been increasing understanding of the gendered nature of homelessness in Australia. Most significantly, this gendering has occurred through the acknowledgement of the links between domestic violence and homelessness and this has played out in Australian social policy through the funding of specialist domestic violence services. However, not all women are assisted by these specialist services—either because they are not homeless due to domestic violence, or because they fall through the gaps in the service system. Homelessness exposes these women to heightened vulnerability to violence. This article considers homeless women's experiences of violence and their implications for homelessness policy. Framed by Australian and Victorian social policy and drawing on a qualitative study of 29 women, all of whom had experienced violence during homelessness, the article argues that greater policy attention needs to be paid to ensuring homeless women's safety.     

Battered Immigrant Mexican Women's Perspectives Regarding Abuse and Help-Seeking

SUMMARY

A qualitative, pilot study employing in-depth ethno-graphic interviews was conducted to examine perceptions and attitudes towards abuse and the help-seeking behaviors of a sample of ten battered immigrant Mexican women. Findings indicated that participants' attitudes about seeking help were influenced more by cultural factors (e.g., gender-role expectations, famialism) than by psycho-social stres-sors (e.g., immigrant status, financial dependency). Children's welfare played a salient role in women's decisions about seeking help, both as a deterrent and a motivating factor. Women's attitudes about their own abuse were more tolerant than their attitudes about hypothetical situations involving others. Changes in women's attitudes about abuse reflected changes only after some type of intervention had taken place. The majority of the women in the sample had misconceptions or were uninformed about shelters. Suggestions for further research and intervention with this population and a model of internal and external determinants of help-seeking behavior are presented.     

Resources,Family Organization,and Domestic Violence Against Married Women in Minya,Egypt

I evaluate the influence of household wealth, women's socioeconomic dependence, status inconsistency, and family organization on physical abuse in the prior year and attitudes about wife abuse and divorce among 2,522 married women in Minya, Egypt. Household wealth is negatively associated with physical abuse. Women who are dependent on marriage because they have sons and less schooling than their husbands are more likely to have experienced physical abuse and to report marginally more tolerance for such abuse. Women who are isolated from natal or biological kin and living with marital relatives are more likely to have experienced physical abuse. Findings underscore the role of women's dependence and social isolation in enabling physical abuse among women of all economic classes.     

Homelessness and Substance Abuse: Which Comes First?

Abstract

The present paper uses a social selection and social adaptation framework to investigate whether problematic substance use normally precedes or follows homelessness. Clarifying temporal order is important for policy and program design. The paper uses information from a large dataset (n=4,291) gathered at two services in Melbourne, supplemented by 65 indepth interviews. We found that 43% of the sample had substance abuse problems. Of these people, one-third had substance abuse problems before they became homeless and two-thirds developed these problems after they became homeless. We also found that young people were more at risk of developing substance abuse problems after becoming homeless than older people and that most people with substance abuse issues remain homeless for 12 months or longer. The paper concludes with three policy recommendations.     

Shattering the Myth of Invulnerability: Exploring the Prevention Needs of Sexual Minority Women Living with HIV/AIDS

Developing effective safer-sex programs for women living with HIV/AIDS (WLH/A) is a national HIV prevention priority. Existing programs focus predominantly on heterosexual women's experiences and ignore the needs of sexual minority women (SMW). Thus, we conducted semi-structured interviews with 16 sexual minority WLH/A to better understand their sexual risk behaviors and corresponding HIV prevention needs. Most of the interviewees were African American (75%) and poor (75%). We used strategies of Grounded Theory to code the interviews for key themes, which included the following: differences between relationships, risk, and protective behaviors in male and female relationships; links between substance abuse and unsafe sex; need for safer-sex or prevention programs to address SMW-specific skills and topics; and the importance of addressing women's resiliency and the social context of women's risk in prevention programs. Conclusions include concrete suggestions to make safer-sex programs more responsive to the needs of SMW.     

Women's Experience of Co-Occurring Substance Abuse and Mental Health Conditions

ABSTRACT

This study explored the relationship between gender and co-occurring substance abuse and mental health conditions among a sample of 754 consumers of behavioral health services in the southwest U.S. Logistic regression was used to determine factors that would predict women's unique experience of dual diagnosis. Women were almost seven times more likely than men in this sample to have a diagnosis of posttraumatic stress disorder in conjunction with substance abuse. Women were also significantly more likely to experience anxiety and mood disorders and to have been married. Implications of these findings for social work practice are suggested.     

Best Practices in the Treatment of Substance-Abusing Women in the Child Welfare System

ABSTRACT

This paper reviews the literature on women's chemical dependency and its effects on their children. Many risk factors (e.g., a history of traumatic exposure) and consequences (interference with parenting) of substance abuse are unique for women, giving rise to special treatment needs of substance-abusing women with children. Substance-abusing mothers also experience unique barriers to receiving the services they need to recover, such as absence of child care and lack of gender-specific treatment in their communities. Model programs are described and recommendations are offered for best treatment practices for women with chemical dependency who present in the child welfare system.     

Survivors of Woman Abuse

Abstract

The feminist social work and related literature on abused women has focused on women's processes of empowerment but has overlooked the question of women's movement from individual survival to collective resistance. In this feminist qualitative study, I explore the processes through which survivors of abuse by male partners become involved in collective action for social change. Using story telling as a research method, I interviewed 11 women about the processes, factors, insights, and events that prompted them to act collectively to address violence against women. I found that women's movement from individual survival to collective action entails significant changes in consciousness and subjectivity. Women's processes of conscientization are complex, contradictory and often painful because they involve political and psychic dimensions of subjectivity, protracted struggles with contradictions and conflict, and resistance to knowledge that threatens to unsettle relatively stable notions of identity. I suggest that feminist social work theory and practice must take into account three interrelated elements of women's transformative journeys: the discursive and material conditions that facilitate women's movement to collective action; the social, material and psychic costs of women's growth; and the multifaceted and difficult nature of women's journey in recognizing and naming abuse, making sense of their experiences, and acting on this knowledge to work for change. I recommend that feminist social work practice with survivors recognize that survivors can and do contribute to social change, and develop new, more inclusive liberatory models of working with survivors of abuse.     

Sexual Revictimization in Adult Women: Examining Factors Associated with Their Childhood and Adulthood Experiences

Using data collected from a sample of adult women (n = 234), this study examined the relationship between the experience and disclosure of childhood sexual abuse and subsequent adult sexual violence. Multivariate analyses revealed that physical force during the childhood sexual abuse experience was significant in both children's decisions to disclose as well as in adult revictimization experiences. Furthermore, childhood disclosures were significantly associated with adulthood disclosures about revictimization, but only when there was no action following the childhood disclosure. The implications for enhancing training and education about understanding and responding to children and women's disclosures about sexual violence are discussed.     

Risk Factors for Homelessness Among Lesbian, Gay, and Bisexual Youths: A Developmental Milestone Approach

Lesbian, gay, and bisexual (LGB) youths are over-represented in the homeless population. To examine why some LGB youths become homeless, this report compares homeless and non-homeless LGB youths. Of the 156 LGB youths, 48% reported ever being homeless (i.e., running away or being evicted from home). Results indicate that sexual orientation awareness and the initiation of sexual behavior occurred earlier in homeless than in non-homeless LGB youths and predated the first homeless episode. Substance use was more frequent and first occurred at an earlier age in homeless as compared to non-homeless LGB youths; however, substance use occurred subsequent to first homelessness. Childhood sexual abuse was associated with homelessness; and, early sexual orientation development was related to homelessness among youths without a history of sexual abuse. Findings suggest that interventions should help youths cope with their unfolding sexual orientation and work to prevent or address the consequences of sexual abuse.     

Characteristics of Homeless Alcohol and Drug Abusers Identified Through an Assertive Outreach Program

Differences between substance abusers and non-abusers, and among abusers of alcohol, drugs, or both substances, were investigated for 1166 persons identified as homeless or at risk of homelessness by an assertive outreach program in a moderate size city. The 603 self-reported substance abusers included disproportionate numbers of male, Black, unmam'ed, and currently homeless persons with a history or symptoms of mental illness, who expressed a primary need for assistance dealing with the social seIVice system. Type of abuse was associated with demographic charaeten'stics, length of homelessness, mental illness status, and primary expressed needs. An accurate picture of subgroup differences can aid design and delivery of services for the homeless.     

Latina and African‐American Girls in the Juvenile Justice System: Needs,Problems, and Solutions

This review focuses on Latina and African‐American girls in the juvenile justice system with a special emphasis on their mental health, substance abuse, and treatment needs. Like many young women in the juvenile justice system, Latina and African‐American girls often have histories of neglect, abuse, and trauma, which contribute to later mental health and substance abuse issues. Despite these histories, juvenile justice professionals sometimes rely on stereotypes rooted in cultural deficit thinking to explain Latina and African‐American girls' delinquency. Relying on gendered, racialized, and classed stereotypes and assumptions can result in decisions that negatively impact Latina and African‐American girls' access to mental health, substance abuse, and other types of treatment. Policy and practice implications for better addressing the needs of Latina and African‐American girls are discussed.     

Recovery Processes in a Treatment Program for Women

ABSTRACT

Recovery processes of 32 women were explored in six focus groups following completion of treatment in a community based women-specific substance abuse group program. Grounded theory analysis yielded an over-arching theme of Building a House of Recovery and several sub-themes describing women's perceptions of the processes that were central to their recovery.