Gender Responsive Substance Abuse Training for Women

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Gender Responsive Substance Abuse Training for
Women
Victoria Nitcher-Sherman, LMFT Licensed Marriage
Family Therapist, Professional Trainer
Consultant

• Creating a Balance between
• Separateness Connectedness

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Gender Responsive Substance Abuse Treatment
for Women
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At the conclusion of the training, you the
learner

• Will be able to discuss why it is important to
  take gender into consideration when developing
  substance abuse treatment strategies and
  programs
• Will be able to explain how traditional substance
  abuse treatment is primarily tailored to meet the
  needs of the male client
• Will be able to explain the importance of
  integrating gender and trauma in improving care
  for both men and women

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At the conclusion of the training, you the
learner will

• Will be able to explain The basic concepts of
  Relational- Cultural Theory
• Will be able to explain Priority Access and
  Interim Services for Pregnant Women
• Will be able to utilize The Gender Responsive
  Program Self-Assessment Tool
• Will be able to list The Seven Core Gender
  Responsive Treatment Guidelines developed by
  WSPIC

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Gender Differences
Physical Differences
Psychological Differences
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Physical Differences in Drug and Alcohol Use
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Women Use for Different Psychological
Reasons
Prostitution
Relationships
Rape
To Cope
neglect
Childhood Sexual Abuse
DOMESTIC VIOLENCE
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Men Use for Different Psychological
Reasons
Intoxication
Trauma
Celebrate
Party
Social Outings
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Men and Women have Different Treatment Needs
Historically, most treatment programs were
designed for men and women were expected to fit
into the same program model.
This has not worked well because the specific
needs of women were not well attended to as a
result.
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Traditional Behavioral Health Treatment

• Traditional Treatment does not offer child care
  services.

• Traditional Treatment occurs in mixed gender
  group settings

• Traditional Treatment does not address the issues
  of trauma, domestic violence and abuse.

• Traditional Treatment does not allow you to bring
  a child into treatment

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ConnectionsRelational-Cultural Theory
No woman is an island, entire of itself every
woman is a piece of the continent. John
Donne
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Relational-Cultural Theory

• Three Major Concepts of the Theory
• Cultural Context
• Relationships
• Pathways to Growth

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1. Cultural Context
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2. Relationships
It's so Natural
Sharing Secrets
Playing Ball
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3. Pathways to Growth
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When clinicians are trying to help women change,
grow and heal from addictions, they need to
create environments in which women can experience
mutual, empathic, healthy relationships with
their counselors and with one another
Covington, 2007
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Understanding the Unique Needs of Women
2004 United Nations Research Study

• The United Nations developed a monograph on the
  treatment of drug-addicted women around the
  world. The general consensus was the following

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Personal Issues
Fear of Losing Children
Domestic Violence
Shame Embarrassment
Partners Disapproval
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Treatment Issues
Long Wait Lists
Could you choose?
On-Site Daycare
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Systemic Issues
Coordinating Treatment Services
Inadequate Housing
Education Employment
Transportation Issues
Family Planning
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Women's Services Practice Improvement
Collaborative
Designed to enhance Connecticuts current
Behavioral Health Service System for Women
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The Process Becoming More Gender Responsive
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Priority Access to Treatment
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Interim Services for Pregnant Women
Education
Referrals
Treatment
Prenatal Care
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Education about Human Immunodeficiency Virus
(HIV)
Proper treatment during pregnancy, delivery and
the newborn period can reduce the risk of
transmission to less than 1
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Education aboutTuberculosis (TB)
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Education about Alcohol and Drug use on the fetus

• Alcohol or Drugs Cross the Placenta through the
  Placenta

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Education about the risk of needle-sharing, if
applicable
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A Referral for Prenatal Care
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A referral to the next higher level of care
Partial Hospitalization
Residential Treatment
Intensive Outpatient Hospitalization
Outpatient
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Continuing the Process. . .
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Guiding Principles for Gender Responsive
Treatment Guidelines
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Core Womens Program Guidelines

1. Assessment Engagement
2. Recovery Planning
3. Clinical Treatment Program Design
4. Recovery Supports
5. General Program Environmental Features
6. Staff Competencies and Training
7. Program Evaluation

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Module 1
Assessment Engagement
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Healthcare Needs Including Children
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Important Elements to Include in the Assessment
Connecticut Sexual Assault Crisis Services, Inc.
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Recovery Planning
Module 2
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Recovery Planning
Client Name Jane Doe Date 11/10/10

1. Objectives Behavior Based Concrete
2. Client self-identifies issues with support of
   staff, develops corresponding coping strategies.
3. Promotes Self Reliance
4. Strengths-Based
5. Reviewed Revised every 90 Days

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Recovery Planning
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Module 3
Clinical Treatment Program Design
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Clinical Treatment Program Design
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Clinical Treatment Program Design
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Module 4
Recovery Supports
Stepping Stones
Making Connections
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Recovery Supports

• NEEDS SUPPORTS
• Mental Health Issues Medication Management
• Mental Health Treatment
• Partial Hospitalization
• Intensive Outpatient
• Outpatient Treatment
• Services for the Family Al Anon
• Family Therapy
• NAMI
• AA/NA
• Women for Sobriety
• Substance Abuse Treatment
• Substance Abuse Issues Methadone Maintenance
• Partial Hospitalization
• Intensive Outpatient
• Outpatient

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Recovery Supports

• NEEDS SUPPORTS
• Domestic Violence (DV) Local DV Program
• CT Coalition Against DV
• Educational Training CT Works
• Vocational Training Bureau of Rehabilitation
  Services
• Community Colleges
• Technical Schools
• Local Adult Education Programs
• Trauma Trauma Directory Local Sexual
  Assault Programs
• CT Sexual Assault Crisis Services
• Childcare Head Start
• Care 4 Kids
• 211 Info Line

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Recovery Supports
versus
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Module 5
General Program Environmental Features
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General Program Environmental Features
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General Program Environmental Features
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Module 6
Staff Competencies Training
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Staff Competencies Training
Professional Boundaries
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Staff Competencies Training
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Module 7
Program Evaluation
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Gender Responsive Substance Abuse Treatment for
WomenQUIZ

• 1. Women are more likely to develop more
  physical related problems as a result of alcohol
  use than men such as (check all that apply)
• Liver Damage
• Skin Problems
• Brain Deterioration
• Gall Stones
• Women are more likely to become dependent on
  which substances more quickly than men
• Alcohol
• Opiods
• Stimulants
• Marijuana
• All of the above

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• Women are more likely to develop dependency on
  alcohol more quickly than men because (check all
  that apply)
• They generally drink more than men
• Men have more muscle than women
• Men have more water in their body then women.
• Women have less of two important enzymes that
  break down alcohol.
• Women begin using alcohol at an earlier age then
  men.
• A womans cravings and use can be influenced by
  hormonal changes. TRUE or False
• One of the primary reasons women use substances
  is
• To be the life of the party
• Because they like the effects they get from the
  substance
• To numb memories and feelings associated with
  past trauma
• For reasons of status

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• Traditional Treatment Programs are geared toward
• Mens Needs
• Womens Needs
• Women typically form their identity through
  (check all that apply)
• Their relationships
• Their place jobs
• How well they get along with others
• Their place in the world
• 8. Women have different treatment needs than
  men?
• TRUE or False

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• Items to consider when developing Gender
  Responsive Programming for Women include (check
  all that apply)
• The kind of insurance the woman has.
• Childcare
• The ability to bring children to program with
  them
• Parenting classes
• Mixed gender group
• Trauma Treatment
• An equal number of male and female counselors
• Which of the following three are the main
  concepts of Relational-Cultural Theory?
• Trauma
• Relationships
• Pathways to Growth
• Safety
• Cultural Context

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• 11. Based on The Relational-Cultural Theory,
  what is seen as being central to womens sense of
  personhood, sense of worth, and pleasure
• Having children
• Being a good partner
• Forming and enhancing relationships with others
• When considering the Cultural Context of
  Relational-Cultural Theory, Culture serves as
• Recognition that ones race is the primary source
  of ones identity.
• A framework of values and beliefs that people use
  to organize their experiences.
• A way to define oneself just like gender or age.

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• 13. When thinking about Relational-Cultural
  Theory, which is the guiding principle of
  growth for women
• Connection
• Separation
• Womens ability to express their emotions and
  connect with others is considered a _____________
  in Relational-Cultural Theory.
• weakness
• strength
• Personal Issues associated with Womens use
  include
• Shame and guilt
• Relationship Issues
• Fear of losing children
• Trauma
• All of the above

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• 16. Obstacles to entering treatment include
  (check all that apply)
• Childcare issues
• Inability to attend treatment with their partner
• Transportation
• Taking leave from employment
• Long wait lists
• Ability to pay
• Pregnancy issues
• The following are considered Special
  Populations and are provided priority access to
  treatment by The Department of Mental Health and
  Addiction Services
• Minorities
• Adolescents
• Pregnant and Parenting Women

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• 18. The goal of DMHAS is to admit pregnant women
  within how many hours from their request for
  services
• 24 hours
• 72 hours
• 48 hours
• 36 hours
• 19. If placement of pregnant women is not made
  within the specified time frame, at a minimum,
  which of the following interim services must be
  made available to the woman?
• A referral to prenatal care
• A referral to the next higher level of care
• Education about Tuberculosis (TB)
• Education about safe sexual practices
• A referral to detox
• Education about needle-sharing
• A referral to the next lower level of care
• Education about Alcohol and Drug use on the fetus
• Education about HIV
• Education about STDs

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• 20. Which of the following are Guiding
  Principles for Gender Responsive Treatment
  Guidelines according to Dr. Covington and Dr.
  Bloom? (check all that apply)
• Community Collaboration
• Services should address substance abuse, trauma
  and culturally relevant.
• Services should be provided to the womans
  partner as well.
• Childcare should be provided
• Environment should be based on safety, respect
  and dignity.
• Environment should be decorated with women in
  mind.
• Services should address substance abuse, trauma,
  mental health and culturally relevant.
• Women should be provided transportation.
• Women should be provided with opportunities to
  improve their socioeconomic conditions.
• Women should be offered parenting classes.
• Acknowledge that gender makes a difference.

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• 21. Which of the following are Core Womens
  Program Guidelines? (check all that apply)
• Program Evaluation
• Joining and Reflective Listening
• Assessment Engagement
• Recovery Supports
• Childcare and Family Services
• Clinical Treatment Program
• Pre and Post Natal Care
• Recovery Planning
• Program Environmental Features
• Staff Competencies Training
• 22. When engaging with a client, eye contact,
  body language and communication style needs to be
  adjusted based on the womans culture and life
  experiences. TRUE or False

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• 23. An assessment
• Should be completed within the first week of
  treatment
• Is an ongoing process
• Should be completed within 72 hours of the woman
  being admitted.
• Should be completed prior to the woman
  discharging

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• Which of the following is not one of the
  Important Elements to Include in the
  Assessment?
• Scheduling a health assessment if one has not
  been completed within the last year.
• Address life skills issues
• Address Housing needs
• Address legal issues
• Assist her and her children in getting on correct
  entitlements.
• Address trauma history
• Address mental health issues
• Address gambling issues
• Assist her in obtaining her drivers license if
  she doesnt have one
• Address vocational needs
• Address eating disorders
• Address issues of grief and loss
• Address parenting issues

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• Objectives in a clients Recovery Plan should not
  be
• Concrete
• Subjective
• Behavior Based
• A Recovery Plan should
• Promote Self-Reliance
• Be Strengths-Based
• Be signed by the client
• Reviewed and revised every 90 days
• All of the above

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• It is or is not important to have childcare
  available to women during the initial.
• 28. The Program should (check all that apply)
• Provide mixed gender groups
• Provide predominantly female staff
• Be sensitive to the likelihood of trauma
• Provide transportation to the clients during
  their stay
• Have staff and décor that is reflective of its
  clientele
• Incorporate religious based services into its
  program
• 29. Recovery Supports are only important for the
  women once she discharges from treatment? True
  or FALSE

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• 30. In developing the clinical design of your
  program, it is important to
• Program staff and décor reflect the cultural
  background of clients who are seen there.
• Should include the clients spouse, regardless of
  the relationship.
• Assume that each client entering treatment has a
  trauma history.
• Should include children
• Should include the clients biological family
  regardless of the relationship.
• Should allow the woman to define her own support
  system to include in treatment.

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• 31. When working with clients, we should assist
  her in seeing how her addiction has impacted
  every aspect of her life. This includes all
  except
• Spiritual
• Employment
• Emotional
• Physical
• 32. Recovery Supports are only important
• Once the client leaves treatment
• Should be developed while the client is in
  treatment
• Should be developed while the client leaves
  treatment and identified upon discharge.

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• Which of the following are examples of
  appropriate Recovery Supports
• Faith Based Programs
• CT Works
• Domestic Violence Programs
• Recovery Centers
• Care 4 Kids
• Outpatient Treatment
• All of the above

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• Children should not be included in treatment as
  women need to concentrate and focus on their own
  issues. FALSE True
• Staff should have training that includes (check
  those that do not belong)
• Child Development
• Parenting Issues
• Trauma
• Co-Occurring Disorders
• Life Skills Issues
• Womens Issues
• The effects of substance abuse and mental health
  on children
• Vocational Training

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