Long-Term Residential Substance Abuse Treatment for Women: Lessons Learned From Israel

Maayan Schori

Maayan Schori1, E. Lawental2,3, Y. Sapir4. 1School of Social Policy and Practice, University of Pennsylvania, United States; 2Haifa Drug Abuse Treatment Center, Israel; 3Tel-Hai Academic College, Israel; 4The Central School for Social Welfare Workers, Ministry of Social Affairs, Israel

Background: Policymakers and treatment providers must consider the role of gender when designing effective treatment programs for women substance abusers. The aims of this study were to examine women substance abusers’ perceptions regarding factors that contribute to their retention, as well as pretreatment internal and external factors (demographic, personal and environmental factors, factors associated with substance use and with the treatment process, and networks of support) contributing to retention and abstinence in a women-only treatment center in northern Israel.

Methods: Data regarding perceptions toward treatment were collected via semistructured interviews conducted in five focus groups (n=5 per group; total n=25) spanning 18 months. Participants were women living in a treatment center for at least 3 months at the time the focus group was conducted. Data examining pretreatment internal and external factors were collected from 65 women who were treated in the program during the 2-year study period. Of these, 42 were residents for more than a month and completed a battery of questionnaires. Twenty-three women who completed the program (12 months) were compared to the 19 women who did not. Nineteen of the 23 women who completed the questionnaires also completed a posttreatment follow-up 3 years later.

Results: A content analysis of the interviews revealed five central themes: factors associated with treatment entry; contribution of treatment in a women-only setting; significant aspects of treatment; difficulties with the setting; and the future. Analysis of the questionnaires revealed that compared to noncompleters, completers had fewer psychiatric symptoms; higher levels of introverted behavior in stressful situations; higher levels of resilience and a better sense of coherence; less ability to share emotions; and more peer support for entering treatment. No significant differences were found with regard to demographic and substance use factors. All 19 women who completed treatment and the follow-up questionnaire remained abstinent from illicit drugs for 3 years following the initial assessment (corroborated by treatment personnel).

Conclusions: Results indicate that women see the women-only treatment setting as extremely significant; the home, staff, and other women satisfy primary needs (identity, sense of belonging, self-value, love, and security). Also, there is a profile of psychiatric comorbidity, extrapunitiveness, and fewer personal and social resources that predict a risk for attrition. Thus, women may be identified early and treatment staff can utilize the results to assist clients in achieving their treatment goals. Results can inform policymakers in making decisions regarding the allocation of resources, by pointing to the importance of long-term women-only residential treatment in increasing positive treatment outcomes. This is particularly important in the current sociopolitical climate in Israel as it pertains to substance abuse treatment.

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Middle East
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