Introduction 1. Woman's Place in Man's Life Cycle 2. Images of Relationship 3. Concepts of Self and Morality 4. Crisis and Transition 5. Women's Rights and Women's Judgment 6. Visions of Maturity References Index of Study Participants General Index

In a Different Voice. Psychological Theory and Women’s Development. Cambridge, MA (Harvard University Press) 1982.

Recent research has shown that women and men differ in substance abuse etiology, disease progression, and access to treatment for substance abuse. Substance abuse treatment specifically designed for women has been proposed as one way to meet women's distinctive needs and reduce barriers to their receiving and remaining in treatment. However, relatively few substance abuse treatment programs offer specialized services for women, and effectiveness has not been fully evaluated. This article reviews the literature on the extent and effectiveness of substance abuse treatment programming for women and provides an overview of what is known about the components of successful treatment programs for women. Thirty-eight studies of the effect on treatment outcomes of substance abuse treatment programming for women were reviewed. Seven were randomized, controlled trials, and 31 were nonrandomized studies. In our review, six components of substance abuse treatment programming for women were examined: child care, prenatal care, women-only programs, supplemental services and workshops that address women-focused topics, mental health programming, and comprehensive programming. The studies found positive associations between these six components and treatment completion, length of stay, decreased use of substances, reduced mental health symptoms, improved birth outcomes, employment, self-reported health status, and HIV risk reduction. These findings suggest that to improve the future health and well-being of women and their children, there is a continued need for well-designed studies of substance abuse treatment programming for women.

Effectiveness Of Substance Abuse Treatment Programming For Women: A Review

OBJECTIVE: Understanding the complex diagnostic and treatment issues posed by the co-occurrence of severe mental illness and substance use disorders has become a necessary exercise in current psychiatric practice. The authors reviewed research studies from the past six years that have contributed to our knowledge about effective assessment, diagnosis, course of illness, and treatment approaches. Research on special populations, including women, persons infected with HIV, and violent patients, is highlighted. METHODS: PsycINFO, Silver Platter, and MEDLINE were used to search for English-language studies published in the United States and other countries. To augment the search, selected bibliographies were reviewed with a focus on clinical standards. Information was sought on epidemiology, screening and assessment strategies, course of illness, models of treatment delivery, and cost of care. Results and conclusions: Although estimates of the prevalence of substance use disorders vary by population, a higher...

https://ps.psychiatryonline.org/doi/pdf/10.1176/ps.50.11.1427

Co-Occurring Severe Mental Illness and Substance Use Disorders: A Review of Recent Research

This article is focused on examining social and contextual factors related to HIV-risk behavior for women. Specifically, this article has three main purposes: to review the literature on selected social and contextual factors that contribute to the risk for the heterosexual transmission of HIV and AIDS, to review and conduct a meta-analysis of HIV-prevention interventions targeting adult heterosexual populations, and to suggest future directions for HIV-prevention intervention research and practice. Results suggest that the HIV-prevention interventions reviewed for this article had little impact on sexual risk behavior, that social and contextual factors are often minimally addressed, and that there was a large gap between research and the practice of HIV-prevention intervention.

Women, sex, and HIV: Social and contextual factors, meta-analysis of published interventions, and implications for practice and research

The present study looks at patterns of drug use and alcohol use, social and economic circumstances, criminal involvement and health problems among a sample of 66 women opiate users with children. Data were collected using a structured interview. The women reported a wide range of substance use and other problems including depression. Many were heavy and regular drinkers. Most of the women were in a relationship with an opiate user: one-third reported that their partner had been physically violent towards them. Almost all of these women were living in a state of poverty. Many of the mothers were in conflict regarding their dependence upon drugs and their fears about their children being taken into care. The women who were most severely dependent upon both heroin and alcohol felt that if they sought treatment this might help them to avoid having their children taken into care. At the same time they were afraid that, by approaching treatment, this might increase the risk of their children being taken from th...

Drug-using mothers: social, psychological and substance use problems of women opiate users with children

Although the number of females served in United States treatment programs for substance use has increased over the last decade, women continue to be underrepresented. This suggests that the prevalent treatment models, which tend to be male-oriented, may not provide appropriate strategies to meet women's needs. Substance use problems in women appear to be multidetermined phenomena in which genetics, familial history, psychosocial issues, and other environmental factors play contributing roles. Working from a relational theoretical model of female psychosocial development, a continuum of expanded services addressing the entire context of women's lives is discussed.

The Needs of Women with Substance Use Problems: An Expanded Vision for Treatment

The addicted prostitute faces a risk of AIDS from both her sexual practices and intravenous drug use. While the sexual practices of these women have been studied, much less is known about their needle-using practices. We suggest women in the sex industry are more enmeshed in the drug-using scene and occupy a more constricted set of social roles than other women. They will therefore lack the resources and have fewer opportunities to engage in safer behaviors compared to women who support themselves by other means. The analysis is based on 9,055 addicted women not in treatment. Women who trade sex for money and/or drugs are less likely to use new needles on any consistent basis or to clean old needles. They are more likely to share needles with others compared to women who support themselves by other means. Three identifiable patterns of needle-using practices emerge: indiscriminate sharing, monogamous sharing with a sexual partner, and exclusive use of new needles. To reach those engaged in promiscuous sharing, needle-swapping programs must be particularly "user friendly." Where needle-using behaviors reflect an intimate relationship, the spouse/sex partner must be engaged if change is to take place. Finally, policymakers and practitioners should capitalize on the strengths and strategies of those who report they consistently use sterile needles.

Needle-using practices within the sex industry. National AIDS Research Consortium.

In three Texas cities illicit drug injectors not in treatment were located by outreach and interviewed with a standard questionnaire. In all the cities the drug injectors were predominantly undereducated and unemployed young men from minority groups. In Dallas and Houston most were Black, while in San Antonio most were Hispanic. The most frequently reported primary drug in Houston was cocaine, but in Dallas and San Antonio it was heroin. The high needle risk for AIDS and the low rates of positive HIV antibody tests in these samples present a special window of opportunity for prevention of AIDS.

Illicit drug injectors in three texas cities

HIV and drug use are higher among prisoners than the general US population. This study examines drug dependency/use and differences between prisoners who volunteered for HIV testing and those who did not in a less densely populated state. It was hypothesized that prisoners who volunteered for an HIV test were engaged in more drug use and other risky behaviors than those who did not. Survey data were collected from 600 randomly selected inmates (567 males and 33 females) from 15 state prisons. Subjects were male (95%), white (63%), never married (43%), and 44% volunteered for an HIV test since entering prison. Ninety-two percent of inmates met DSM criteria for drug dependence in their lifetime. Those who volunteered for HIV testing were 2.6 times more likely to ever have used PCP; 1.5 times more likely to ever have used cocaine; 1.4 times more likely to ever have had a problem with drugs; 1.3 times more likely to have used opiates, and 1.6 times more likely to report having been sexually or physically abused. Implications for interventions are discussed.

Deena D. Watson

Papers

The Needs of Women with Substance Use Problems: An Expanded Vision for Treatment

Needle-using practices within the sex industry. National AIDS Research Consortium.

Illicit drug injectors in three texas cities

Drug dependency and HIV testing among state prisoners