Gender Responsive Programming

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Transcript Gender Responsive Programming

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:
1. Will be able to discuss why it is important
to take gender into consideration when
developing substance abuse treatment
strategies and programs;
2. Will be able to explain how traditional
substance abuse treatment is primarily
tailored to meet the needs of the male
client;
3. 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:
4. Will be able to explain The basic
concepts of Relational- Cultural Theory
5. Will be able to explain Priority Access
and Interim Services for Pregnant
Women;
6. Will be able to utilize The Gender
Responsive Program Self-Assessment
Tool;
7. 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
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Men Use for Different
Psychological Reasons
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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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Connections
Relational-Cultural Theory
No [wo]man is an island, entire of
itself; every [wo]man is a piece of
the continent.
John Donne
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Relational-Cultural Theory
Three Major Concepts of the Theory:
1. Cultural Context
2. Relationships
3. Pathways to Growth
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1. Cultural Context
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2. Relationships
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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 drugaddicted women around the world. The
general consensus was the following:
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Personal Issues
Fear of Losing Children
Domestic
Violence
Shame
&
Embarrassment
Partner’s Disapproval
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Treatment Issues
Could you
choose?
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Systemic Issues
Coordinating Treatment
Services
Family Planning
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Inadequate
Housing
Transportation
Issues
20
Designed to enhance
Connecticut’s 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
Education Pregnant Women
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 about
Tuberculosis (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
Gender
Socioeconomic
Status
Community
Environment
Relationships
Services
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Core Women’s
Program Guidelines
1.
2.
3.
4.
5.
Assessment & Engagement
Recovery Planning
Clinical Treatment Program Design
Recovery Supports
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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Module 2:
Recovery Planning
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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
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Recovery Supports
NEEDS
Mental Health Issues
SUPPORTS
Medication Management
Mental Health Treatment
Partial Hospitalization
Intensive Outpatient
Outpatient Treatment
Services for the Family
Al Anon
Family Therapy
NAMI
Substance Abuse Issues
AA/NA
Women for Sobriety
Substance Abuse Treatment
Methadone Maintenance
Partial Hospitalization
Intensive Outpatient
Outpatient
Local Recovery Centers
CCAR
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Recovery Supports
NEEDS
SUPPORTS
Domestic Violence (DV)
Local DV Program
CT Coalition Against DV
Educational Training
Vocational Training
CT Works
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 Women
QUIZ
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
2.
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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3.
4.
5.
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 woman’s 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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6.
Traditional Treatment Programs are geared toward
 Men’s Needs
 Women’s Needs
7.
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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9.
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
10.
Which of the following three are the main concepts of “RelationalCultural 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 women’s sense of personhood, sense of worth, and
pleasure:
 Having children
 Being a good partner
 Forming and enhancing relationships with others
12.
When considering the Cultural Context of Relational-Cultural
Theory, Culture serves as
 Recognition that one’s race is the primary source of one’s
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
14.
Women’s ability to express their emotions and connect with others
is considered a _____________ in Relational-Cultural Theory.
 weakness
 strength
15.
Personal Issues associated with Women’s 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
17.
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 STD’s
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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 woman’s 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 Women’s 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 woman’s
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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24.
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 driver’s license if she doesn’t have
one
 Address vocational needs
 Address eating disorders
 Address issues of grief and loss
 Address parenting issues
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25.
Objectives in a client’s Recovery Plan should not be:
 Concrete
 Subjective
 Behavior Based
26.
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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27.
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 client’s spouse, regardless of the
relationship.
 Assume that each client entering treatment has a trauma
history.
 Should include children
 Should include the client’s 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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33.
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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34.
Children should not be included in treatment as women need to
concentrate and focus on their own issues. FALSE True
35.
Staff should have training that includes: (check those that do not
belong)
Child Development
Parenting Issues
Trauma
Co-Occurring Disorders
Life Skills Issues
Women’s Issues
The effects of substance abuse and mental health on children
Vocational Training








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