After completing treatment for a substance use disorder (SUD), female patients frequently go back to their lives with a hopeful attitude and the expectation that previous relationships can be resumed without too much of a change. However, if problematic intimate relationships, sexuality, and family conflicts are not dealt with effectively or not addressed at all, the relapse risk is high.
“Addressing the nature of a patient’s relationships is paramount in addiction treatment, for women in particular,” says Sarah Franklin, the clinical manager of the Women’s facility at Lakeview Health. “Women tend to be more relationship oriented than men.” The Rose of Lakeview, the women’s addiction treatment center at Lakeview Health, primarily uses Stephanie Covington’s gender-responsive treatment model to treat addiction in women. Dr. Covington’s Helping Women Recover program addresses four key areas in separate modules: the self, relationships, sexuality, and spirituality.
“From the perspective of the Relational Model, some women use alcohol and other drugs in order to make or keep connections,” writes Covington. “Finkelstein (1993) suggests that designers of programs for addicted women need to take into account (1) past family relationships, (2) current family relationships, and (3) relationships with friends and partners, and (4) relationships developed within the treatment context.”
The Rose was designed with number 4 in mind. “Little things can have a big impact. For example, when the women come out of detox, they all share the spa bathroom together,” says Franklin. “We didn’t build the spa just to have a beautiful space. We built it so that the women are encouraged to spend time with positive peers. In our dining room, we have a lot of family-style tables to make it a place where women want to hang out and foster positive relationships.”
Learning to build healthy relationships in rehab will help female patients stabilize their recovery after discharge. Frequently, toxic relationships paved the way for their addiction. As Covington explains:
“First, male partners often introduce women to drugs. Many women start using substances in order to feel connected with addicted lovers, or they drink because their boyfriends urge them to. Second, whether or not a male partner first encouraged a woman’s drug use, he often is her supplier once she is addicted. Third, addicted women’s lives are full of men who disappoint them, do not provide for their children, and go to jail. These women long for the fathers of their children to provide emotional and financial support, but such longings often lead to disappointment and solace in drug use.”
Scenarios like these need to be addressed in treatment. If the reason for the SUD was self-medicating stress caused by relationships, then leaving such relationships unchanged is a recipe for disaster.
Too many women still base their identity on the gender roles they were socialized to play: wife, mother, or daughter. “In treatment, we try to help them figure out who they are as individuals,” says Franklin. “If they go back to their relationships we want them to have their own voice and autonomy because they are going to need that for their recovery.”
It is especially problematic if the partner is in active addiction himself. “Going back to such a situation is extremely risky,” warns Franklin. “It’s a lot easier for a woman to fall back into playing the same role in the relationship if her partner is still in active addiction. If both parties are willing to work on their recoveries in separate programs with different therapists and different sober living facilities, it could work. We’ve seen marriages succeed that way.”
Effective addiction treatment should include rebuilding and setting healthy boundaries—for all parties involved. The family has a central role to play in the treatment of substance use disorders. Parents and life partners should help addicted loved ones by being compassionate supporters. Ideally, they get actively involved in the treatment process. Lakeview Health offers families the opportunity to participate in a three-day family workshop. The workshop consists of group sessions with several families.
“Addiction is a relationship that constricts a woman’s life,” writes Dr Covington. “The task in helping a woman to recover, then, is to help her transfer her need for relationship to sources of growth-fostering connections.”
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