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Women Across the Life Span: A National Conference on Women, Addiction and Recovery (July 12-13, 2004)


Welcome and Opening Keynote Address

H. Westley Clark, M.D., J.D., M.P.H., CAS, FASAM
Director, Center for Substance Abuse Treatment (CSAT)

Dr. Clark, as Director of the Center for Substance Abuse Treatment (CSAT) under the Substance Abuse and Mental Health Services Administration (SAMHSA), leads the Center’s national effort to provide effective and accessible treatment to all Americans with addictive disorders. In his opening remarks, Dr. Clark will provide an overview of CSAT’s history and future direction on women’s issues, highlighting the importance of addressing the concerns of women with multiple needs across the life span. He also will discuss key findings from recent CSAT projects and their implications for treatment providers serving women and their children and families.

View Dr. Clark's PowerPoint Presentation
Watch Video: Windows Real


Plenary Sessions

Gender Differences in Drug Abuse Across the Life Span

Cora Lee Wetherington, Ph.D.,
Women and Gender Research Coordinator, National Institute on Drug Abuse

In the past several years, the National Institute on Drug Abuse (NIDA) has been actively promoting a research agenda on women, gender differences, and drug abuse. As recently as a decade ago, NIDA’s research efforts rarely focused on gender differences. Today, however, NIDA supports gender-differences research in all its major program areas. And this research is repeatedly showing that gender matters in the etiology, consequences, prevention, and treatment of drug abuse. Dr. Wetherington highlights selected findings on gender differences that have emerged in the past few years. Topics include a new look at gender differences in the epidemiology of drug abuse, differences emerging in animal behavioral studies, differences in the pathways and progression to drug abuse, and implications of gender differences for treatment.

View Wetherington PowerPoint Presentation
Watch Video: Windows Real


Treating Co-Occurring Disorders Across the Life Span


Sheila B. Blume, M.D.,
State University of New York, Stony Brook

Psychiatric disorders that co-occur with substance use disorders are a common phenomenon, both in the general population and among patients in treatment. Dr. Blume reviews definitions of “dual diagnosis” and the history of our thinking about co-occurring diagnoses, as well as highlight the complex relationships between the two types of disorders when they are present in the same patient. The epidemiology of dual diagnosis is reviewed, including a discussion of the higher prevalence rates among women and caveats for how best to interpret and understand the data.

Dr. Blume also discuses how to evaluate patients for co-occurring disorders, emphasizing the variation of diagnoses across the life span and the importance of primary versus secondary diagnosis distinction. The use of a timeline is illustrated. General principles of treatment also are discussed, along with the need for combined or coordinated services and the importance of communication with patients, mutual-help groups, families, and other service providers who are involved in trying to help these difficult but rewarding patients.

View Blume PowerPoint Presentation

View Blume Bibliography

Watch Video: Windows Real


Expert Panel on Trauma-Informed Services

Norma Finkelstein, Ph.D., LICSW
Executive Director,
The Institute for Health
and Recovery
Cambridge, MA

Vivian B. Brown, Ph.D.,
Chief Executive Officer,
PROTOTYPES
Culver City, CA

Maxine Harris, Ph.D.,
CEO for Clinical Affairs,
Community Connections
Washington, DC

This expert panel provides participants with information on the interrelatedness of substance abuse and trauma and why an understanding of trauma is essential to provide effective treatment. Presenters address why trauma-informed services are critical and how not paying attention to issues of trauma can be harmful to clients. The presentation outlines three different ways for understanding what it means for a system to be trauma informed and offer suggestions as to which service venues may be the best match with which approach. Steps in trauma recovery, are integrated with substance abuse recovery, and presenters discuss issues of engagement, therapeutic alliance, life narratives, and restoration of hope.

View Finkelstein PowerPoint Presentation

View Brown PowerPoint Presentation

View Harris PowerPoint Presentation

Watch Video: Windows Real

 

Workshop Sessions

A.1 Readiness of the Workforce To Offer Gender-Specific Services
This workshop focuses on how better to prepare the workforce to train staff and implement state-of-knowledge services for women. Speakers discuss what is needed to provide effective treatment for women, in the context of the skills, composition, concerns, and needs of treatment agencies and their staff. Issues discussed include recruitment and retention of qualified people, crucial to delivering gender-specific treatment, and challenges that the treatment workforce faces (e.g., different types of treatment settings, diverse client groups, varying credential requirements, staff with varying disciplines and backgrounds).

Presenters:
Karen Mooney, LCSW, CAC III
Alcohol and Drug Abuse Division, Colorado Department of Human Services
Denver, CO

Nancy Roget, M.S.
Mountain West Addiction Technology Transfer Center (ATTC)
Reno, NV

View Mooney/Roget PowerPoint Presentation

A.2 Residential Women’s Treatment: Cost-Benefit and Outcome Findings From a CSAT Cross-Site Evaluation
In this workshop, the presenter discusses findings from a cross-site, longitudinal evaluation of CSAT’s residential women and children and pregnant and postpartum women programs. The presentation focuses on findings relating to the costs and benefits of this treatment approach—overall and for subpopulation groups of particular policy interest. Outcome findings on various topic areas also are discussed.

Presenter:
Kenneth Burgdorf, Ph.D.
Independent Consultant/Evaluator
Derwood, MD

View Burgdorf PowerPoint Presentation

View Cost Benefits Findings

View Cost Benefits Methodologies

A.3 Engaging Male Partners and Families in Recovery
This workshop provides participants with a better understanding of the importance of relationships in women’s lives and in their addiction and recovery, explores strategies for helping women understand the connection between intimacy and substance use or abuse, and presents strategies for safely engaging partners in women’s recovery. Presenters highlight two effective programs that not only help the client develop models for healthy relationships, but also attempt to involve women’s partners and their families in the recovery process. Presenters discuss the strength of partners, family members, and community residents as vital to sustaining healthy recovery in women, while also addressing the challenges (e.g., lack of resources) in implementing such approaches.

Presenters:
Carl Goodman
Multnomah County Department of Adult Community Justice
Portland, OR

Barbara Kappos, M.S.W.
Bienvenidos Family Services
Los Angeles, CA

View Goodman/Kappos PowerPoint Presentation


A.4 Intergenerational Substance Abuse and Resiliency
In this workshop, the presenters identify and address challenges, strengths, and realities associated with families experiencing alcohol and drug abuse. They discuss strategies for developing resiliency skills for children and youth living in families with substance abuse problems and explain why all high-risk children are not the same. In addition, the presenters highlight selected programs that have been identified and included in SAMHSA’s National Registry of Effective Programs as appropriate for this population.

Presenters:
Gale A. Held, M.P.A.
SAMHSA Model Programs Dissemination Project
Rockville, MD

Naomi Weinstein, M.P.H.
Children of Alcoholics Foundation
New York, NY

View Held PowerPoint Presentation

View Weinstein PowerPoint Presentation


A.5 Reentry Programs and Postincarceration Issues
This workshop explores some of the unique treatment needs of women reentering mainstream society after being incarcerated. The presenters discuss how community-based treatment programs can maximize continuity for women transitioning from an in-custody treatment program. They address how treatment supports women in their efforts to deal with reentry issues, such as reestablishing day-to-day relationships with minor children and securing employment after incarceration. This session also describes trauma-based interventions from a clinical and correctional perspective.

Presenters:
Joan B. Gillece, Ph.D.
Maryland Department of Health and Mental Hygiene
Jessup, MD

Steven R. Williams
Dorchester County Department of Corrections
Cambridge, MD

View Gillece/Williams PowerPoint Presentation


A.6 Medication-Assisted Treatment Issues for Women
This session discusses the evidence supporting medication-assisted treatment (MAT) approaches and how to create MAT programs that are focused on the unique needs of women, particularly pregnant women and women with young children. The presenter addresses such challenging issues as increasing women’s accessibility to MAT programs, combining MAT with other therapeutic interventions, and reducing the stigma that many women experience as a result of using MAT.
 
Presenter:
Susan F. Neshin, M.D.
JSAS Healthcare, Inc.
Asbury Park, NJ

View Neshin PowerPoint Presentation


B.1 Building a Circle of Support for Families Affected by Addictions and Fetal Alcohol Spectrum Disorders
Addressing fetal alcohol spectrum disorders (FASD) is not as simple as diagnosing a child or telling a woman not to drink. It requires a complex understanding of the strengths and needs of the parent, the child (of any age), and the community. Services and supports for these high-risk families must be multifaceted and pay attention to the needs of all involved. To optimize success, we need to take a holistic approach to the entire family. This workshop examines FASD from the point of view of the child and the parent, with particular attention to the specialized needs of Native Americans. A mother’s experiences with addiction, recovery, and the effects of substance use on the family are explored, as well as how FASD affects everyday life. Presenters examine practice models to address the issues raised.

Presenters:
Daniel Dubovsky, M.S.W., LSW
SAMHSA FASD Center for Excellence
Rockville, MD

Kathy Jones, Ph.D., RSW
West Region Child and Family Services
Winnipeg, Manitoba

Kathleen T. Mitchell, M.H.S., LCADC
National Organization on Fetal Alcohol Syndrome (NOFAS)
Washington, DC

View Dubovsky PowerPoint Presentation

View Jones PowerPoint Presentation

View Jones Handout

View Mitchell PowerPoint Presentation


B.2 Integrated Service Delivery for Women in Treatment With Children
In this workshop, participants learn about effective strategies and best practices their treatment agency or organization can use to respond to the special needs of women with children. The presenter first provides a brief overview of the landscape of women with children treatment programs (e.g., how we define them, their diversity), with a focus on issues concerning children. She touches on child, family, and parent risk factors and how to address them. The main emphasis of this session is a detailed discussion about how to create a service plan for the children that is integrated with the parent’s service plan so that the family as a whole is treated.

Presenter:
Valera Jackson, M.S.
The Village
Miami, FL

View Jackson PowerPoint Presentation


B.3 Outreach for Linking Women With Multiple Vulnerabilities to Substance Abuse, Mental Health, and HIV Services
In this workshop, the presenter discusses a targeted outreach model, the PROTOTYPES Outreach Model, for
women with multiple vulnerabilities who abuse substances. This model is designed to increase access to care and ensure linkages to needed services, such as HIV/AIDS prevention; substance abuse treatment; domestic violence services; support groups; and referrals to HIV, sexually transmitted diseases, tuberculosis, and hepatitis testing and screening. Innovative strategies for meeting each woman at her own level of readiness for behavior change is presented. Also discussed are findings from an ongoing independent evaluation of PROTOTYPES’ outreach programs on client outcomes and the kinds of services women are linked to and the implications of these findings for treatment providers.

Presenter:
Ruth Slaughter
PROTOTYPES
Culver City, CA

View Slaughter PowerPoint Presentation


B.4 Gendered Justice—Women in the Criminal Justice System
There is both a need and an opportunity to bring knowledge from the fields of substance abuse, mental health, and trauma to the management and programming of women in the criminal justice system. Because of the increased number of women in the system over the past decade, gender-appropriate services have become a critical issue in many jurisdictions. After giving a descriptive profile, the presenter focuses on the challenges encountered by women in the criminal justice system and those who work with them. Findings and recommendations from the 3-year National Institute of Corrections Gender-Responsive Strategies Project are presented. The presenter outlines guiding principles (as well as a treatment model) for those interested in developing gender-responsive policy and practice. She also addresses several key legal considerations for women.

Presenter:
Stephanie S. Covington, Ph.D., LCSW
Institute for Relational Development and Center for Gender and Justice
La Jolla, CA

View Covington PowerPoint Presentation

View Convington Handout


B.5 Enhancing Recovery: Addressing Nicotine Addiction in Treatment Programs
This workshop discusses the importance of addressing nicotine addiction in the course of managing other addictions. Presenters highlight and discuss implications of findings from recent studies on the benefits of addressing nicotine addiction in substance abuse treatment programs and among women in recovery. They review promising approaches, interventions, and lessons learned from systemic and program-based efforts in Massachusetts and Louisiana. The ABCs of developing a client-centered tobacco program based on motivational interviewing principles are highlighted, as well as programmatic issues such as policy development and implementation and creating an environment that supports tobacco intervention. Resources, relevant Web sites, and tips for getting started are shared.

Presenters:
Janet Smeltz, M.Ed., CADAC
Institute for Health and Recovery
Cambridge, MA

Melanie Thornton, M.S.W., GSW
Jefferson Addictive Disorders Clinic
Metairie, LA

View Smeltz/Thornton PowerPoint Presentation

View Smeltz/Thornton Handout


B.6 Women Involved in Multiple Systems and the Clinical Implications for Substance Abuse Treatment: Using a Single Coordinated Care Plan
Meta House for Women and Children is a residential treatment program that participated in a cross-system collaborative effort to develop an integrated service network for women in recovery who are involved in the substance abuse treatment, child welfare, and Temporary Assistance to Needy Families systems. The presenters focus their discussion on the development and implementation of the Single Coordinated Care Plan, a client- and family-centered approach that is gender and culturally specific, strength-based, built on natural and community supports, and designed to address primary barriers experienced by women involved in multiple systems. The presenters discuss the treatment and clinical issues and effective means of addressing those issues that may require multiple services and strategies.

Presenters:
Francine Feinberg, Psy.D., ACSW, LCSW
Meta House, Inc.
Milwaukee, WI

Patricia A. Aniakudo, M.S., LPC
Meta House, Inc.
Milwaukee, WI

View Feinberg/Aniakudo PowerPoint Presentation

View Feinberg/Aniakudo Handout #1

View Feinberg/Aniakudo Handout #2

View Feinberg/Aniakudo Handout #3

View Feinberg/Aniakudo Handout #4


C.1 Choosing the Right Model of Trauma-Specific Services for Your Clients and Organization: Discussion With the Experts
This workshop follows immediately after and builds on the plenary session, Expert Panel on Trauma-Informed Services, and is intended to provide an overview of the different trauma treatment models available. Each of the four speakers provides a brief introduction and overview of a model. Participants then have an opportunity to ask more indepth questions about the specific models and which to use with certain types of clients. The panel provides participants with practical advice on how to decide which model is the best fit for their treatment setting and how they can take steps to implement it into their organization.

Presenters:
Stephanie S. Covington, Ph.D., LCSW
Institute for Relational Development & Center for Gender and Justice
La Jolla, CA

Maxine Harris, Ph.D.
Community Connections
Washington, DC

Dusty Miller, Ed.D.
ATRIUM Institute
Northampton, MA

Lisa Najavits, Ph.D.
McLean Hospital
Cambridge, MA

View Covington PowerPoint Presentation

View Harris PowerPoint Presentation

View Miller PowerPoint Presentation

View Najavits Handout


C.2 Strategies for Engaging Women Clients
The fact that women’s substance abuse experiences are different from men’s has important implications for the planning and delivery of treatment programs. This session discusses culturally sensitive best practices and effective treatment strategies that service providers can employ to increase their success in attracting and engaging women with co-occurring substance use, mental, and trauma disorders. It discusses strategies along the treatment continuum—from outreach to assessment to treatment to transitional and aftercare—and addresses issues such as family-centered treatment, child care, and wraparound services.

Presenter:
Elke Rechberger, Ph.D.
PROTOTYPES
Culver City, CA

View Rechberger PowerPoint Presentation


C.3 Housing Models for Substance Abuse Treatment Clients
This workshop presents nontraditional models of treatment and housing for women with substance use disorders and their families. Two models discussed in detail include (1) Amethyst, Inc., a private, nonprofit agency in Columbus, Ohio, that provides long-term substance abuse treatment, blended with transitional and permanent supportive housing and (2) SHIELDS for Families’ EXODUS Program in Los Angeles, California, which is an 86-unit apartment complex where women with substance use disorders and their children live in individual apartments with an onsite treatment program, child development center, youth program, and vocational services center. The workshop examines the characteristics and service needs of these families, the successes in and challenges to providing housing in combination with treatment, and financially feasible and viable strategies for a successful transition to community living. Presenters also discuss funding resources available to implement housing models.

Presenters:
Virginia O’Keeffe, Ph.D.
Amethyst, Inc.
Columbus, OH

Kathyrn Icenhower, Ph.D., LCSW
SHIELDS for Families, Inc.
Los Angeles, CA

View O'Keeffe PowerPoint Presentation

View Icenhower PowerPoint Presentation


C.4 Two Key Allies: Recovering Women as Partners in Treatment Organizations and Recovery Community Organizations as Advocates
This session discusses the important role that recovering individuals play as partners in treatment organizations by helping inform appropriate treatment approaches and providing mentoring and support to other women in recovery. It also addresses the role that recovery community organizations play in advancing larger advocacy, program, policy, and research efforts. A framework is presented that captures the benefits and challenges of integrating recovering women’s knowledge, experiences, and insights into treatment systems; highlights gender-specific and culturally sensitive approaches that lead to successful involvement of recovering women in the design and delivery of services; and provides recommendations to facilitate the development of organizational policy and practices that enhance opportunities to involve women in recovery. Also discussed are best and promising practices and approaches for how recovery community organizations can be effective advocates in advancing women’s treatment by mobilizing diverse populations, forging strategic alliances, educating policymakers and opinion leaders, and providing input to treatment systems.

Presenters:
Rene Andersen, M.Ed.
Western Massachusetts Training Consortium
Holyoke, MA

Patricia Henderson, NCRS
WINR: Women in New Recovery
Mesa, AZ

Gloria Grijalva Gonzales, CSAC
San Joaquin County Office of Substance Abuse and Mental Health
Stockton, CA

View Gonzales PowerPoint Presentation


C.5 Perinatal Issues and Issues During Pregnancy
This workshop addresses a variety of critical issues affecting pregnant women who are using alcohol and drugs. Outreach and treatment models that are tailored to the needs of pregnant women are discussed, as well as the appropriate standard of care for this population. A critical issue that addressed is the ongoing controversy and debate about the use of medications for pregnant women.

Presenter:
Janet Mitchell, M.D., M.P.H., FACOG
Mack & Associates
Brooklyn, NY

View Mitchell PowerPoint Presentation


C.6 Methamphetamine: The Equal Opportunity Drug
This workshop focuses on the application of evidenced-based strategies in methamphetamine treatment with women. An effective, evaluated treatment model is presented, along with a discussion of factors affecting treatment entry, participation, and completion as they relate specifically to women. Attention is given to criminal justice as well as children’s issues.

Presenter:
Richard Rawson, Ph.D.
UCLA Integrated Substance Abuse Programs
Los Angeles, CA

View Rawson PowerPoint Presentation


D.1 Motivational Interviewing: Increasing Behavior Change With Women Clients
The workshop informs participants of the motivational interviewing (MI) principles and interventions that engage clients in successful behavior change. The presenter discusses how service providers can collaborate, negotiate, and share with clients decisionmaking strategies that can increase the likelihood of client change across a continuum of care. The workshop includes a demonstration of a motivational interview that addresses the client’s readiness for change.

Presenter:
Kathyleen Tomlin, M.S., LPC, CADC III
Kaiser Permanente Addiction Medicine Department
Portland, OR

View Tomlin PowerPoint Presentation

View Tomlin Handout


D.2 Clients’ Children: How Can We Support Them?
This workshop provides an overview of the cluster-based planning and outcomes management system that is used to identify subgroups of children whose mothers can be served in women’s treatment and recovery programs. The speakers describe eight clusters of children who have been identified and then discuss clinical strategies to meet the needs of these children. These strategies are based on a developmental perspective, recognizing the changing needs of children over time, and include interventions with the child, the parent-child dyad, the extended family, and the broad community.

Presenters:
William Rubin, M.A.
Synthesis, Inc.
Columbus, OH

Virginia O’Keeffe, Ph.D.
Amethyst, Inc.
Columbus, OH

Arthur Krzyzanowski, Psy.D.
Children’s Research Triangle
Chicago, IL

View Rubin PowerPoint Presentation

View Krzyzanowski PowerPoint Presentation


D.3 Treatment for Women With HIV/AIDS and Other Infectious Diseases
Professionals in the various health care delivery systems need to understand the connections between infectious diseases and substance abuse to recognize and assess these often concurrent conditions. This workshop addresses the medical issues surrounding infectious diseases and discusses how to expand or enhance the core capabilities of substance abuse treatment programs to provide effective services for their clients and families with specific needs attributed to HIV/AIDS, sexually transmitted diseases, tuberculosis, or hepatitis B and C. It also looks at how treatment providers can work with other community partner agencies to provide a more comprehensive array of health services for women with substance use disorders and their children.

Presenter:
Janet Mitchell, M.D., M.P.H., FACOG
Mack & Associates
Brooklyn, NY

View Mitchell PowerPoint Presentation


D.4 The Unique Treatment Needs of Adolescent Girls: As Seen Through the Lens of the Juvenile Justice System
Like their adult female counterparts, girls often are arrested for nonviolent crimes that are drug related and are entering the system with serious mental health and medical issues associated with substance abuse, high-risk sexual behavior, and violence. These adolescent girls, however, have treatment needs that often are different from those of adult women in similar circumstances. This workshop discusses the unique needs of adolescent girls and uses information related to their experiences in the juvenile justice system to focus on those needs. The presenters discuss information such as prevalence rates of adolescent girls with co-occurring disorders in the juvenile justice system, recent advances and future challenges in assessment, early intervention, gender-specific programming, and cross-system collaboration.

Presenters:
Frank Scafidi, Ph.D.
The Village
Miami, FL

Kara S. Riehman, Ph.D.
RTI International
Research Triangle Park, NC

View Riehman PowerPoint Presentation


D.5 Faith-Based Treatment and Spirituality in Women’s Treatment
Presenters in this workshop discuss the concept of blending spirituality and faith with treatment to provide the best recovery outcomes. The specific issues and needs unique to women in their recovery are addressed. Participants learn through a “whole”-istic approach how to assist their clients in managing all aspects of their substance abuse and life issues. Using successful strategies from current programs, presenters give participants specific tools (e.g., program overview, curriculum, case studies) and resources (e.g., books, tapes and videos) necessary to integrate a faith-based approach into all areas of their work with women in recovery. Also included is a first-hand experience on the barriers and rewards of becoming a licensed, fully faith-based treatment program. In addition, presenters explore with participants the critical step of understanding one’s own faith and spirituality as it relates to one’s clients’ recovery.

Presenters:
Susan Farah, R.N., RADT II
Second Chances
Statesboro, GA

Geneva Berns, M.A.T.
Sisters of St. Francis Congregational Leadership Team
Rochester, MN

View Farah PDF


D.6 Clinical Treatment Among Culturally Diverse Populations: Roundtable Discussion
This 2-hour roundtable discussion focuses on identifying and fostering effective and culturally appropriate substance abuse treatment programs and systems of care that adequately support the unique and diverse needs of four racial and ethnic groups: Hispanic, African-American, Asian, and Native American. After a brief introduction and overview of the prominent issues and challenges that both cut across and are particular to the groups, the four panelists answer participants’ specific questions about best practices and how to implement culturally competent models in their own treatment settings.

Presenters:
Jacqueline Butler, M.S.W., LISW, CCDC
University of Cincinnati
Cincinnati, OH

Constance Falleaf
White Bison
Colorado Springs, CO

Barbara Kappos, M.S.W.
Bienvenidos Family Services
Los Angeles, CA

Ann S. Yabusaki, Ph.D.
Coalition for a Drug-Free Hawaii
Kaneohe, HI

View Butler PowerPoint Presentation

View Yabusaki PowerPoint Presentation

Conference Program

Hear What People Had to Say About the Conference

Coming soon.


For a listing of more general reports that address issues affecting women with substance use disorders and their children and families, please click on the TIE category, Recent Reports, Articles and Fact Sheets.