Gender-Responsive Drug Court Treatment: A Randomized Controlled Trial

Women who participate in women-only substance abuse treatment programs benefit from reduced PTSD and better treatment outcomes than women in mixed-sex treatment programs.

Introduction

Standard substance abuse treatment programs typically treat both men and women together, providing the same service regardless of gender. Yet research has shown that the treatment needs of women are quite different and more complex than those of men. Women who are drug offenders are significantly more likely than men to experience symptoms of psychiatric disorders, parental stress, housing issues, and have histories of sexual and physical abuse. There is also an increased demand by women for childcare, pregnancy services, and services for women with histories of trauma and domestic violence. Can gender-specific drug programs (e.g. programs that only work with women) address these issues that disproportionately affect women offenders? Previous research indicates that when women participate in gender-specific drug programs, they have lower levels of arrest, fewer mental health issues, and increased drug treatment participation, than women who participate in mixed-gender treatment programs. Evaluating these programs can help find out what approaches are optimal to prevent women from returning to the criminal justice system. Increasing their participation in these programs, reducing their drug rates and symptoms of psychiatric disorders can assist this process. This study analyzes whether women’s participation in treatment programs (evidenced by their violations of court-mandated attendance), drug rates, and symptoms of post-traumatic stress disorder differ if they are in a gender-specific or mixed-gender drug treatment program.

Findings

Women assigned to women-only drug treatment programs were more likely to attend the program and therefore were less likely to be remanded to jail or terminated from treatment. However, they were just as likely to be arrested for use drugs within two years after the program when compared to women assigned to mixed-gender drug treatment programs.

  • Compared to mix-gender groups, women assigned to women-only treatment groups were less likely to be remanded to jail: 1.9 times for those in women-only treatments, compared to 2.4 times for mixed-gender groups.
  • Women were less likely to be terminated from treatment for not attending meetings or showing unsatisfactory progress: 13% of women assigned to women-only groups were terminated from treatment for unsatisfactory progress compared to 16% of women assigned to mixed gender groups.
  • Overall, both groups experience significant reduction in drug and alcohol use, although the effect is not long-term. There is no difference in the reduction of drug use or in the numbers of arrests two years after the treatment program between the women-only or mixed-gender treatment groups.
  • 31% of all women participants exhibited symptoms of post-traumatic stress disorder (PTSD) in the beginning of the program. After the program, the women-only groups have twice the reduction in current PTSD symptoms than the mixed-gender groups.
  • 33% of all women participants were arrested at least once within two years of treatment entry. There is no difference in number of arrests between participants in the women-only programs and mixed-gender programs.  

Women who participate in women-only substance abuse treatment programs reduce symptoms of post-traumatic stress disorder and are more likely to complete treatment, however there is no effect of these programs on long-term rates of arrest or drug use among women

Methodology

150 women who entered drug court treatment in San Diego County, California participated in this study. They were randomly assigned to single-sex treatment or mixed gender treatment programs. All participants were treated under the drug court model, which combines intensive supervision, mandatory drug testing, individual and group counseling, self-help group discussions, escalating sanctions, and treatment.

The gender-specific treatment enhances the usual drug court standards of care by becoming a woman-only program, facilitated by women only. The gender-specific treatment uses two programs, Helping Women Recover and Beyond Trauma, which are designed to be relevant to the needs of drug-dependent women under criminal justice supervision.

The Helping Women Recover is a 17-session program organized into four modules that explore the self, relationships, sexuality, and spirituality. Beyond Trauma is an 11-session program focused on teaching women about trauma and abuse, helping them understand the reactions to trauma and abuse, and developing coping skills.  Participants were paid $15 for a baseline interview and $10 for a follow-up interview via gift cards. Data were collected at program entry, during treatment, and 22 months after treatment entry.

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