This is a great article about gender and age specific treatment written by Kenneth Chance in February 2017 – Frank Say
In recent years drug and alcohol treatment programs have grown dramatically in the United States, yet most addiction treatment centers’ programs are designed for all adults, age 18 and older, and both men and women. This broad-based, treatment-for-everyone approach might not be as effective as a gender and age specific alcohol and drug rehab program might be for many who suffer from substance use disorders. This paper outlines only a few reasons why it is important to address the specific treatment needs of both younger and older adults, and why the importance of a gender specific treatment facility.
Age Specific Considerations
Ask any older adult this question: “If you had a choice between going to an alcohol and drug rehab program that has mostly 18-30-year-olds, who are single and still supported financially by their parents’, or, a treatment program where only older adults, most of whom are either currently employed in a career or recently were, and, are either married or have been married – which would you choose?” Most, if not 100% of the time, the latter choice would be made by an older adult.
As a rule, young adults need to learn life skills and how to liberate from their financially supportive parents, while older adults need to re-learn relationship skills, primarily with their significant other. Younger adults may also require educational support to launch into a career, while older adults may need to protect a career already in place, or, learn how to live sober in retirement. These and other life stressors are more suitably treated in an age appropriate clinical setting where group therapy and psychoeducation are focused on the needs of the age appropriate group.
The brain of an individual with a long-term, moderate to severe substance use disorder is handicapped in being able to self-regulate emotional states such as irritability and frustration that often leads to angry outbursts or internalized rage. Additionally, undiagnosed and untreated depressive and anxiety disorders further create emotional states that fluctuate daily, and hourly for the newly detoxed client. The tension created by generational differences in social attitudes and behaviors between older and younger adults only intensify feelings of irritability and frustration among clients, thus creating an atmosphere of “us” versus “them.” An age specific treatment program is therefore more conducive in reducing such tension in the milieu.
Gender Specific Considerations
Gender differences are more than simply physiologic; they include gender programming and socialization, familial roles, social privilege, economic differences, career and educational differences and gender based stereotypes. While some of these differences are obvious, others might not be. For instance, male privilege carries over into the treatment experience and may hinder the male’s ability to make changes in his thought process sufficient to effect much needed behavioral changes for lasting recovery. Similarly, a female’s need for relational expression might be threatened with a male in her treatment program.
Women tend to have less family support when entering treatment than men do. This is compounded when the woman has children under her care, and/or when she is pregnant. Additionally, women tend to have more severe family problems than men, which need to be addressed in treatment.
Sexual posturing between younger men and women occurs naturally as part of the growth process into maturity. When one adds a severe substance use disorder on top of an already abundant hormonal young man or woman, and, when one then removes that substance from the individual, sexual posturing becomes even more of an issue in changing behavior conducive for long-term recovery.
Generally speaking, men tend to be more left-brained oriented in their thought process and are often emotionally numb or, even more disturbing, emotionally inaccessible. This directly impacts the clinical team’s ability to treat the male client, especially in a 30-day treatment program. Misogynistic attitudes must also be considered in effective treatment of substance use disorders with men as disrespect for women may be a factor in relapse prevention. Good clinical work coupled with a thorough fourth step inventory helps men see their part in problems in their relationships with women, and that typically means breaking down the walls of misogyny. This is only one example of the merits of a gender specific treatment program for men.
For women who continue to see themselves dependent upon a male figure for whatever reason, be it financial support or emotional validation, being in a gender specific clinical setting helps them change such a belief so that they may access their true power as an independent and equal woman.
There are differences in the mental health needs of men and women. For instance, while more women report mental health problems than men do, such as depression for instance, more men commit suicide than women by almost a 4:1 ratio. For this reason, the mental health component of providing treatment solutions for men must adequately screen for and identify their mental health needs. That’s not always easy because men tend to hide mental illness by denying its existence, all the while self-medicating through alcohol and/or drugs.
While women and men experience early childhood trauma, men tend to believe that they can be tough and “gut it out” while women are more likely to act out in negative behavior. Treating trauma for women versus treating it for men is different in how one screens, assesses and delivers evidence-based trauma treatment. Both genders require safety in their treatment facility where professionally trained trauma-informed staffs provide clinical support, especially on weekends. Sexual harassment takes on many forms and staff require education and training in order to prevent and stop such harassment between clients, as well as between clients and staffs.
Taking an antidepressant or a mood stabilizer may be more of a hurdle for men than women as men tend to believe they should be able to function “normally” without medication. This is an example of gender stereotyping that needs to be debunked for the successful treatment of a mental health condition.
When sexual dysfunction, sex addiction, serial relationships and other sexually oriented pathologies are required, having a gender and age specific treatment program is necessary. By placing men and women who suffer from sex addiction in a coed and all-age milieu, the risk of sexual acting out behavior is increased unnecessarily. Having separate groups and residential facilities is not enough. The actual programs should be separated physically on different campuses by age and gender populations and served by different clinicians and staffs to help mitigate the risk of sexually damaging behavior.
What is presented here is a very high level view of why gender and age specific alcohol and drug rehab programs are a very necessary option within the overall treatment industry. The benefits for the client, the client’s family and the staff are immense. Prior to admitting into a treatment program, one should carefully consider the clinical needs of the client and, when age and gender matters are critical to the success of one’s treatment from a substance use disorder, a gender and age appropriate program might be the better choice.