Women, trauma and substance abuse : understanding the experiences of female survivors of childhood abuse in alcohol and drug treatment

Despite the available evidence suggesting gender should be considered in the provision of alcohol and/or drug (AOD) treatment, programmes are frequently offered in an apparent 'gender vacuum'. This article argues that the generalist 'one size fits all' approach of many AOD services is not gender neutral but should be understood as implicitly gendered in that it neglects the specificity of women's needs in relation to abuse, mental illness and parenting. The discussion presented in this article is based on a qualitative study of the experiences of adult women with histories of childhood sexual abuse and/or domestic violence in AOD treatment. By examining the ways in which AOD treatments effectively ignore or minimise gender, this article uncovers intervention practices that efface the complexities underpinning AOD use among women and suggests ways in which alternative models of service delivery can create more validating and supportive environments. Key Practitioner Message: Some of the common assumptions underpinning alcohol and drug treatment do not adequately acknowledge the specific needs of female clients and so gender-neutral service provision can be disenabling for women; Punitive service cultures or behaviour change strategies have a differential impact on female clients, many of whom have prior and ongoing experiences of abuse and violence; Service models that acknowledge the complex responsibilities and relational histories of female clients are more likely to engender a positive response and provide the opportunity to address the multiple and complex needs that can go unmet in non-specialist services.