Team Clinical Insight
Holistic Model of Care for Women
On almost every addiction treatment center’s website you’ll find the catch-all phrase, “We offer a holistic approach to drug and alcohol addiction treatment.” This catch-all phrase is used broadly to describe treatment of the whole individual, alluding to the fact that there is no one-size-fits all solution for treating addiction. Drug and alcohol addiction is a manifestation of underlying issues that need to be addressed to either reduce or remove entirely the abuse of drugs and alcohol.
When it comes to clinically treating adult women suffering from alcohol and drug addiction, you can remove the drugs and alcohol in a medical or social detox setting, but once medically stable the discovery and healing of underlying issues is paramount. Underlying alcohol and chemical dependency issues may include past trauma such as emotional or physical abuse, it may include underlying mental-health issues such as bipolar disorder, depressive disorders, or anxiety disorders, it may even be fundamentally related to adolescent behaviors and mentalities.
Clinically speaking, if we do not promote the psychological, emotional, physical, spiritual, and cognitive healing, then, we have done nothing to undo the underlying issues that prompted the substance use disorder and the probability of relapse is almost guaranteed.
At Serenity Peaks Recovery Center we understand that an alcohol and drug addiction and underlying causes for the addiction manifest themselves differently for men and women. This is why we value a gender-specific, evidence-based treatment approach which have been empirically shown to be effective in the treatment of addiction and dual diagnosis. In fact, we are among a very small handful of treatment programs here in the state of Colorado that offers women’s specific treatment.
Below you will find insights into the pros and cons for both individual and group based therapies. It is our goal to provide you with a realistic framework for what works and what does not work within treatment settings. Unlike other programs it's important for us to recognize limitations within treatment settings and how we overcome those limitations programmatically. If you are comparing programs, hopefully the below information will empower your conversation with other providers as well.
Individual Therapy Styles for Women
For someone who is considering therapy, it can be overwhelming and even frightening. There are many different options for treatment out there, but without experience, it may be difficult to determine what will work best for you. You can rely on a friend or family member’s experience to guide you, but that still doesn’t guarantee that it will be the best option for you personally.
While there are many things that may characterize the best option for you, we are going to focus on gender. Specifically, we want to look at the most popular therapy methods and how they can be empowering and helpful to women who are looking for assistance handling a mental disorder or substance addiction. There are five excellent treatment options that can help you with your upcoming journey.
Cognitive Behavioral Therapy
The first type of therapy we are going to talk about is cognitive behavioral therapy, which is often abbreviated as CBT. This kind of therapy has a goal of helping to change an individual’s way of behaving and thinking that might be contributing to their struggles. One of the best things about CBT is that it can be used for all sorts of things. It is used for anxiety, depression, drug abuse, relationship problems, and more. It can also be used in one-time situations that tend to come up in everyday life.
Women who are seeking therapy for mental disorders or addiction may find that CBT is an empowering option. The woman will be discussing her problems with a therapist or counselor in order to determine her current methods of handling these difficulties. After that, it involves learning and incorporating new thinking and behavior that can make experiencing difficult situations in the future less stressful and overwhelming. As CBT can be used in many facets of life, the woman who has completed these sessions can then apply the process toward any new problems that crop up in life.
Dialectical Behavior Therapy
Another excellent option for women’s therapy is dialectical behavior therapy, which is often known as DBT. This therapy has extensive research behind it showing that it can be extremely effective in reducing self-harm, suicidal behavior, substance use, depression, anger, and more. It is also commonly implemented for those who have eating disorders, which tends to be more common among females. This type of therapy involves behavioral skills training over a number of different sessions. The sessions are more extended than with CBT, but a lot of useful information is provided at each session.
The modules involved in DBT include mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. DBT assumes that the person in question needs to learn entirely new behaviors in various contexts, which replace old and less helpful behaviors. By completing all four modules, these women will then be able to navigate problematic situations without as much distress. DBT can be very effective for women as it offers a safe space to practice new behavior as an individual and in group situations. Many women will prefer a women’s group, which allows for better understanding between participants.
Our third therapy suggestion for women is motivational interviewing. This type of counseling relates to determining any insecurities and mixed feelings within an individual, so they have the needed motivation to want to make a change. This type of therapy is often very short term. It is commonly used with those who are addicted to drugs or alcohol.
Motivational interviewing provides a supportive environment for the woman in question. The interviewer mainly listens and reflects on what the individual is saying so they can begin to understand their own reasoning and motivations. Many women appreciate that this type of therapy is less about intervening and more about communicating. It can be a safe place to let out feelings that may not see the light of day in regular life.
While it is disheartening to consider, the truth of the matter is that women are often the victims of trauma in their lives. This is where trauma therapy comes in. This type of therapy can be used for any kind of trauma, old or new. It might be used for newly diagnosed PTSD or it can be used for decades past childhood abuse. The beauty of this therapy is that it can work in so many different situations and with so many types of trauma. A good trauma therapist will provide a woman seeking therapy with the hope of a better life, connection with someone outside of the situation, information on how to handle the situation better, and respect regarding your problems and choices. Trauma therapy is something that can encompass different methods of treatment, so it’s always best to speak with a few therapists before deciding on one.
The final therapy type that we’ll discuss can be extraordinarily empowering and beneficial for women is visiting a psychiatrist. This person is a medical professional who has specialized knowledge about mental health and substance use disorders. As they are a medical doctor, they can not only engage in talk therapy but can also prescribe any needed medication. By seeing a psychiatrist for sessions, a woman has the ability to connect with the medical doctor on a higher level. In addition, this can be a real time saver for someone who needs medication and would prefer not to spend time with both a doctor and psychotherapist or who simply cannot afford additional appointments. As women are often less financially secure, psychiatric sessions can be an excellent option for seeking assistance with their problems.
As a woman who is seeking assistance with substance use disorders or mental disorders, there are many options out there. Choosing one based on your own specific needs and comfort is always the best idea. The five therapies mentioned above are common and easy to find, they also tend to be extremely effective. Hopefully, this will provide you with information to start your search and begin recovering in whatever way needed.
Group Therapy for Women
There are three areas in need of consideration when thinking about the pros and cons of group therapy: 1) clinical contact hours required by the state and insurance companies to bill for services; 2) understanding the limitations of predefined clinical contact hours and the effects that has on the holistic model; and, 3) the benefits to group therapy when it comes to providing a holistic framework for self-discovery and empowerment.
Required Clinical Contact Hours
First and foremost, for every level of care inside drug and alcohol addiction services, including mental health services, a-number-of hours must be met for the service to be both preauthorized by insurers and billable according to state standards. Partial hospitalization (PHP) or day-treatment, for example, requires that an individual receive a minimum of 25 clinical contact hours, not to exceed 30 clinical contact hours. But for intensive outpatient (IOP) services, this level of care requires that an individual receive a minimum of 15 clinical contact hours, not to exceed 20 clinical contact hours.
When it comes to meeting these minimal requirements, we can start to see how the “holistic” model of care might be disrupted. It is impossible to provide up-to 30 hours of individual attention within a clinical setting. If a therapist works 40 hours a week and his or her case load is made up of only six clients, the therapist would have to cover 180 hours of therapy between the six individuals if it were not for the concept of group therapy. This impossibility reveals the importance of a group setting in that the only way to get those hours is to combine individuals within a group.
Limitations of Desired Clinical Hours
If these hours are not met, insurers will not pay for any of the clinical services, even if the days of service were authorized before-hand. Working within a framework that requires programs to work in this way, can have drawbacks. For example, some individuals may require more one-on-one therapy to work on trauma issues or mental health concerns. In programs with more than a few individuals within treatment, these extended sessions can stretch clinical band width to a degree that is unmanageable.
A group therapy session might be less ideal given the holistic need of the individual, but if the client participates in an hour based trauma session instead of group, the client loses two hours of the clinical contact time needed to meet the hour(s) insurers require.
These constraints naturally fall onto families that pay for treatment with cash. Roughly eighty percent of all treatment is paid for by insurance and this binds the vast-majority of treatment programming to the above prescribed way clients are cared for. Though group therapy is ubiquitous among treatment providers, whether they take cash only or accept insurance, the standard model of care is a derivative of predefined state and insurance based regulations.
You may also wonder how, in a group of say, 8 people, how each person receives enough one-on-one attention to justify “holistic” care. If one client becomes the point of conversation within a two hour group, how does someone else receive attention such that their needs are met as well?
The quick answer is that a group setting is only as strong as the clinical team member providing the care. Most clients experience anxiety, depression, and a many other mental and physical health related issues. It’s the job of the clinician to ensure that each client understands the intervention within a group and how to execute the intervention within the real world; even if a group is focused on a single individual.
And what about age considerations? A twenty-two-year-old male, who is in treatment for heroin addiction, who has been living in mom-and-dad’s basement for the last three years, and who has never held a job, is in a much different place in life than a thirty-two-year-old woman, who is in treatment for meth addiction, married with two kids, has a master’s degree, and can still hold-down a job, all things considered? What does it mean when a treatment program says they treat individuals who are 18-and-up?
Many facilities practice coed based groups where both men and women come together in the same group therapy session. This has many implications given that men and women go to treatment, in the first place, for not only different drug and alcohol addictions, but generally go to treatment for a variety of alternative reasons such as psycho-social stressors, both physical and mental health issues, etc. The point is that having like-minded individuals within a group setting matters so that the likelihood of sharing stories, engaging with others, and working on difficult issues can be addressed.
Coed groups can be a huge distraction to the holistic model. Sexual tension arises, sure, as its own distraction, but if men and women enter treatment for entirely different reasons, then the likelihood of them relating to others within the group of the opposite sex naturally goes down.
So why are we saying all this? Serenity Peaks has been successful to-date in managing both client outcomes and family expectations. Treatment is ideal for individuals struggling with drug and alcohol addictions, including mental health issues, but our treatment program is not invested in over promising concepts of holistic care when the very framework for providing clinical care undermines that concept. Serenity Peaks Recovery is not in the business of over promising and under delivering. Any treatment provider should be honest about the above limitations as they are inherent within treatment modalities and should also have staff that is capable of increasing individual client attention without disrupting required hours.
If a program is not properly staffed and the vast-majority of work is done within a group settings or group settings where age, sex, psycho-social stressors, etc., are not taken into consideration, then, the notion of holistic care becomes unrealistic. At Serenity Peaks we are staffed such that we can appropriately accommodate individuals within a holistic framework. Serenity Peaks Recovery Center specifically treats young-adults between the ages of 18-30 and is a gender specific program dedicated to young adult women. Not many programs can make this claim.
You are investing a lot of recovery capital into your loved one’s recovery and it’s important that you as a family member understand both the benefits and limitations to the services that are being provided. Serenity Peaks Recovery understands these limiting factors and is fully staffed to a degree that allows individuals to receive extended individual sessions like one-on-one trauma therapy while also meeting necessary clinical contact hours required by outside forces. At Serenity Peaks, our clients receive an array of clinical group services that include evidenced based DBT, CBT, and motivational interviewing groups, equine therapy, art therapy, and nutritional based therapy; to name a few of the ways we approach group. We also provide all of the above care within our individual settings and can offer more than one individualized clinical session as needed given the size of our staff.
The Benefits of Group Therapy
The sole purpose of group therapy is not to meet billable hours, it is also an evidenced based practice which is why both the state and insurers want to see an individual in treatment, specifically group based therapy. However, meeting these requirements is only possible with both a fully trained staff and, also, enough staff members to appropriately build the necessary holistic framework.
No matter who you are, it can be more than a little overwhelming to visit a mental health therapist or substance abuse counselor for the first time. While men and women both suffer mental disorders and addiction, the ways these disorders manifest can be very different. For instance, women are more likely to be diagnosed with an anxiety or somatization disorder, while men make up a larger number of those who have antisocial personality disorder or a substance abuse problem.
This also means that what works for one person in therapy might not work for another. A group therapy program needs to be able to address the needs of every individual in the group. As such, some women may be more comfortable with a mixed gender group while others may want to seek out a women-focused group for therapy. Some may prefer a small group setting while others may prefer a larger group situation.
Since Serenity Peaks Recovery Center is a gender specific program we will explain why gender specific care is so important for the individuals we treat. Group therapy can be a huge help to many people and offers many of the same positive effects that are found in individual therapy.
Accurate Screening and Evaluation
One of the most important aspects of therapy is the initial screening and ongoing assessment. Screening takes place as a short process for defining problems that exist, which will also determine whether a more thorough evaluation is needed. Intake will look at mental disorders, eating disorders, anxiety disorders, substance abuse problems, risk of self-harm, and history of trauma. Assessment, on the other hand, happens over time and is ongoing with a therapist.
In a group therapy situation where women are involved, the intake process can explore things that might not be explored men’s group therapy intake. For instance, therapists leading these groups will likely be more sensitive to women’s values and beliefs, emotional state, language, and culture. The people involved in the therapy will have more nuanced awareness of each woman’s strengths, support systems, and coping styles. That means that more appropriate questions and suggestions for treatment can come to light.
For women who are interested in therapy, on an inpatient or outpatient basis, group therapy can make that situation less frightening for some. A facility or therapist who focuses on women will likely have services available that are appropriate for women’s specific needs. They might offer special programs for those who are pregnant or have children. They may also offer life skill training that caters to women and their unique needs. This can make a person feel more involved in their treatment and more likely to succeed.
Many therapy groups that feature women’s therapy groups will have the ability to provide referrals to social service programs, daycare, and other parent related services. This is important because women are often less financially independent than men. Having many of their needs met through therapy, along with outside help, makes the process of becoming healthy much more likely.
No Longer Feeling Alone
Whether seeking therapy for mental disorders or substance use addiction, it can feel like a lonely road. Group therapy can help a woman realize that they are not the only person out there going through the same things. This can be crucial for a person who has spent years wondering if they are alone in their feelings. By interacting with other women, it allows the ‘mask’ to drop that is used in everyday social situation. Instead, they can express anger and frustration about their situations or reveal things they may not feel they can in their life outside.
This ability to be honest and then feel accepted for that honesty can really offer an excellent space to start healing. Challenging and supporting each other will go hand in hand and lead to an understanding of an individual them self, as well as those around them. As relationships are often a huge priority for women, having that group to connect with can lead to breakthroughs, friendships, and more. The added camaraderie between women can lead to pushing each other to continue improving.
Something else that often comes from group therapy for women is a feeling of power and control over the lives of the participants. By being actively involved in the many aspects of therapy, a woman is-able-to feel empowered about her own life. Group therapy offers a place to be authentic and become stronger. This isn’t necessarily applicable with regards to physical strength, but emotional strength, better self-image, and financial independence.
Feeling capable as an individual is something that is important to everyone and can help with self-esteem, along with other issues. Having control over a situation and feeling as if there is a way forward is a big part of group therapy and can be a positive for women considering therapy.
Understanding Influencing Factors
For women who have mental disorders or substance abuse problems, the factors that influence these issues can differ from a man’s experience. Women often begin using substances because of stress, low self-esteem and relationship problems, which is important to touch on in group therapy. Women tend to be more affected by substance abuse of a partner, as well. In addition, women who are struggling with these problems often have trauma in their history, including children or interpersonal sexual abuse. A group therapy session with women can bring these things to the forefront so they can be better understood and healed from.
There are many reasons for group therapy to be an excellent option for women who are struggling with substance abuse or mental illness. Having a group of people who understand your struggles can lead to a knowledge that you are not alone. In addition, having other women to interact with can lead to experiences that might not be possible in other types of therapy situations. For anyone who is considering the option of group therapy, this list should give you an excellent start for understanding what you have to gain.
Finally, we often hear client’s who’ve been to multiple treatment centers say things like, “group therapy doesn’t work for me” or “I get it”. What we recognize, though, as a facility is that clients who receive group therapy of course don’t have issues with the knowledge gained within group settings, it’s the execution of the interventions received in group therapy. Whether you are seeking treatment for drugs and alcohol addiction or are a family member seeking treatment for a loved one, it’s important that you or your loved one starts taking responsibility for their actions, everyday.
It is one thing to say we know something and it is an entirely different thing to put knowledge into action. What happens within Serenity Peaks group therapy sessions has value and you can choose to treat it as knowledge, as if the things we learn will cure us alone, or you can take that knowledge and put it into action within your own life. The prior will surely lead to relapse while the former will help you take control of your life. Many things have happened in your life that may not be entirely within your control or your fault even, but you have to take responsibility at some point for your actions and group therapy is a way of accessing holistic interventions that can empower the new you moving forward.