Gender Separate Gender Specific Gender Differences Gender differences

Gender Separate & Gender Specific

Gender Differences • Gender differences are biologically and socially based • These differences have implications in a variety of areas including: q. Active Addiction q. Treatment Phase q. Dual Diagnoses q. Aftercare Considerations

Active Addiction & Brain Differences • Women become more intoxicated faster and experience other symptoms sooner • Women coming into residential treatment have more consequences • Mortality rates are higher for women with SUD (50 -100 x)

Hormonal Differences • Estrogen – Promotes social interest, provides a sense of wellbeing, feel socially relaxed • Spikes during first 2 weeks of cycle • Progesterine – Causes increased irritability, desire to be alone, increased reactivity to relationship stress, curbs sexual desire • Spikes during second 2 weeks of cycle • Testosterone – Triggers sexual desire, Men have 10 -100 Times more than women • Oxytocin – “The Cuddle Hormone, ” Reduces Stress

Implication • Estrogen (higher in first 2 weeks) Fuels Oxytocin and Dopamine Reward Production • This + chemical reaction mimics being in love – highly rewarding to the brain • Negative chemical reaction happens when there is rejection ØResults in decrease in dopamine, estrogen and oxytocin ØHuge relapse risk in early recovery ØWomen are more likely to be taken out of treatment or recovery by a relationship

Females VS Connection = Survival Connection requires social skills Conflict alerts that connection may be threatened Tend and Befriend to cope with this Self esteem = Ability to maintain close relationships Treatment goal: Fix your picker & Relationships Males Achievement = Survival Achievement requires competition Conflict alerts that elevated status may be available. Fight or Flight more likely Self esteem = Ability to individute from others Treatment goal: Learn to connect

Population Differences Men are more likely to need treatment including: - Anger Management - Self-esteem related to employment - Difficulty sharing feelings in close relationships - Narcisistic and Antisocial Personality Traits Women more often need: - Teaching assertiveness and carefrontation skills - Trauma informed care o Sexual traumas higher rates o Trauma leads to more trauma - Disordered Eating & Body Image - Borderline and Dependent Personality Traits

Pros & Cons of Gender Seperate Pros o Fewer pairing off instances in recovery community o Women share more often in same sex groups o Men can be more vulnerable without women present (? ) o Provides safe environment to discuss past trauma o Increased LOS Cons o More expensive to staff and keep separate facilities o Lose the benefit of the perspective of the opposite sex from peers o Exposure to proper boundaries with the opposite sex (? ) o More training of staff

Clinical Focus • Anger Management vs. Shame Resilience • Conflict Resolution Skills vs. DBT Skills • Keeping Clients in Treatment • Women begin Therapeutic Leave (TL) at 30 days • Men begin TL at 45 days • Women want calls and contact with children • Therapeutic Community o Women gossip/ passive communication o Men more likely to be aggressive

Aftercare • Women with children are less likely to go to ¾ sober living due to work and childcare constraints • Women are more open to seeing a therapist • More difficult for any client with childcare responsibilities to attend 12 -step meetings • Challenge of fewer women in AA makes recommendations like working steps with a sponsor more challenging

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