The Brain Story Certification: Module 17
Module 17: Addiction Treatment, Part B – Specialized
Approaches for Women & Indigenous Populations
Excerpt from “Women & Addiction”
Stephanie Covington, PhD, LCSW
Institute for Relational Development & Center for Gender and Justice
- Women’s groups of the 1960s/1970s brought to light many of the social problems we are conscious of now.
- Historically there was non-gender responsive treatment. Gender-responsive treatment is more normative now. IT is about both the materials used an how the environment addresses both the strengths and challenges.
- Gender-neutral = male-centric – be aware of this in programming as a bias towards patriarchy
- Guiding Principles for Gender-Responsive Services:
- Gender
- Environment
- Women’s Services
- Economic & Social Status
- Community
- socio-economic status
- community
- We need to acknowledge that gender influences the provision of services
- The environment needs to create a sense of safety, respect, and dignity.
- Relationships – policies, practices, and programming that is relational while promoting healthy connections with children, family, significant others, and the community.
- Services – Does it address substance use, trauma, and mental wellbeing through culturally relevant services that are integrated and comprehensive.
- Do women have an opportunity to improve their socio-economic status
- Is there an establishment of comprehensive, collaborative community services.
- Some issues faced by women with an addiction
- Shame & stigma – more so than males
- Physical & sexual abuse – higher rates than those who were not addicted
- Relationship issues
- Fear of losing children
- Fear of losing their partner
- Needing permission of partner to partake in treatment
- Treatment issues
- Lack of services for females
- Lack of understanding treatment
- Long waiting lists
- Childcare service gaps
- Systemic issues
- lack/insufficient financial resources
- lack of clean/sober housing
- poorly coordinated services
Excerpt from “Women & Addiction”
Stephanie Covington, PhD, LCSW
Institute for Relational Development & Center for Gender and Justice
- Modern methods of addictions treatment look at multiple modes and social problems for intervention. Go from a single lens to interwoven pieces that include:
- Medical and biopsychosocial services
- Outreach and engagement
- Screening and monitoring
- Assessment
- Counselling
- Case management
- Support services such as:
- Life-skills
- Advocacy
- Primary healthcare
- Family programs
- Housing support
- Training/employment
- Community supports such as:
- Transportation
- Child care
- Recovery Community Support
- Faith-based supports
- Housing Assistance
- Family Strengthening
- This is about being able to address the complexity of people’s lives
- Women’s Integrated Treatment – see Covington’s work here
Excerpt from “Women & Addiction”
Stephanie Covington, PhD, LCSW
Institute for Relational Development & Center for Gender and Justice
- If we work with people who have experienced trauma, we need to adjust how we wor with them in ways where they can achieve the maximum benefit. Trauma-informed services:
- Take trauma into account
- Avoid retriggering trauma reactions and/or retraumatizing the client
- Modify the behaviour of the practitioner and other staff in an organization to support the client’s coping capacity
- Allow survivors to manage their trauma symptoms successfully so that they can access, retain, and benefit from the services received.
- Trauma is defined in the DSM-iV-TR.
- Types of abuse:
- Sexual
- Physical
- Emotional
- Domestic
- Witnessing abuse/violence
- Self-inflicted violence
- Military sexual assault
- Gender-specific
- Stigmatization (looked at with distant)
- Women/girls in the criminal justice system
- Women and girls of colour
- Women/girls living in poverty
- Non-binary and sexually diverse women and girls
- Women and girls with mental illness
- Women and girls with physical challenges
- Cultural disdain
- Indigenous
- Japanese internment
- Gender differences
- Look over the lifespan.
- The greatest risk is from family members.
- Abuse of males usually comes from people that don’t like the individual.
- Abuse of females comes from people the female may have feelings of love for.
- Stigmatization (looked at with distant)
Excerpt from “Women & Addiction”
Stephanie Covington, PhD, LCSW
Institute for Relational Development & Center for Gender and Justice
- Helping women recover
- Theory of addiction
- Holistic health model
- Chronic neglect of self in favour of something or someone else
- Theory of Women’s Psychological Development
- Relational-cultural Theory
- Theory of Trauma
- Three Stage Model
- Upward Spiral – A Transformational Model (see a Covington presentation here.
- Theory of addiction
- Helping Men
- What is the messaging that men get early in life – what does it mean to be a man?
- What do men need to do to achieve wellbeing – how does this compare with the messaging they received early on in life?
- Application of theories
- Psychological development (Relational-cultural theory)
- Attachment theory (Ainsworth, Bowlby, Harlow, & Stern)
- Theory of Trauma (Three Stage Model, Transformational Spiral)
- Theory of Resilience (Biscoe, Wolin, & Wolin)
- Theory of Addiction (Holistic Health Model)
Excerpt from “The Wellbriety Movement: Cultural Healing from Addiction”
Don Coyhis
White Bison Inc
- Discusses the “Peter Principle” (see concept explained here).
- Examines the elder knowledge for cycles and the seen and unseen world. Examines natural laws.
- Healing, Spirituality, ceremonies, and interconnectedness are the essential foundations – depending on language, cultural values, elder teachings, and interconnectedness that are held through vision, principles, laws, and values.
Excerpt from “The Wellbriety Movement: Cultural Healing from Addiction”
Don Coyhis
White Bison Inc
- Canadian Residential Schools were a model adapted from America.
- Imperialism and abuse removed the community tools that created interconnectedness. Fear, guilt, shame, and anger replaced the indigenous ways of knowing. Hurt people hurt people.
- We blame the kids for the system when it is the system that fails the kids.
Excerpt from “The Wellbriety Movement: Cultural Healing from Addiction”
Don Coyhis
White Bison, Inc.
- Historical trauma is a combination of immense losses and traumatic events that are perpetrated upon an entire culture. It includes the removal of:
- Culture
- Language
- Land
- People
- Ways of life
- Religion
- Family structure (such as being relocated or forced into boarding schools)
- The observational changes of trauma often do not surface for 2-3 generations. This is intergenerational trauma.
- How do we go back to indigenous ways of knowing and knowledge systems? Restoring Language, Cultural Values, and Elder Teachings.
- Shift to intergenerational healing by:
- Restoring culture
- Reviving Language
- Preserving Land
- Focusing on people’s health emotionally, mentally, physically, and spiritually.
Excerpt from “The Wellbriety Movement: Cultural Healing from Addiction”
Don Coyhis
White Bison, Inc.
- How do we promote healing.?
- Create a healing environment
- Follow the Seven Steps for Systemic Community Development:
- Conduct a community readiness assessment
- Firestarter Headman/ Headwoman
- 7 Wellbriety Training
- Grief Recovery Coaches
- Community Visioning Process
- Vision Book
- Planning and Implementation – including additional training.
- Tackle unresolved grief at a community level – build community infrastructure – community support groups.
- Reestablish culture, to get rid of secrets that allow for the hurt to thrive.
- Share secrets to that the community can heal.
- We need to Recognize abuse, Acknowledge abuse, Forgive abuse, and change environments that allow abuse to thrive.
- Types of forgiveness:
- Basic forgiveness
- Forgiving the unforgivable
- Forgiveness of self
- Forgiving others