Factors influencing women's recovery from substance abuse: A grounded theory approach.

Abstract

The study of female substance use has traditionally been neglected. Yet female substance abusers differ from their male counterparts in the areas of economic resources, vulnerability to impaired family relations, abuse and victimization, social isolation, shame and stigma when entering treatment, and treatment resources to meet their needs as women and mothers. Despite this, females do as well, or better, than males in treatment, However, the number who actually complete treatment is still very low. A grounded theory approach was used to identify conditions influencing treatment retention and to develop a model of women's recovery from substance use. Miller's mutual empowerment model was used to generate preliminary hypotheses. Miller's model states that women's psychological development occurs in the context of their relationships and connection to others. It was hypothesized that the relationship with the treatment provider would be the critical variable influencing treatment retention. It was further hypothesized that supportive, empowering relationships are a crucial aspect of recovery, as well as the emergence of a new identity. These hypotheses were supported. A model, recovery through connections, was developed. A woman's recovery is dependent upon the connections she forms with treatment and herself. The importance of these connections is derived from the woman's need to fill a void, or state of deficit. The recovery process consists of two stages: connection with treatment and connection with self. Connection with treatment represents a positive connection with treatment. This connection is facilitated or hindered by positive and negative treatment characteristics. Positive treatment characteristics facilitate the formation of supportive relationships and lead to treatment completion. Negative treatment characteristics impede their formation and lead to quitting treatment. In the connection with self stage the woman is learning to meet her own needs and access power within herself. Personal qualities facilitating this connection are will, resourcefulness, spirituality and trusting others. Qualities hindering this connection are shame and self-doubt. Two contextual factors influencing the model are external forces and mothering. The final outcome is transformation. In transforming her life the woman transfers her connections from a using lifestyle and culture to a non-using, prosocial lifestyle.