Tailoring Treatment to Women in Outpatient Substance Abuse Treatment: 1995-2000

Background and purpose: Evidence suggests that tailoring substance abuse treatment to women can often lead to better outcomes, particularly for subgroups of women. However, there is limited availability of treatment tailored to women. This investigation examined recent changes in outpatient substance abuse treatment tailoring to women and identified unit and contextual factors associated with these practices.

Methods: Data were from two waves of a national outpatient substance abuse treatment program survey (n=618 in 1995, n=566 in 2005). Tailoring to women was measured as availability of prenatal care, child care, single sex therapy, and same sex therapists, and the percentage of staff trained to meet female clients' needs. Comparisons of weighted means between waves indicate which practices changed over time. Multiple logistic regressions with generalized estimating equations test associations between unit and contextual attributes and tailoring to women.

Results: Two measures of tailoring to women declined significantly between 1995 and 2005: availability of single sex therapy (from 66% to 44% of units) and percent staff trained to work with women (from 42% to 32% of units). No aspect of tailoring to women became more common. Proportion of clients female, total number of clients, methadone status, and private and government managed care were associated with higher odds of tailoring to women. For-profit facilities, which became more prevalent during the study period, had lower odds than other units of tailoring treatment to women.

Conclusions and implications: Some key aspects of outpatient substance abuse treatment tailoring to women decreased significantly in the last decade raising concerns about access to this type of care. Managed care contracts may offer one mechanism for counteracting these trends.

Funding: This research was supported by Grant 5 R01 DA003272 from the National Institute on Drug Abuse (NIDA).