Treatment failures: the role of sexual victimization in women's addictive behavior.

Women substance abusers usually labeled as treatment failures are described and case illustrations are presented. The role of sexual victimization in the substance abuse is considered, as is the use of substances to mitigate posttraumatic stress symptoms. Abstinence as a precondition of treatment is examined, and more objective case conceptualization and treatment planning advocated. Aspects of the long-term therapeutic relationship are discussed.