Division of Alcohol, Drugs, and Addiction, McLean Hospital, Belmont, Massachusetts, USA.
Division of Women's Mental Health, McLean Hospital, Belmont, Massachusetts, USA.
Am J Addict. 2022 Jan;31(1):9-21. doi: 10.1111/ajad.13242. Epub 2021 Nov 3.
This thematic analysis of qualitative interviews from participants in Stage II randomized controlled trial examined women's and men's experiences in group therapy for substance use disorders (SUDs).
Interviews were conducted with 77 women and 38 men after completion of either the gender-specific Women's Recovery Group (WRG) or mixed-gender Group Drug Counseling (GDC). Interviews were coded for themes using a deductive approach with a coding scheme modified from the Stage I trial. Satisfaction was measured quantitatively posttreatment.
Participants had high satisfaction scores with no significant differences between groups. Women in GDC rated group gender composition as less helpful than those in WRG. In the GDC group, women more frequently discussed the theme of self-perception (e.g., feelings of comfort, safety, shame) compared with men. Men overwhelmingly expressed the benefits of having women in the group, whereas women expressed advantages and disadvantages of mixed-gender groups and preference for single-gender groups. Guilt and shame were discussed by women and men; however, only women discussed stigma and its important role in their addiction and recovery.
Men more frequently endorsed the helpfulness of mixed-gender groups than did women while women appreciated the enhanced support in single-gender SUD groups. Issues of stigma are especially salient for women.
Men and women express differences in their experiences of SUD group therapy. Only women endorse stigma as an obstacle to their treatment and recovery. Tailoring treatment to meet women's and men's needs may enhance engagement, retention, and clinical outcomes.
本研究通过对第二阶段随机对照试验的定性访谈进行主题分析,考察了女性和男性在物质使用障碍(SUD)团体治疗中的经历。
在完成特定于性别的女性康复团体(WRG)或混合性别团体药物咨询(GDC)后,对 77 名女性和 38 名男性进行了访谈。使用从第一阶段试验修改而来的推导方法和编码方案对访谈进行了主题编码。治疗后进行了满意度的定量测量。
参与者对治疗的满意度评分很高,两组之间没有显著差异。GDC 组的女性对团体的性别构成评价不如 WRG 组的女性。在 GDC 组中,女性比男性更频繁地讨论自我认知主题(例如,舒适感、安全感、羞耻感)。与男性相比,女性更多地表达了混合性别团体的优势和劣势,以及对单一性别团体的偏好。男性压倒性地表达了女性在团体中的好处,而女性则表达了混合性别团体的优势和劣势,并对单一性别团体表示了偏好。女性和男性都讨论了内疚和羞耻感;然而,只有女性讨论了耻辱感及其在她们成瘾和康复中的重要作用。
男性比女性更频繁地认可混合性别团体的有益性,而女性则欣赏单一性别 SUD 团体中增强的支持。耻辱感问题对女性尤为突出。
男性和女性对 SUD 团体治疗的体验存在差异。只有女性将耻辱感视为治疗和康复的障碍。根据女性和男性的需求调整治疗方法可能会提高参与度、保留率和临床效果。