« Shaping the Future-A Multisectorial Challenge »

52th International ICAA Conference on Dependencies

Estoril, Portugal2009

Sylvain Harvey

Gender Specific Residentiel Therapeutic

Communities

• Where are we coming from…• The switch to gender specific programming• The resistance• The benefits• Conclusion

The Portage experience

Plan of presentation

• Portage was founded in Canada 1970 as a Therapeutic Community based on the American Daytop Model

• Long term, residential program 12 months plus in duration

• Every client entering Portage was expected to follow the same therapeutic program from beginning to end

• Highly confrontational, little distinction between male and female as specific needs

The Portage experience

Where are we coming from

• Low retention rate, program was more effective for males than females

• Staffing was almost exclusively ex-addicts• Interaction between male and female residents

was highly controlled, severe reprimands for “game playing” or “cheap feelings” breaking of the cardinal community rule of “no sex” often cause for expulsion

• Very poor performance of woman in treatment

The Portage experience

Where are we coming from

• In a desire to serve a greater female clientele Portage developed an experimental mother and children program. Mothers spent day in coed program with the other male and female clients

• Although children benefit significantly; women remained difficult to attract and retain in treatment

• Sexual acting out, couple formation remained the principal cause of program abandonment

• The dynamics in our female group helped us understand that many of the women entering treatment had little experience in positive interpersonal relationships with their own gender

The Portage experience

The switch to gender specific

• In 1995 Portage underwent major changes• Portage modified the induction process: it

became more welcoming, less confrontational and challenging towards the client

• In 1999 a critical year for Gender Specific Programming at Portage

• Increasing awarness and recognition of different treatment needs of males and females

The Portage experience

The change

• January 2002, all Portage facilities implement one day a week gender specific programming

• May 2003, adult programming at Lac Echo becomes fully gender specific

• May 2004, all Portage programs become gender specific except our West Island facility directed by Allan Farkas

The Portage experience

The change

• Initial reaction by residents: resentful and negative -similar reaction amongst the adolescent

• More pronounced resistance amongst women than men

• Several departures at the beginning• All concerns were encouraged to be expressed and

worked trough in group supervision and discussion group

• Residents adapt quicker than staff

The debate continues but no one wishes

to return to old ways

The Portage experience

The resistance or…

• Women share more openly in a gender specific environment

• Men find it easier to express some fears and emotions in a male only environment

• Sexual issues are easier to deal with for both genders

• Women find it easier to form friendships with other women

• Significant increase in the number of female clients

• Improved client retention for both genders and treatment outcomes

The Portage experience

The benefits staff

Women• There is more care and less acceptance in

the women community• Group interaction is more in dept and

victimizing is less present• Group interaction is much deeper and less

superficial« I feel less alone and my relationships are more

honest and I have the feeling that I belong now »

The Portage experience

The benefits client

The benefits client

Men

• The general atmosphere of our community is much calmer and conflicts are easier to manage and resolve

« I felt more support from the men »

« In the presence of women I used to hide aspects of my personality I didn’t like. With men, they surface and I have to adress them »

The Portage experience

The conclusion Increased female population and

retention for both males and females in all Portage programs

Elimination of treatment abandonment due to couple formation

Decrease in incidences and inappropriate behaviors for both gender

Significantly improved outcomes on all measures for both genders