Although many investigators have written about the need for single-gender treatment for women with substance use disorders (SUDS), there are very few specific therapies developed for this population, and even fewer empirical studies to determine the relative effectiveness of these therapies versus standard treatments in a mixed-gender setting. The primary aim of this study is to develop a 12-session, manual-based relapse prevention group therapy treatment for women with SUDS. This treatment manual for a Women's Recovery Group (WRG) will focus on themes that are relevant to women with SUDS. There will be an emphasis on educating patients about treatment and relapse prevention of SUDS in a context that is relevant to women including the role of depression and anxiety in women's recovery from substance use, the role of partner relationships in recovery, substance use through the female life cycle, substance abuse and reproductive health, fostering mutual support, and the effect of physical and sexual assault on recovery. The manual will combine therapist information and instructions with patient worksheets, handouts and homework assignments. To accomplish this aim, we will: a. Obtain outside review of the manual at two different stages of its development from experts in the treatment of women with substance use disorders. b. Obtain monthly assessment of subjects' substance use, addiction recovery, and treatment utilization throughout the treatment intervention and for 3 months afterwards. These assessments along with data from a group of subjects receiving """"""""treatment as usual"""""""" (i.e., mixed-gender Group Drug Counseling) will help to inform our development of later versions of the manual. c. Establish the acceptability of the manual-based treatment intervention by obtaining session-by-session and overall patient and therapist satisfaction ratings. d. Develop and refine therapist competence and adherence measures for the treatment intervention, and develop instructions for their use by raters. e. Revise the manual in an ongoing way, based on information from elements a-d above, while conducting the group intervention twice in the pre-pilot phase, and twice again during a pilot study The investigators will then conduct a pilot study in which outcomes among subjects receiving the treatment intervention will be compared with outcomes of subjects who receive """"""""treatment as usual.""""""""
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