The Importance of Gender-Responsive Treatment in Working with Girls
Girls Got Issues:
The Importance of Gender-
Responsive Treatment in
Working with Girls
Dr. Tyffani Monford Dent
Falisa Asberry, MS
Objectives
Gain understanding of the prevalence of mental health issues in girls
Learn how mental illness presents differently in girls vs. boys
Gain understanding of the components of gender-responsive treatment
Why Gender-Specific
Treatment?
Why Girls Need Gender-
Competent Programs
•
•
•
Girls develop in unique & powerful ways that require specialized focus
Programs designed for boys do not address unique & complex needs of girls
Programs for are more successful when:
For Boys
• Focus on rules
•
Offer ways to advance thru structured system
For Girls
• Focus on relationships with other people
• Offer ways to master their lives while keeping these relationships intact
Note:
Primary focus of Gender-Responsive
Treatment has come from Adult and
Juvenile Corrections
Mental Illness and
Girls
Women and girls with mental health and/or substance use conditions/disorders are at higher risk for associated physical health and medical problems.
Mental Health by
Gender
Boys are more likely than girls to have a mental health need
BUT
Girls are more prone to anxiety and depression
Girls are more likely to come to the emergency department having attempted suicide
Girls have higher prevalence rates of
PTSD, eating, sleeping, somatization and borderline personality disorders and features.
Girls have higher rates of co-occurring mental health and substance use rates.
Gender differences in aggression narrow beginning in adolescence
Interpersonal stress is higher in adolescence, especially with girls--and more related to depression in girls than boys
Girls more likely to ruminate than boys
Issues in working with girls
SAMHSA Assertions about working with girls
Women and girls are different from men and boys in
Physiology
Cognition
Emotions social development communication patterns roles, socialization
Risks resiliency.
Biological/physiological
Adolescence, pregnancy, perimenopause, and menopause are distinct periods in a woman’s life, each accompanied by a range of physiological, psychological, and developmental changes, with changing risks, opportunities, and support needs.
Societal gender-role expectations
That stereotypes about sexuality in the media and community, and the unrealistic portrayal of their bodies
Gender influences communication, life priorities, responsibilities, and expectations.
Recognition of resiliency
Societal expectations and messages regarding women’s sexuality can deter healthy sexual development and decision-making.
Experience with trauma
Being female means there is an increased likelihood of violence and trauma trauma can have a strong and longlasting effect on development and on the experiences of women and girls.
Societal and cultural interpretations and contexts shape how the trauma experiences are
defined
accepted, prevented,
Women and girls are more frequently vulnerable to violence and trauma, and this vulnerability must be addressed in prevention efforts as well as other mental health and substance abuse services.
Prevalence Rates
Boys & Girls
Girls are 3-4 times more likely to be victims of sexual abuse than boys.
Girls are more likely to be victimized physically, and sexually by a family member.
Victimized girls are more likely to present serious mental health symptoms.
18
Boys and girls respond differently to abuse. Boys generally become aggressive.
Girls tend to internalize the injury, sometimes becoming aggressive and other times becoming depressed, or both at the same time.
Boys tend to minimize their negative emotions.
Relationships are critical to the emotional development of women and girls and also play a significant role in both the development of, and recovery from, mental health and substance use conditions/disorders.
shame and personal guilt feelings
That women and girls who are trauma survivors may have “triggers” of traumatic memories that can cause them to re-experience the trauma.
Of the developmental impact of violence and trauma on girls in childhood and adolescence, and how it can influence their transition to adulthood.
Of the increased vulnerability to violence and trauma for girls and women with disabilities
Of the concept and potential impact of historical-cultural and intergenerational trauma
Special Populations
As many studies and reports have indicated, differences in cultural beliefs and values are important to consider in mental health service delivery, as they affect treatment preferences and outcomes.
Culture impacts how individuals receiving mental health services
• identify and express or present distress
• explain the causes of mental illnesses
• regard mental health providers
• utilize and respond to treatment
Hogg Foundation for Mental Health (2006)
SAMHSA
Although women and girls may share many biopsychosocial and spiritual characteristics as a gender group, women and girls are heterogeneous.
Culture, age, socioeconomic status, religion, disability, and racial and sexual identity all influence women’s gender roles. It is critical that staff understand how sociocultural identities differ among women and girls and may lead to different health outcomes.
Cultural identity and impact on girlhood
May identify more with race/ethnicity than girlhood
Cultural beliefs about girlhood
(marianismo, being black first and girl second)
Areas of competency needed (SAMHSA)
Sex and Gender Differences
Relational Approaches in Working with
Women and Girls
Understanding Trauma in Women and Girls
Family-Centered Needs of Women and Girls
Special Considerations During Pregnancy
Women’s Health and Health Care
Collaboration and Interdisciplinary Skills
What is Gender-
Responsive Treatment
Treatment that addresses the unique needs of girls and women
Trauma-informed, integrated treatment approach
What does GRT do?
“Create environment in which program development, content, and material reflects understanding of the realities of the lives of women and girls…that addresses and responds to their strengths and challenges”
(Covington & Bloom)
Theory underlying
GRT
Strengths-based
Relational Centrality
Holistic
Safe
Evidence-Based
Strengths-Based
Promote empowerment and activate social supports
Understand their relational capacities as assets and manage relational aggression
Resiliency
innate capacity that when facilitated and nurtured empowers to successfully meet life’s challenges with a sense of self-determination, mastery and hope.
Identify strengths and build upon them
Know about Protective Factors
Religion
Family
Self-esteem
Educational achievements
Independence
Clear expectations
More intensive reserved for those who are the most vulnerable
Avoid referring to girls as “high-risk”
Rise Sister Rise language “Girls At-
Promise”
Increasing strengthsbased
Engage the girls in being active participants—give a voice
Develop natural supports/bonds
Teach new skills based on strengths
Provide equitable academic & vocational experiences
Support leadership skill development
Relational
Agreement among researchers that girls’ friendships are critical in the development of adolescent identity, behaviors, and overall health
Relational-Cultural
Theory
(Jean Baker Miller)
People grow through and toward relationships throughout the lifespan, and that culture powerfully impacts relationship.
Impacts cognitive, emotional, physical, and spiritual health
Gilligan & Mikel
Brown
Critical need for girls to experience relationships in which their voices are heard without being alienated
Building healthy alliance
Girls socialized to listen to others
Girls value the emotional exchange that takes place in relationships
Need to
Agreement on
Goals of intervention
Collaboration on tasks required to achieve goals
Trustng and respectful relationship that is safe
Female staff may have the advantage in this
Demonstrate
Respect women and girls.
Value connection with others and recognize women’s and girls’ need for connection as a legitimate objective.
Value and express compassion, warmth, support, empathy, authenticity, humility, and sensitivity toward women and girls.
Value women and girls as active participants in their health and wellness, and recognize that they are capable of setting their own priorities and identifying steps toward change.
Recognize sexual stereotypes and sexualizing messages regarding women and how these messages can affect one’s attitudes, expectations, and treatment of women and girls.
Promote healthy connections
Emphasize positive connections with family, peers, school, and community
Expose to positive role models
Promote healthy relationships among girls
Social competency techniques
Cognitive interventions that decrease negative self-view
Safety
•
Physical Safety
•
Emotional Safety
•
Surroundings that Value
Females
•
Single-gender programming
– in small groups, free from attention of adolescent males
Evidence-Based
Test measures
YLS/CMI
Early Assessment Risk List for Girls
(EARL-21G)
BDI
Massachusetts Youth Screening
Instrument (MAYSI-II)
Child and Adolescent Needs and
Strengths-Juvenile Justice (CANS-II)
Promising Curricula
(Per OJJDP)
Girls Circle
•
Girls 9-18—Aggression, violence, family problems,
AOD, trauma
Project Chrysalis
Girls 14-18 who have been abused.
Movimiento Ascendencia (Upward Movement) was established in Pueblo, Colorado
Girls 8-19, Hispanic—delinquency, gang prevention
Girls, Inc. Friendly PEERsuasion
Ages 11-14, primarily AOD, conflict resolution
Other Options
VOICES: A Gender-Responsive
Curriculum for Girls
Growing Beyond: A Workbook for
Girls
Growing Great Girls A Gender
Responsive Life Skills Curriculum
Project Girl (Media and body image)
Creating Resiliency in Girls
Michigan Department of Human Services
BUT…
women and girls are heterogeneous.
Remember
Their presentation and needs often differ from boys
Programs/interventions designed for boys may not meet their needs
Must
Individualized Assessment
Helping Alliance
Gender-responsive programs/resources
Healthy connections
And Again, Recognize their differences
Value the FEMALE PERSPECTIVE
Celebrate & honor the FEMALE EXPERIENCE
Respect & take into account FEMALE
DEVELOPMENT
EMPOWER young women to reach their full potential
Contact Information
DrTyff@yahoo.com
Www.MonfordDentConsulting.com
