The Importance of Gender-Responsive Treatment in Working with Girls

Report
Girls Got Issues:
The Importance of GenderResponsive 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 GenderCompetent 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 GenderResponsive 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 AtPromise”
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


Project Chrysalis

•
Girls 14-18 who have been abused.
Movimiento Ascendencia (Upward Movement) was
established in Pueblo, Colorado


Girls 9-18—Aggression, violence, family problems,
AOD, trauma
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

[email protected]

Www.MonfordDentConsulting.com

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