"I'm a Stepping Stone to their Healing": An exploratory study of the role of treatment providers in Aboriginal women's healing from problematic substance use and experiences of violence

Abstract

The association between women’s problematic substance use and their experiences of trauma and violence is well established in the literature. Research has demonstrated high rates of physical and sexual abuse among women seeking drug treatment services. Women who attempt to address their trauma-related concerns through conventional, male-centred substance use treatment options often find they do not succeed. In response, integrated treatment services have been developed to account for women's experiences of trauma. Not well addressed however is the unique experiences of First Nations, Inuit and Métis women. Guided by the post-colonial feminist framework, this exploratory study applied a community-based, qualitative approach in an attempt to understand what it means to address trauma from a gender-informed lens in Aboriginal women’s treatment for problematic substance use. Using the constructivist grounded theory method, I explored the perspectives of drug treatment providers within Aboriginal addiction treatment centres from across Canada. A secondary analysis of 30 interviews with drug treatment providers in six facilities revealed that trauma and violence, based in historical and contemporary impacts of colonization, are significant concerns in the lives of Aboriginal women. Connections were made between women’s histories of violence, low self-esteem, and associated substance use. In addition, parenting challenges and issues with the child welfare system were identified as significant concerns for women in treatment, which greatly impacted their healing journeys. Existing approaches to treatment applied by service providers were explored, and the findings highlighted the importance of culture, identity, and self-esteem building in addressing the trauma and substance use related needs of Aboriginal women. It was found that treatment providers, especially those with lived experience, play a key role in supporting Aboriginal women’s healing from violence and problematic substance use. This study directs our attention to the need for further research and policy on the application of trauma-informed and trauma-specific approaches to drug treatment for Aboriginal women.