Amethyst Women’s Addiction Centre – A Program for Deaf Women

Amethyst: Who We Are and How We Started

Amethyst opened it doors in February 1979. The work which led to this began in 1975. An Ottawa committee requested that a group of women working mainly in addictions and health care met to look at the needs of women with addictions. At the time, the only service for women dealing with addictions was an Alcoholics Anonymous Discussion Group. In the 70's there was growing evidence that women experience substance abuse problems very differently than men. During this time, research was also beginning to indicate that many women had experienced sexual abuse as children. Research then and now supports that the vast majority of women dealing with substance abuse have also experienced severe sexual, physical and emotional abuse as children. This often leads to profound mental health problems.

Amethyst explored ways of providing support for women. Conventional programs were made mainly for men but women then and now live in very different roles than men. For women dealing with addictions, shame is a deep issue and dealing with it needs to happen in a safe place where women feel they can expose the internalized messages they received as children and also connect with other women to break the sense of isolation. As a way to address decreasing the isolation that women with addictions often experience, groups have always been a very important component of the work we do at Amethyst.

In addition to substance abuse services, Amethyst also provides services for women who identify gambling as a problem. This service is fairly new to Amethyst, although we are consistently seeing an increase in the numbers of women accessing this service. Another important program at Amethyst is our Health Promotion program. The goal of this program is to encourage women to create healthy lifestyle changes, through helping them take control over their lives. A number of workshops are available to women throughout the community. Support and services are also offered to children who are affected by their mothers’ addiction issue.

We also recognize that everyone has different needs and experiences and therefore, honouring, respecting, and attending to diversity is a priority. Services are available in both English and French. But we also recognize that a woman’s experience of addiction is affected by her race, class, mental health, (dis)ability, sexual orientation, etc. Central to our services is the belief that a woman’s experience of addiction cannot be separated from the social context in which her use becomes problematic.

In order to access services at Amethyst, a woman first needs to call us. At this time, the Intake worker gets some preliminary information from the woman, and schedules an initial appointment. Currently, the waiting period between when a woman first calls Amethyst and the initial appointment is between three and six weeks in the substance use program and between two and four weeks in the problem gambling program.

When the woman comes to Amethyst for the initial assessment appointment, it is an opportunity for the woman to share some information about her life, her use, and her understanding of what has led to the problematic use. The counsellor also provides the woman with more detailed information about Amethyst, and at this time, the woman and the counsellor decide together whether or not Amethyst is an appropriate service for what the woman needs.

There are three components to our program: individual counselling, group counselling and an intensive treatment program. During the pre-treatment phase, a woman can access individual counselling and group counselling, and once she has completed the intensive treatment program, women are encouraged to make use of individual and group counselling for up to two years of follow-up support. Counsellors are able to see women on an individual basis about once every three weeks, and therefore, encourage women to seek additional support in the groups that happen three times per week in the substance use program. The purpose of these groups is to create a safe place where women can let out the painful stories and emotions they have experienced so that they can move on from these. An important aspect of group participation is to break the sense of isolation that most women experiencing an addiction feel, and to help women recognize that their reactions to trauma and pain are normal. We encourage women to relate to what other women share, but ask that women do not offer advice or make judgements about what has been shared.

The other component of our services is the Intensive 10 Day Program, which is offered seven times per year. These are closed groups that include no more than 12 women. This program consists of sharing groups, relaxation exercises, and psycho-educational workshops each day. The purpose of this program is to allow women to explore their addictions in a more in-depth way, in the company of other women, and to discover new ways of coping and living without relying on alcohol or drugs. We address a range of topics, including (but not limited to) relapse prevention, women and depression, anger, women and violence, and shame and addiction.

In the problem gambling program, there are also three components available: individual counselling, group counselling, and the intensive treatment program. However, at this time, groups are only available once every two weeks and the intensive treatment program takes place over a number of weeks. Women meet once a week for two hours for a total of ten weeks. A major difference between the problem gambling program and the substance use program is that the substance use program is abstinence based, whereas the problem gambling program is harm reduction based. Therefore, in the problem gambling program, support is provided to women in order to either help maintain abstinence from gambling or reduce the harm associated with their gambling.

I'll let you know about my experience in this area. I went back to school when my youngest child entered Grade 1 and three years later I graduated with my MSW. My final step before that was my placement at Amethyst. I went to CAS after my graduation and a year later got to apply for a job at Amethyst because there was a position available - and I got it. Within the first two months I met with a client who was deaf and used sign language so we met with an interpreter. This was new for me, but lots of things resonated with me because of my children. I have 5 now aged 14 to 22, but the third and fourth children are deaf. They were diagnosed as babies and did get therapy so they are oral now but continue to experience a lot of difficulties because of being deaf.

I perceived that there was a reason why I got to meet with that woman. Since then I have met with several other women who are deaf and three of them use sign language. At Amethyst individual counselling has been the main focus for these women, though they did have some access to group sessions when interpreters were available. However, for women who are struggling with an addiction problem, recovery and sobriety often necessitates a more intense program, such as our 10 Day Program, or a short term residential program. But for people in Canada who use sign language and have an addiction, there is no residential service at all. In the United States, there are a few programs, and I have referred clients to one in Rochester, New York. This program includes hearing and deaf and hard of hearing clients, but is for both women and men.

It was a difficult place for several of the women I have worked with. Amethyst came into existence because for many women it is not helpful to be surrounded by men when they are struggling with recovery. This was part of the issue for my clients who attended the program in Rochester, as well as the fact that in order to access services they need to travel to the United States. This is what motivated us to apply for funding for American Sign Language interpreters so we could do a Pilot Project on our 10 Day Intensive Program that would available for women who are deaf and use sign language.

The Pilot Project.

When it was confirmed that we would get some funding for interpreters we formed a Steering Committee, including several local addiction agencies and support agencies for deaf or hard of hearing clients. The other agency that we have been close to in this is the Canadian Hearing Society where we get interpreters. For several months the Steering Committee met and we circulated information about the Pilot Project all over Ontario. This was sent to addiction agencies and health agencies and other organizations. It was confirmed that we would have two deaf women in the Pilot Project. One was from out of the city and one from within the city. We reviewed our 10 day program and got feedback and suggestions about how to work effectively with interpreters, as well as information about the specific needs of people who are deaf. The project started on March 1, 2004. The deaf women did participate well and shared their stories. They both shared about the difficult experience they had been through at Rochester and were happy to come to program in Ontario and most importantly, to come to one that is women only.

Overall, the feedback we received was very positive:

• Women shared that it was very important that it was an all-women environment, as they were better able to discuss their experiences of violence. Felt that an all-women environment increased feelings of safety
• Women enjoyed the range of topics we cover, and appreciated that we address the social context in which their substance use became problematic
• Generally speaking, women enjoyed and felt comfortable that it was an integrated environment with both deaf and hearing women. One deaf women stated however, that she would like to have the choice however to attend treatment in an all deaf-women environment
• Small group size was very important: helped to equalize the power dynamics between hearing and deaf women, and also worked to slow down the pace of the program.

• For the deaf women, the length of the day was too long. Even the length of sessions were too long.
• Too much information in such a condensed period of time.
• For the woman from out of town, nights and weekends were really hard for her. Day program services are not appropriate for women from out of town.
• Staff could have done more to model communication with the deaf women that did not rely on interpreters

Based on my research, I don’t think that there are any services anywhere in the world that are specific to deaf women who have an addiction. From what I shared before, it is clear that many women need to address their problems only with other women.

Feedback? Suggestions? Comments?