The voices of welfare reform. (female welfare recipients present views concerning substance abuse and its effect on employment) (includes related articles on the use of art therapy as treatment for substance abusers)

Welfare recipients give their input on ways that human service departments can help substance-abusing clients reach self-sufficiency and sobriety.

The authors performed this study under a contract with the Office of Policy and Planning in the New Jersey Department of Human Services through a grant from The Annie E. Casey Foundation. All opinions in this article are those of the authors and do not necessarily represent the views of The Annie E. Casey Foundation, the New Jersey Department of Human Services, or Rutgers University.

Substance abuse may be the greatest barrier that welfare recipients must overcome to enter and remain in the workforce. Projections of the number of substance-impaired welfare recipients range as high as 1 million, and researchers estimate that at least 25 percent of women receiving public aid are so severely addicted that they are unable to maintain employment.(1) The import of these numbers is magnified if the impact on these women's children - and the increased potential for another generation of disadvantage and dependency - is considered.

Substance-affected women who receive welfare have always faced numerous challenges in their day-to-day lives as women and mothers. Under Aid to Families with Dependent Children, these women were usually able to count on receiving a subsistence level of benefits as long as they complied with eligibility requirements and provided adequate care for their children. With the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and the requirements of Temporary Assistance for Needy Families, however, overcoming these day-to-day challenges has become even more critical. Benefits are now subject to time limits, and recipients must work to receive public aid.

Although much has been written about the needs of addicted women and their children, human service departments have only a limited understanding of how they can best address these needs. Further, although a growing amount of literature addresses the treatment methods and interventions that are most effective for women, most treatment resources were originally designed for men and are often inappropriate or inaccessible for women.(2)

In many areas related to addiction, men and women require very different screening, outreach, and treatment approaches:

* Women are more intolerant than men of substance abuse in themselves and in other women, and they experience greater stigma and denial.