For women in recovery, their children may be their main motivator toward living sober, says licensed clinical social worker Twyla Wilson.
But child care and addiction treatment are difficult to coordinate, she added.
"That's often a huge barrier for women for treatment is they have no one to take care of their children while they seek help," Wilson said during her session Thursday at North Dakota's annual behavioral health conference, drawing from her decades of work with addiction patients as a psychotherapist in North Carolina.
Women's addiction wasn't recognized until the 1960s, according to Wilson, who said, even after that time, "we were thinking of the male as the client."
"We do have to admit that gender makes a difference, that women are different from men, because recovery services were one-size-fits-all for a long time," said Wilson, adding that women's recovery deals deeply with biological, psychosocial and parenting aspects of addiction.
"There are greater levels of shame and stigma for women who have addictions," she said.
Speaking before the health conference, Pamela Sagness, director of the North Dakota Department of Human Services' Behavioral Health Division, said women's recovery is a special need in the state.
From mothers' medication management to babies born exposed to substances, treatment efforts are better than a punitive approach, Sagness said.
"We recognize addiction as a chronic disease, and we can't punish our way out of it," she said. "There's nothing that will make a mother not want to go to treatment than being told you can't bring your newborn."
Ideal treatment would engage mothers and their children, according to Wilson.
"I would hope that their children could be treated simultaneously, so while Mom is getting better, the kids are getting some resources to both understand her addiction and understand, in age-appropriate manners, how that's been for them," she said. "Then Mom and kids have to have the ability to spend time together and rework their relationships, and they need therapeutic support for that."
A mother coming home from treatment to misbehaving, unregulated children could be triggered to relapse from that destabilization, said Wilson, adding that treatment and sober living facilities for mothers and children are effective, but still emergent.
"It's not the norm yet," she said.
The state behavioral health conference continues through Friday.