“Don’t You Understand That We Are Punishing You for Your Own Good?”: Attitudes of Women With Substance Use Disorder to Punitive and Therapeutic Methods in Closed Communities

The growing numbers of women with substance use disorder (SUD) and the resulting establishment of dedicated treatment and rehabilitation services have spawned a rich literature on the etiology of addiction among women, their therapy needs and the effectiveness of the treatments they receive. Nevertheless, very few studies have examined the punitive methods applied to women with SUD as part of their treatment. This study examines the positions of thirteen Israeli women with SUD regarding punishments meted out in closed therapeutic communities (TCs), and their experienced short- and long-term implications. The findings suggest ambivalence toward the harsh treatment and punishment in the communities, and to their negative repercussions for the clients’ mental condition after their release. We conclude that the methods of treatment and punishment in these settings must be changed and based on the clients’ strengths and empowerment. Punishments should be meted out in a proportional way, and as a last resource.