Helping Women Recover & Beyond Trauma (HWR/BT) [Trauma Treatment (Adult)]

About This Program

Target Population: Adult women with addictive disorders and a trauma history (e.g., abuse, domestic violence, community violence, etc.)

Program Overview

HWR/BT is a combined intervention of 29 sessions that integrates three theories: a theory of addiction, a theory of women’s psychological development, and a theory of trauma; and then adds a psychoeducational component that teaches women what trauma is, its process, and its impact. The program model is organized into seven modules. The first four: Self, Relationships, Sexuality, and Spirituality are areas that recovering women have identified as triggers for relapse and as necessary for growth and healing. The last three: Violence, Abuse, and Trauma; The Impact of Trauma on Women’s Lives; and Healing from Trauma; focus on the trauma with a major emphasis on coping skills, with specific exercises for developing emotional wellness. The program comes with facilitator’s manuals, two participant workbooks (A Women’s Journal and A Healing Journey), and 3 DVDs. The materials are designed to be user-friendly and self-instructive. A special edition for criminal justice settings has also been developed.

Note: The Beyond Trauma materials were expanded and revised in 2017. The changes include an additional session, expanded sessions, inclusion of information from neuroscience, updated statistics, and resources. These changes have not been reviewed by the CEBC and are not included in the program’s Scientific Rating.

Program Goals

The overall goals of Helping Women Recover & Beyond Trauma (HWR/BT) [Trauma Treatment (Adult)] are to accomplish a/an:

  • Decrease in substance use disorders
  • Decrease in depression
  • Increase in understanding of trauma
  • Decrease in trauma symptoms
  • Increase in self-efficacy
  • Stabilize recovery

Essential Components

The essential components of Helping Women Recover & Beyond Trauma (HWR/BT) [Trauma Treatment (Adult)] include:

  • The Helping Women Recover part of the combined curriculum with four modules with specific topic areas for each of the 17 sessions (there is also a self-administered recovery scale for each module):
    • Module A: Self - 4 sessions with a total of 13 activities:
      • Defining Self
      • Sense of Self
      • Self-Esteem
      • Sexism, Racism, and Stigma
    • Module B: Relationships - 5 sessions with a total of 18 activities:
      • Family of Origin
      • Mothers
      • Mother Myths
      • Interpersonal Violence
      • Creating Healthy Relationships and Support Systems
    • Module C: Sexuality - 5 sessions with a total of 14 activities:
      • Sexuality and Addiction
      • Body Image
      • Sexual Identity
      • Sexual Abuse
      • Fear of Sex while Clean and Sober
    • Module D: Spirituality - 3 sessions with a total of 10 activities:
      • What is Spirituality?
      • Prayer and Meditation
      • Creating a Vision
  • The Beyond Trauma part of the combined curriculum with three modules with specific topic areas for each of the 12 sessions.
    • Module A: Violence, Abuse and Trauma - 4 sessions with a total of 11 activities:
      • Introduction to the Program
      • The Connections between Violence, Abuse and Trauma
      • Power and Abuse
      • The Process of Trauma and Reactions to Trauma
    • Module B: The Impact of Trauma on Women’s Lives - 2 sessions with a total of 8 activities:
      • How Trauma Impacts our Lives
      • Abuse and the Family
    • Module C: Healing from Trauma - 6 sessions with a total of 21 activities:
      • The Connection between Trauma and Addiction: Spirals of Recovery and Healing
      • Grounding and Self-Soothing
      • The Mind and Body Connection
      • Our Feelings
      • Healthy Relationships
      • Endings and Beginnings
    • Recommended group size: 6-12 women with one facilitator
    • Each session also has an adaptation option for girls ages 13-18

Program Delivery

Adult Services

Helping Women Recover & Beyond Trauma (HWR/BT) [Trauma Treatment (Adult)] directly provides services to adults (regardless of whether they are parents or caregivers) and addresses the following:

  • Substance abuse, interpersonal violence, symptoms from experiencing trauma

Recommended Intensity:

One or two 90-minute sessions of Helping Women Recover per week.

Recommended Duration:

29 sessions – approximately 4-7 months

Delivery Settings

This program is typically conducted in a(n):

  • Community Agency
  • Jail
  • Outpatient Clinic
  • Prison or prerelease center
  • Residential Care Facility
  • Reentry Agency/Facility


Helping Women Recover & Beyond Trauma (HWR/BT) [Trauma Treatment (Adult)] includes a homework component:

Women have two journals used consecutively to process their group experience and practice skills.

Resources Needed to Run Program

The typical resources for implementing the program are:

  • Facilitator’s guides
  • Flip chart
  • Workbooks
  • Room with chairs in a circle
  • A group facilitator
  • Art supplies for collage work

Education and Training

Prerequisite/Minimum Provider Qualifications

Counselor with experience in the field and with group work or a college graduate

Education and Training Resources

There is a manual that describes how to implement this program , and there is training available for this program.

Training Contact:
Training is obtained:

Training can be provided onsite. There are also trainings available at various sites in California and other parts of the U.S. Once the program is implemented, fidelity scales are available to assist with implementation.

For more information see, and

Number of days/hours:

Generally 2 days

Additional Resources:

There currently are additional qualified resources for training:

Please contact the Training Contact above for a list of certified trainers.

Relevant Published, Peer-Reviewed Research

This program has been reviewed and it was determined that this program lacks the type of published, peer-reviewed research that meets the CEBC criteria for a scientific rating of 1 – 5. Therefore, the program has been given the classification of "NR - Not able to be Rated." It was reviewed because it was identified by the topic expert as a program being used in the field, or it is being marketed and/or used in California with children receiving services from child welfare or related systems and their parents/caregivers. Some programs that are not rated may have published, peer-reviewed research that does not meet the above stated criteria or may have eligible studies that have not yet been published in the peer-reviewed literature. For more information on the "NR - Not able to be Rated" classification, please see the Scientific Rating Scale.

Covington, S., Burke, C., Keaton, S., & Norcott, C. (2008). Evaluation of a trauma-informed and gender-responsive intervention for women in drug treatment. Journal of Psychoactive Drugs, SARC Supplement 5, 387-398. doi:10.1080/02791072.2008.10400666

Type of Study: One group pretest-posttest study
Number of Participants: 202


  • Age — 18-54 years
  • Race/Ethnicity — White 41%, Hispanic 31%, Black/African American 18%, and Other 10%
  • Gender — 100% Women
  • Status — Participants were from a twelve-month residential drug and alcohol treatment program for women.

Location/Institution: California

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined the use of the Helping Women Recover and Beyond Trauma (HWR/BT) curricula in a residential drug and alcohol treatment facility for women. Women who successfully completed the HWR/BT programs were assessed at several points in time. Measures included the Trauma Symptom Checklist, Beck Depression Inventory, and Addiction Severity Index for females. The findings indicated less substance use, less depression, and fewer trauma symptoms —including anxiety, sleep disturbances, and dissociation—after participation in the HWR/BT curricula. Limitations included the lack of a comparison or control group and a high rate of attrition between intake and exit.

Length of postintervention follow-up: None.

Messina, N., Grella, C. E., Cartier, J., & Torres, S. (2010). A randomized experimental study of gender-responsive substance abuse treatment for women in prison. Journal of Substance Abuse Treatment, 38(2), 97–107. doi:10.1016/j.jsat.2009.09.004

Type of Study: Randomized controlled trial
Number of Participants: 115


  • Age — Mean=36 years
  • Race/Ethnicity — 48% White, 17% Black, 26% Hispanic, and 9% Other
  • Gender — 100% Female
  • Status — Participants were women who participated in prison based substance abuse treatment.

Location/Institution: California

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study compared post-release outcomes for women who participated in prison-based substance abuse treatment. Women were randomized to a gender-responsive treatment program using the manualized Helping Women Recover and Beyond Trauma (HWR/BT) curricula or a standard prison-based therapeutic community. Data were collected from the participants at prison program entry and 6 and 12 months after release. Measures included the Addiction Severity Index (ASI) Lite and the Posttraumatic Stress Diagnostic Scale, along with administrative records from the prison and treatment providers. Results indicate that both groups improved in psychological well-being, but data from the Posttraumatic Stress Diagnostic Scale was not reported at the follow-up time point. HWR/BT participants had greater reductions in drug use, were more likely to remain in residential aftercare longer, and were less likely to have been re-incarcerated within 12 months after parole. Limitations included a lack of fidelity measures during the active treatment phase, the relatively small sample size, and limited power in the study.

Length of postintervention follow-up: 1 year.

Messina, N., Calhoun, S., & Warda, U. (2012). Gender responsive drug court treatment: A randomized controlled trial. Criminal Justice and Behavior, 9(12), 1539-1558. doi:10.1177/0093854812453913

Type of Study: Randomized controlled trial
Number of Participants: 94


  • Age — Mean=36 years
  • Race/Ethnicity — 58% White and 22% Hispanic
  • Gender — 100% Women
  • Status — Participants were women offenders admitted into participating drug court programs.

Location/Institution: San Diego, CA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study compared outcomes for women offenders who participated in four drug court programs. Participants were randomly assigned to either Helping Women Recover and Beyond Trauma (HWR/BT) or standard mixed-gender treatment. Measures utilized include the Posttraumatic Stress Diagnostic Scale (PDS) and the Addiction Severity Index–Lite (ASI). Results showed that there were no significant differences between the HWR/BT and standard groups on drug use or PTSD symptoms at follow-up. HWR/BT participants had better in-treatment performance and more positive perceptions related to their treatment experience. Limitations include the small sample size and concerns regarding treatment fidelity across the sites.

Length of postintervention follow-up: Unclear – approximately 22 months after treatment entry with treatment lasting 15 to 24 months. Subjects still in treatment at follow-up were excluded from the analyses.

Additional References

Covington, S. (December 2013). “Chapter IV: Understanding and applying gender differences in recovery.” In United Nations Interregional Crime and Justice Research Institute (UNICRI) (Eds.), Dawn Drug Alcohol Woman Network: Promoting a gender-responsive approach to drug addiction (a collection of good practices). Turin, Italy: Author.

Covington, S. (2008). Women and addiction: A Trauma-informed approach. Journal of Psychoactive Drugs, November (Suppl. 5), 377-385. Retrieved from

Poole, N., & Greaves, L. (Eds). (2012). Becoming trauma informed. Toronto, Ontario, Canada: Centre for Addiction and Mental Health (CAMH).

Contact Information

Stephanie S. Covington, PhD, LCSW
Agency/Affiliation: Center for Gender and Justice
Phone: (858) 454-8528
Fax: (858) 454-8598

Date Research Evidence Last Reviewed by CEBC: June 2018

Date Program Content Last Reviewed by Program Staff: November 2018

Date Program Originally Loaded onto CEBC: June 2013