McLean Hospital 115 Mill Street Belmont, MA 02478
Shelly F. Greenfield, MD, MPH, is an addiction psychiatrist, clinician, and researcher. She serves as principal and co-investigator on federally funded research focusing on substance use disorders treatment, gender differences, and substance health services. She received a National Institute on Drug Abuse (NIDA)-funded career award in substance use disorder patient oriented research and NIDA-funded grants to develop and test a new manual-based group therapy for women with substance use disorders.
Dr. Greenfield is a member of the Board of Directors of the American Academy of Addiction Psychiatry and the American Psychiatric Association’s Council on Addiction Psychiatry, and chair of the NIDA Clinical Trial Network’s Gender Special Interest Group. She is editor in chief of the Harvard Review of Psychiatry, a distinguished fellow of the American Psychiatric Association, and is the recipient of numerous awards including McLean’s Jack H. Mendelson Memorial Award for Research and the R. Brinkley Smithers Distinguished Scientist Award from the American Society of Addiction Medicine.
Dr. Greenfield is a leading clinical and research authority on the treatment of substance use disorders. Her research focuses on a wide range of questions regarding development, implementation, quality, and financing of treatment services for substance use disorders in the US and globally. Dr. Greenfield’s Alcohol and Drug Abuse Clinical and Health Services Research Program focuses on four main areas: gender differences in substance use disorders, development of effective treatments for substance use disorders in special populations such as women and people with substance use and co-occurring other psychiatric disorders, effective implementation of treatment services for substance use disorders, and public health efforts aimed at prevention and early detection.
Dr. Greenfield received two NIH/NIDA grants to develop and test the implementation of an effective group therapy for women with substance use disorders. The Women’s Recovery Group (WRG) therapy was designed for women with substance use disorders (SUDs) who are heterogeneous with respect to the substance(s) used (e.g., alcohol or drug), co-occurring psychiatric disorders, trauma histories, and age or stage of life (e.g., single, partnered, pregnant, parenting). The WRG study was developed and tested in two clinical trials that demonstrated efficacy, participant and therapist satisfaction, and the feasibility of implementing the group in real-world clinical settings. In the Stage I trial, a manual-based 12-session group therapy for women was developed and pilot tested in a randomized controlled trial compared with mixed gender group drug counseling (GDC). This trial found that the WRG was equally effective as mixed-gender GDC in reducing substance use during the 12-week in-treatment phase, but demonstrated significantly greater improvement in reductions in drug and alcohol use over the post-treatment follow-up phase compared with GDC. In the larger two-site Stage II randomized controlled trial, the WRG was implemented in a rolling group format consistent with community practice, and compared with the GDC control. The study found that it was feasible to implement the WRG in the rolling group format and that women in the WRG had clinically meaningful reductions in their substance use that were at least equivalent to the control condition. These studies concluded that the women-focused WRG is efficacious and can be feasibly implemented in community-based clinical settings. The WRG can enhance clinical outcomes among women with substance use disorders. The WRG dissemination manual was published in 2016.
The WRG study used a mixed methods approach. Two qualitative studies demonstrated enhanced affiliation among members in the WRG compared with GDC, a putative mechanism of action of the WRG. Another qualitative study used grounded theory to examine women’s experiences in both the WRG and GDC. Compared to GDC, women in WRG more frequently endorsed feeling safe, embracing all aspects of one’s self, having their needs met, and feeling intimacy, empathy, and honesty. These attributes of single gender group therapy can increase treatment satisfaction and improve outcomes.
In addition to developing and testing a new group therapy (the WRG) for women with SUDs, Dr. Greenfield and her collaborators have investigated implementation of screening, brief counseling, and pharmacotherapy for individuals with alcohol problems and tuberculosis in Russia; services for women with substance use and co-occurring psychiatric disorders; substance use and HIV risk behaviors; and financing and quality care for children and adults with substance use disorders. With colleagues at Brigham and Women’s Hospital and Partners in Health, Dr. Greenfield developed and tested an approach to behavioral counseling and naltrexone treatment of alcohol use disorders integrated into routine care for tuberculosis in the Tomsk Oblast, Siberia. With her colleagues in the NIDA Clinical Trials Network Gender Special Interest Group, Dr. Greenfield has investigated gender differences in HIV risk behaviors in individuals with SUDs, and gender differences in technology acceptance in SUD treatment, among other studies. Other studies with colleagues and collaborators have focused on the effect of state and federal financing on substance use disorder treatment.
Greenfield SF, Sugarman DE, Freid CM, Bailey GL, Crisafulli MA, Kaufman JS, Wigderson S, Connery HS, Rodolico J, Morgan-Lopez AA, Fitzmaurice G. Group therapy for women with substance use disorders: results from the women’s recovery group study. Drug and Alcohol Dependence 2014;142:245-53.
Sugarman DE, Kaufman JS, Trucco EM, Brown JC, Greenfield SF. Predictors of drinking and functional outcomes in men and women following inpatient alcohol treatment. American Journal on Addictions. 2014;23(3):226-33.
Sugarman DE, Wigderson SB, Iles BR, Kaufman JS, Fitzmaurice GM, Hilario EY, Robbins MS, Greenfield SF. Measuring affiliation in group therapy for substance use disorders in the Women’s Recovery Group Study: Does it matter whether the group is all-women or mixed-gender? American Journal of Addiction. 2016;25:573-80.
Brady K, Back S, Greenfield SF, eds: Women and addiction: a comprehensive textbook. New York: Guilford Publications, 2009.
Greenfield SF. Treating women with substance use disorders: the Women’s Recovery Group manual. New York: The Guilford Press, 2016.
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