In this article I discuss the benefits of using road drawings in art therapy for the specialized treatment needs of women in a gender-specific residential substance use treatment center. Gender differences in substance use treatment are explained and the benefits of using art therapy in the treatment of substance use disorders are reviewed. The rationale and procedure for administering road drawings is provided with case examples to illustrate how road drawings address the complex constellation of interdependent biopsychosocial factors that comprise women's specialized treatment needs. Road drawings appear to help clients gain insight into a path of recovery and provide a metaphor for their capacity for change. They are also useful as an informal assessment, offering insights into substance use and psychological state.