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From January 2001 NASW NEWS Seventy-one percent of social workers dealt with substance abusers. By John V. O'Neill, MSW, NEWS Staff The Practice Research Network (PRN) random survey of 2,000 regular NASW members showed a large involvement of members across many settings in diagnosing and treating substance abuse, but found that few members had in-depth education and training for the work. A major objective of the Center for Substance Abuse Treatment (CSAT) in funding the survey was to discover the nature and extent of social work involvement with people who have substance abuse disorders. The survey found that 71 percent of social workers had taken one or more actions in relation to clients with substance abuse disorders in the past year, a number called "astonishing" by Cathy King Pike, the member of NASW's PRN working group who prepared a report to CSAT on the survey. In the past year, 43 percent of social workers performed screening for substance abuse; 26 percent diagnosed it; 19 percent treated primary substance abuse; 47 percent treated secondary substance abuse; 61 percent referred clients to substance abuse treatment; and 11 percent screened for compulsive gambling. Social workers in organizational settings reported that 28.6 percent of clients had substance abuse as a primary or secondary diagnosis: 9 percent primary and 19.6 secondary. Those in private practice saw fewer people with substance abuse problems, 19.1 percent, with 5.9 percent primary and 13.2 secondary. The survey found that NASW members in organizational settings treat more people with drug problems or with both alcohol and drug problems than do private practitioners. Of people with substance abuse diagnoses, 31.1 percent of those seen at organizations were treated for alcohol only, 19.8 percent for drugs only and 49.1 percent for both. In contrast, private practitioners treated 45.5 percent for alcohol only, 15.7 for drugs only, and 38.7 percent for both. Members in organizational settings spend more time on case management for substance abuse clients and less time on individual counseling than did members in private practice. In organizational settings, members spend 22.1 percent of the time on screening clients for substance abuse; 25.9 percent on individual counseling; 13.8 percent on group/marriage/family counseling; 15.3 on case management; 4.1 percent on advocacy; and 14.3 percent on administrative duties. Private practitioners spend 18.9 percent of their time on screening/assessment; 47 percent on individual counseling; 15.3 percent on group/marriage/family counseling; l.6 percent on advocacy; and 11.9 percent on documentation. Those in private practice were asked what they typically do when clients present with substance abuse. Twenty-five percent said they had no clients with substance abuse problems. Others refer to self-help groups (44 percent); refer for substance abuse services but continue to treat for mental/emotional problems (39 percent); treat mental/emotional needs and substance abuse (35 percent); refer to a physician for medication assessment (34 percent); refer to formal substance abuse programs (30 percent); or refer to other independent practitioners (12 percent). Four in five members (81 percent) reported some type of education or training in substance abuse disorders: 68 percent from workshops, seminars or other continuing education; 38 percent from formal coursework; 24 percent from clinical supervision in substance abuse; 16 percent from field placements; and 5 percent from volunteer work. Eighteen percent reported no substance abuse training. Eighty-seven percent hold no certification in substance abuse, according to Pike's draft report for CSAT. Three percent have a certified alcohol and drug abuse counselor (CADAC) certification; 2 percent a certified drug abuse counselor (CDAC) certification; and 3 percent hold a state certification or license in substance abuse. It is not surprising that social workers see more substance abusing clients than some other helping professions, given the breadth of organizations and practice settings, said Pike's report. Yet two-thirds of social workers' training in substance abuse comes from workshops, seminars and other continuing education. This indicates the need for greater distribution among social work academic programs of courses in which substance abuse prevention and treatment are the sole focus and for more readily available certification programs, Pike's report asserted. Social work students need more information about the prevalence of substance abuse among their future clients to highlight the need for formal training in this area. Because of the distribution of clients with substance abuse problems across the broad array of practice settings, training is needed regardless of whether students choose a practice concentration in substance abuse treatment. Funding and scholarships for certification programs in substance abuse would highlight the importance of this type of training and make certification more desirable to social work students, the report said. Back to NASW NEWS Contents
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