Social workers and substance-abusing clients: Caseload composition and competency self-ratings

Past research and reports from the field have described social workers as having a host of negative responses to alcohol- and drug-abusing clients. Some found that substance abuse training increased social workers' sense of security and legitimacy in the therapeutic role with such clients. We report on 23 master's level social workers (MSWs) who completed an intensive g-month substance abuse training program (trainees) and 22 MSW comparison subjects (comparisons). Both trainees and comparisons completed caseload forms identifying their clients by diagnosis and self-rated their competence to assess and treat each client. We predicted that workers trained in substance abuse, when compared with workers who lacked such intensive training, would (a) assess and treat more substance-abusing clients, (b) work with more complex substance-abusing clients (i.e., dually diagnosed clients), and (c) perceive themselves to be more competent to assess and treat substance-abusing clients. No significant differences were found between trainees and comparisons on relevant background variables. Using the t-test statistic to compare groups, we found that social workers trained in substance abuse had more substance abuse cases, with and without additional diagnoses, and rated themselves higher on two of six competency measures: in intervening with clients when all diagnoses were combined and in intervening when substance abuse only diagnoses were combined. This study takes the work a step further in demonstrating how social workers translate substance abuse training into practice. However, findings must be interpreted cautiously since training participants were not assigned randomly and selection bias may have been operating. The study is relevant for other health, mental health, and human service professionals for whom negative attitudes and behavior toward substance-abusing clients may be influenced by education and training.