Social Workers' Knowledge, Opinions, and Adoption of Evidence-Based Psychosocial Interventions for Substance Use Disorders

Background and Purpose: Many social work leaders have advocated the adoption of evidenced-based practices (EBPs) by social workers. However, little research has been conducted regarding the dissemination and adoption of specific EBPs by social workers. Two SUD interventions that have been identified as EBPs are Motivational Enhancement Therapy (MET) and Contingency Management (CM). This study's purpose was to investigate social worker's knowledge, opinions, and adoption of MET and CM. To that end, we addressed the following research questions: (1) Do social workers differ from other substance abuse counselors in knowledge, opinions, and adoption of MET and CM?; (2) What factors influence social workers' knowledge, opinions, and adoption of MET and CM.

Methods: The sampling frame was derived from a national sample of 318 treatment centers. All counselors employed in these centers were recruited to participate in a mailed survey. A total of 1140 questionnaires were completed and returned, including 285 social workers. Dependent variables included counselors' knowledge, perceptions of effectiveness and acceptability, and adoption of MET and CM. Independent variables included counselors' education, experience, recovery status, endorsement of a 12-Step philosophy, attitudes toward EBPs, training in MET and CM, and exposure to colleagues who adopted MET and CM. Chi-square analyses and t-tests were used to test for differences between social workers and other counselors on dependent variables. Logistic and OLS regression models were tested to identify factors influencing social workers' knowledge, opinions, and adoption of MET and CM.

Results: Social workers did not differ from other counselors on knowledge, perceptions of effectiveness, or use of MET or CM. However, social workers rated the acceptability of MET higher than other counselors. No difference was found regarding acceptability of CM. Social workers' knowledge of MET and CM were positively associated with exposure variables, adoption by others and amount of training received. Social workers with more experience had less knowledge of MET. Ratings of effectiveness of MET were negatively associated with experience, and positively associated with attitudes toward EBP and two exposure variables. Ratings of the effectiveness of CM were associated with one exposure variable. Ratings of the acceptability of MET were negatively associated with experience, and positively associated with attitudes towards EBP and one exposure variable. Ratings of the acceptability of CM were positively associated with attitudes towards EBP and CM training. Social workers' adoption of MET was more likely if MET is used by another counselor in the treatment program and if they are trained in the use of MET. Adoption of CM is less likely if the social worker is in recovery and more likely if CM is used by another counselor and if the social worker has been trained in CM.

Conclusions: Exposure to EBPs through training and adoption by colleagues are consistent and strong predictors of knowledge, opinions and adoption of MET and CM by social workers. Less experience and positive attitudes towards EBPs also play an integral role. Efforts to increase the uptake of EBPs should focus on increasing social workers' exposure to and attitudes towards EBPs.