Social Workers Understanding of Substance Use Disorders and Clinical Self-Efficacy

Background/Purpose: Beliefs related to the etiology of substance use disorders are an important area of research influencing treatment staff decisions regarding appropriate interventions as well as their perceptions about the people receiving treatment. Moyers and Miller (1993) identified two major belief models related to alcoholism. They are the disease model and the psychosocial model. Humphreys et al. (1996) broadened the approach to include all substance use disorders and then Miller and Moyer (2001) added a third model which they referred to as the moral/spiritual model. These models have been operationalized and used extensively in research with treatment staff and their approaches to treatment. Another concept that has been examined in the literature is clinical self-efficacy or the belief that one can competently carry out a specified set of actions to achieve a goal. Murdock et al. (2005) established a scale for treatment providers based on Bandura’s model of self-efficacy. The purpose of this presentation is to explore the relationships between conceptualizations of substance use disorders and clinical self-efficacy among a sample of social work MSW students and MSW social work professionals.

Methods: The data for this study are taken from an overall evaluation of a Screening, Brief Intervention and Referral to Treatment (SBIRT) program conducted in a graduate school of social work. MSW students and social workers practicing in the community were invited to participate in a survey that was completed prior to attending an all day workshop on substance abuse issues and motivational interviewing. A total of 56 MSW students and 270 community practicing social workers completed the surveys. The instrument contained three measures on understanding substance abuse disorders: (1) disease model; (2) psychosocial model; and (3) moral/spiritual model and one measure of clinical self-efficacy. The analytic strategy was to first examine differences between MSW students and social workers practicing in the community on the three models and clinical self-efficacy and secondly, to regress the self-efficacy on the three models to determine which models are predictive of self-efficacy.

Results: The findings on the comparison of MSW students and MSW professionals showed that MSW professionals had significantly higher scores on the disease model (t = -.3.27; p <.05) and the moral/spiritual model (t = -4.45; p <.05). The MSW students had higher scores on the psychosocial model (t = 2.56; p < .05). The community practicing social workers had significantly higher scores on the clinical self-efficacy scale (t = -5.18; p <.05). The regression analysis revealed significant interaction effects between status (student vs. practitioner) and the disease and psychosocial model with clinical self-efficacy. Respondents who were high on the disease model scale and the psychosocial models were higher on self-efficacy. The difference was greatest for practitioners when compared to students.

Implications: The findings show that one’s understanding of substance use disorders does have an influence on one’s feelings of efficacy in practice. Implications for clinical treatment and social work education will be discussed.