Workplace Violence in Substance Use Disorder Treatment Settings: Experiences of Social Workers and Implications for Policy and Practice

Workplace Violence in Substance Use Disorder Treatment Settings: Experiences of
Social Workers and Implications for Policy and Practice

Abstract

Background and Purpose: Workplace violence (WPV) is described by the United States Department of Labor as any act or threat of physical violence, harassment, intimidation, or other threatening or disruptive behaviors that occur at work; and in 2014, the rate of injury to healthcare workers related to WPV totaled 14.4 per 1,000 workers, compared to the private sector’s rate of 4.0 per 1,000 workers. In the field of substance use disorder treatment and WPV, the literature is scant, and most studies have focused on inpatient facilities, while no studies have focused specifically on social workers working in SUD treatment settings.

The current qualitative, phenomenological study begins to fill the gap by exploring social workers’ experiences of WPV in SUD treatment settings, as well as perceived reasons for WPV, impacts and responses by both social workers and organizations to WPV, impacts of WPV, and coping and help-seeking behaviors related to WPV.

Methods: Twenty-one semi-structured, in depth interviews were conducted with social workers employed in the field of SUD treatment. The sample was predominantly female (79% female, 21% male) and most respondents identified as white (95% white, 5% Black or African American). Participants were recruited using a combination of purposive and snowball sampling strategies. Interviews were audio recorded and transcribed verbatim by the researcher and a coding plan was developed at the outset of the study. Line by line coding was used to identify relevant codes; both descriptive and in vivo codes were used and the coding plan was updated based on these codes. Data reduction strategies were used to group together similar statements and create broader categories and themes. Thematic analysis was employed to identify repeating patterns throughout the transcripts and similar categories were merged to create key themes.

Findings: Findings highlighted WPV as a widespread occurrence, with all respondents experiencing verbal violence, while fewer experienced physical and sexual violence. Respondents attributed numerous reasons to clients acting out in a violent manner. These reasons included clients’ volatile emotional states, respondents’ views about the predictable and acceptable milestones and behaviors in SUD treatment, clients’ frustrations with agency polices, and the treatment process. Data revealed a pervasive lack of organizational policies around WPV, various impacts on respondents lives both personally and professionally, and multiple ways participants sought help and support following WPV.

Conclusions and Implications: Verbal violence was the most common form of WPV experienced by participants. The study highlighted a pervasive lack of recognition, coherent organizational policies, and standardized proactive responses to WPV; and, a psychological acceptance of WPV as part of the job which lead to both a culture of hypervigilance for novice workers and desensitization for veteran social workers. The current study highlighted a need for development of specific organizational policy around WPV, consistent trainings provided to social workers to address WPV, and a focus on WPV and safety in social work education.