Effectiveness of Paraprofessional Substance Use Disorder Counselor Training

Background. Substance use disorders are common in the United States and nearly 100,000 individuals have died from drug overdose annually since 2020. There is currently an insufficient supply of licensed substance use disorder counselors (SUDCs) to meet demand for services and the gap between supply and demand is projected to grow in the coming decade. Paraprofessional SUDCs offer one path to helping close this gap. The current study presents outcomes from a paraprofessional SUDC certificate program for Bachelor of Social Work (BSW) students. The program was evaluated via knowledge gained from classroom instruction, field placement, and brief workshops.

Methods. Student data (N = 122) were used to examine pre- to post-program changes in generalized SUDC knowledge and pre- to posttest changes in knowledge and self-efficacy from evidence-based workshops from 2018 to 2022. Workshops were conducted both in-person and virtually depending on public health guidance at the time of the workshop. Generalized SUDC knowledge was evaluated via two valid and reliable instruments – the Physicians Competence in Substance Abuse Test (P-CSAT) and the Opioid Overdose Knowledge scale (OOKS) administered pre- and post-program. Brief workshop knowledge and self-efficacy were evaluated via structured questionnaires developed by the research team and administered immediately before and after each workshop. Each workshops focused on one treatment-related modality including harm reduction, family engagement, grief and loss after overdose, motivational interviewing, mindfulness, screening and referral, clinical assessment, suicide risk, pre-natal substance use, integrative treatment, behavioral therapies, and working with special populations. Paired sample t-tests evaluated changes from pre- and posttest data on all measures and standardized effect sizes were used to compare the magnitude of changes across workshops.

Results: Program participation significantly increased generalized SUDC knowledge. Workshops participation significantly increased knowledge on all modalities and self-efficacy for 13 out of 15 modalities. Effect sizes for workshops varied across modalities.

Conclusions: BSW students gained both generalized and modality-specific knowledge via participation in a SUDC certificate program. Both in-person and virtual workshops functioned similarly and were associated with increased knowledge and self-efficacy. Certificate-based programs and the deployment of paraprofessionals SUDCs provide a promising approach to increasing substance use disorder treatment capacity.