Social Work Practitioners Training, Attitudes, and Actions Concerning Firearm Risk Assessment with Clients: A Call for Change

Background. In 2022, 48,117 people died by firearms in the United States (CDC, 2023), where firearms are the leading cause of death for children, especially Black children (Lee et al., 2022). Social workers are in contact with clients at risk of all types of firearm violence, including suicide, homicide, and accidents. Social workers have foundational training in assessment and intervention with at-risk clients, however, limited research suggests that most do not receive firearm-specific training and generally do not discuss firearms with clients (Slovak et al., 2008; Sperlich et al., 2022). This study adds to this small body of literature by assessing what practitioners know and what they do in their clinical practice to prevent firearm injuries.

Methods. We recruited a sample of social workers across New York via online surveys that assessed firearm exposure, knowledge, attitudes, and behaviors with clients towards firearm violence assessment. Descriptive and multivariate analyses were conducted with SPSS.

Results. The sample (N=260) was 80.8% female, average age of 41.47 years. 77% identified as white, 10.6% were Black, and 8.6% were mixed/other race; 7.1% were Latinx. The majority were MSWs (90.4%) who worked in a wide variety of practice settings. 54.6% had not received any training on firearm safety assessment in any context. The vast majority had received training on assessment for suicide lethality (93.1%); 6.9% indicated they had not. The majority (80.8%) had not received any training on assessing for risks of violence perpetration. The majority did not grow up around guns (71%), although 10.5% were gun owners themselves, 2% indicated they carried a concealed weapon, and 23.6% lived with a gunowner. Many reported having lost a close friend or relative due to firearms, by suicide (20.2%), homicide (21.4%), or accidental death (14.4%).

The majority agreed or strongly agreed (76.4%) that gun violence was a problem in their community, and in the community in which they worked (80.9%). However, few reported discussing firearm access with clients (26.3%), providing firearm safety counseling (26.9%, or using a validated screening tool (19.6%). More reported discussing firearm removal with high-risk gun-owning clients (44.3%) and conducting risk assessment with high-risk clients (47.9%). Multiple regression modeling indicated that length of time in practice (Beta=0.23), having received training on firearm safety (Beta=0.28), and having confidence about talking to clients about firearms (Beta=0.38) were significantly associated with enacting behaviors to assess and intervene with clients at risk of firearm violence.

Discussion. Very few studies to date have assessed what social work practitioners know and do about preventing firearm injury. These results confirm previous research indicating that social worker training regarding gun violence assessment and intervention is sorely lacking, with the result that many practitioners do not address firearm risks with clients, even those they deem at high-risk of injury. This has implications for social work education, the development of screening tools, and continuing education, and should serve as a clarion call to urgently address this omission in social worker preparation to reduce deaths, injuries, and traumatic losses to US families.