Findings from an Opioid Workforce Expansion Program (OWEP) for MSW Students in North Carolina

Background and purpose: Opioid Use Disorder (OUD) presents significant public health challenges, yet access to treatment remains insufficient and inequitable nationwide. In NC, 93 out of 100 counties are designated Mental Health Professional Shortage Areas and workforce shortages to persist. In 2019, HRSA awarded $58 million to fund 49 Opioid Workforce Expansion Programs (OWEP) to expand training for the future workforce and equip them for practice skills to address substance use disorders (SUD) and OUD. This mixed-methods study describes one NC MSW OWEP program and presents training outcomes of students’ self-reported addiction counseling competencies adapted from the Substance Use and Mental Health Services Administration (SAMHSA) TAP-21- Addiction Counselor Competencies to assess knowledge, skills, and attitudes of professional practice. The study sought to answer two research questions: (1) Did MSW students who participated in the OWEP program increase their SUD competencies, knowledge, and skills at the completion of the specialized training program? And (2) In what ways did COVID-19 impact OWEP student learning and application of SUD/OUD training and competencies?

Methods: This mixed-methods study evaluated one OWEP program designed for MSW students (N=52) during 2019–2022. Using a retrospective pretest–posttest (RPP) design, an anonymous electronic survey was administered based on adaptations from SAMHSA’s TAP-21. Paired sample t-tests were used to examine differences between the nine pre-and-post-test competency scores of the two cohorts of MSW students. Qualitatively, a deductive thematic analysis approach was used to analyze open-ended text responses. Authors independently reviewed the responses, developed initial codes, and finalized overarching themes. Discrepancies were addressed through discussion among two coders until consensus was reached.

Results: Quantitative findings revealed statistically significant competency improvements, particularly in understanding addiction and application to practice (p. <.001). The areas with the greatest gains were in Understanding addiction, Application to practice, and Professional/ethical responsibilities. Students expressed the least gains in competencies related to Counseling and Professional readiness. Qualitative findings underscored the centrality of field placements to enhance students SUD/OUD knowledge, preparation, and roles. Commonly referenced practice skills and knowledge included SBIRT-Screening, Brief Intervention, and Referral to Treatment; Brief counseling techniques, Motivational interviewing, Using a trauma-informed lens, Psychoeducation, and Harm reduction. Three themes emerged as to how MSW students deepened their SUD/OUD knowledge and applied addiction training to practice: (1) the importance of interprofessional collaboration, (2) population-specific SUD/OUD needs, and (3) expanded awareness of professional identity and role. The impacts of COVID-19 altered students’ experiences but also identified positive, unanticipated changes despite the challenges of the pandemic.

Conclusions and implications: Findings from this study help demonstrate how a targeted effort to integrate SUD/OUD content into students’ learning can create meaningful learning experiences across course work, field placements, and additional learning activities. Financial stipends increased MSW student engagement and are a useful incentive to positively impact the SUD/OUD workforce. Although state and federal efforts are underway to expand the behavioral health workforce necessary to meet growing demand for services, threats to federal funding jeopardize the success and scale of workforce development programs such as the positive benefits of OWEP.