Substance Use in Social Work Education and Training

Preparing for and supporting practice

Hilda Loughran, Wulf Livingston

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781317386148
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

Substance use has become an increasingly common concern for all aspects of social work practice, and especially when working with mental health and vulnerable families. This requires all social workers to have sufficient education and training in alcohol and other drugs across a range of settings.

This volume presents evidence from a number of major studies which examine the current state of social work education in relation to substance use. These contextual considerations are complemented by specific applied analyses which explore classroom, methodological, practice and theoretical considerations within both the UK and America. Substance Use in Social Work Education and Training provides a strong evidence base for the effectiveness of appropriately-targeted education and support given to social workers. It further substantiates calls for a greater inclusion of more on substance use in social work education and curricula.

This book is based on a special issue of the journal Social Work Education.

The Extent and Nature of Practitioners, Encounters with Alcohol and Other Drug Use in Social Work and Social Care Practice

Cherilyn Dance, Sarah Galvani & Aisha Hutchinson

This article considers the extent and nature of social work and social care practitioners’ experience of working with service users whose lives are affected by the problematic use of alcohol or other drugs (AOD). It draws on the findings of a national study of ‘working with alcohol and drug use’ which was conducted in England in 2010–2011. The study reported here comprised an online survey of front-line practitioners (n = 597), complemented by 12 practitioner focus groups and interviews with 21 key informants from participating local authorities and substance use treatment services. This paper focuses primarily on data from one element of the survey. Findings indicate that the great majority of staff encountered service users who are affected by AOD problems at some level, although there were differences between groups of practitioners in the extent and nature of AOD problems for different groups of service users. The differential experiences of staff according to their client groups underlines the need for education and professional development not only to provide training on working with AOD but to ensure that training is contextualised and relevant to practitioners across the range of social work and social care services.

Introduction

The problematic use of alcohol, illicit drugs and sometimes prescription medications (AOD), is a problem that has a long history: consumption of wine and other potentially addictive substances has occurred throughout human history and White (1998) traces treatment approaches as far back as the 1750s. The nature of society’s concerns about problematic AOD use has changed over time, as different patterns of use of various substances, by different groups in society, have come and gone over the years, each raising different social concerns. That society is concerned about these problems relates to the human and financial costs associated with them. Traditionally, these have been particularly recognised at a societal level in relation to crime and health expenditure. At an individual level the dangers or harms associated with misuse vary according to the substances used, the way in which they are used and how frequently they are used, but misuse, particularly over a period of time, is likely to lead to negative consequences for an individual in terms of both health and social well being.

Problems with AOD use alone are unlikely to be the primary reason for people having contact with social work or social care services but where AOD use is impacting on a person’s functioning, particularly the capacity to care for dependants, other social difficulties are likely to arise which may indeed lead to contact with services. At the same time the sorts of problems that bring people into contact with social work may well lay the conditions that can lead to use of substances in an attempt to escape, manage or cope with those problems. This is not restricted to problems with drug or alcohol use impacting on parenting capacity, which is one area that has received a good deal of research and policy attention (Advisory Council on the Misuse of Drugs [ACMD], 2007; Cleaver, Unell, & Aldgate, 2011) but can play out in a variety of scenarios. Indeed, Paylor and colleagues put it this way:

Whatever the form or type of social work intervention, ever since early days of the profession, social workers have been confronted with personal and social problems caused by service users’ use of drugs and alcohol. (Paylor, Measham, & Asher, 2012, p. 1)

Knowledge of the nature and type of difficulties faced by users of social work and social care services using AOD is essential in order to ensure that practice and services are able to respond appropriately. Quite a lot is known about the prevalence of AOD problems in the context of child protection work. In England this issue has been highlighted in the findings of serious case reviews and the Munro Review (Brandon et al., 2013; Munro, 2011), but it is far from being just an English problem. Although there are many important differences between countries in population profiles, patterns of AOD use and arrangements for service delivery (Forrester & Harwin, 2006), concern about this issue is evident worldwide (e.g. Dawe, Harnett, & Frye, 2008; Traube, 2012). However, knowledge about the extent to which practitioners in other areas of practice encounter similar problems is rather patchy. Research has addressed the overlap between AOD use and mental health problems but a review published in 2009 indicates that much of this has been undertaken from a medical, rather than a social or social work perspective. Furthermore, the same authors note that the majority of the research emanates from North America and does not necessarily translate to a UK context (Crome and Chambers with Frisher, Bloor, & Roberts, 2009).

In a similar vein, whilst there is a lot of research, and indeed policy attention, focused on young people’s use of AOD, very little of this explores from a social work perspective—even though it is recognised that young people leaving care—as a group—are at higher risk of developing AOD problems than their counterparts in the general population (Dixon, Wade, Byford, Weatherly, & Lee, 2006; Ward, Henderson, & Pearson, 2003).

With regard to AOD problems among users of Adults’ Social Services, one or two UK studies have explored prevalence and the social work perspective on working with these issues as they affect people with learning disabilities (e.g. Taggart, McLaughlin, Quinn, & Milligan, 2004) and the needs, in relation to alcohol use in particular, of older people using services has recently begun to be recognised (Royal College of Psychiatrists, 2011).

In general, the studies identified above have focused on relatively small or purposive samples and have usually been concerned with ‘the problem’ or the service user, rather than the practitioners’ experience. To our knowledge, no previous study has sought to establish the extent to which AOD problems are to be found on practitioners’ caseloads across the range of social work and social care services in England. This paper attempts to fill this gap in order to inform the evidence base with regard to the significance of AOD problems in social work and social care and to highlight the implications in relation to professional training opportunities.

Research Design

This mixed methods study utilised an online survey to engage a range of social work and social care practitioners working in the ‘front-line’ of service delivery in adults’ and children’s local authority social services to establish their experience in working with AOD problems. In-depth exploration of the research questions was achieved through a series of 12 focus groups with participants representing a variety of roles in either children’s or adults’ social services. These front-line experiences were complemented by semi-structured interviews with key informants. We draw to a limited extent on some of the qualitative data to provide context and examples for some of the findings discussed but it is the survey data that are the main focus of this paper, specifically data which consider the frequency with which practitioners encountered AOD problems and the type of problematic use they encountered.

The Sample and Methods

The sampling strategy aimed to ensure representation of the variety of local authorities in terms of their administrative arrangements (county councils, boroughs and unitary councils), their geographic location within England and levels of affluence/deprivation. Children’s and Adults’ Services directorates were approached separately.¹ Where a directorate was not in a position to participate a second, with similar characteristics, was approached.

The final sample for the study was drawn from 17 social care directorates (10 children’s and seven adults’) from 11 local authorities in England. Lead contacts within each participating directorate agreed to distribute invitations to all social work and social care practitioners with case work responsibility to complete the survey. It should be noted that differing systems of communication networks within agencies inevitably meant that there were variations between authorities in terms of which groups of workers received the invitation.

Response rates to the survey varied across directorates with as few as 12% of potential participants responding in one and as many as 56% in another. A total of 646 practitioners responded from a range of adults’ and children’s social care roles (21% of all those approached) across all directorates surveyed, however, 49 of these were working in specialist alcohol or drug roles at the time of completing the survey. For the purposes of this paper, data for these individuals are excluded since the interest here is specifically in the experiences of practitioners in other specialist social work and social care roles. The effective sample size for the survey is therefore 597.

The bulk of the items in the survey questionnaire was study specific. Embedded within the questionnaire was an adapted version of the Alcohol and Alcohol Problems Perceptions Questionnaire (Galvani & Hughes, 2010). The version used here aimed to capture practitioners’ levels of knowledge about, and attitudes towards, working with issues associated with both alcohol and other drug (AOD) use (Galvani, Dance, & Hutchinson, 2011). [See also Hutchinson, Galvani, and Dance (2013) for further discussion of these findings.] The survey questionnaire included both open and closed questions.

The 12 focus groups were drawn from participating agencies and were organised around primary service user groups—for example, practitioners working with older people, people with physical disability, young people, or children and families.

Key informants were individuals in senior positions within directorates who had a role in strategic planning and/or service commissioning in relation to AOD services within their authority. Participants included managers from both social care and drug and alcohol service settings.

Ethics

The project design and methodology was approved by the ethics committees of the originating university, the Associations of Directors of Children’s Services and Adults’ Social Services (ADCS and ADASS), and the research governance committees of the participating directorates where applicable. All data were collected with informed consent, data were treated confidentially and stored appropriately, and the anonymity of both individuals and agencies was respected.

Sample Characteristics

The characteristics or the profile of the sample is important to consider, particularly in relation to the type of work undertaken by participants and the context in which it is performed, since this is likely to have considerable bearing on the extent and nature of alcohol or drug problems which might be encountered.

The sample was predominantly female (82%) and there was a relatively flat age distribution, both of which are consistent with the patterns elsewhere (Skills for Care 2013; HSCIC (Health and Social Care Information Centre) 2014). However, in comparison with the same source, minority ethnic groups were under-represented in our sample (only 8% of our sample classified themselves as being of minority ethnic origin in comparison with 16% and 10% across the children’s and adults’ social care wo...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Citation Information
• Notes on Contributors
• Foreword
• Preface
• Part I: Context
• Part II: Theory and Methodology
• Part III: Application in Fields of Social Work Practice
• Part IV: Reflection
• Index