Amodeo M, Fassler I
Alcohol and Drug Institute for Policy, Training, and Research, Boston University School of Social Work, MA 02215, USA.
Am J Drug Alcohol Abuse. 2000 Nov;26(4):629-41. doi: 10.1081/ada-100101899.
Past research and reports from the field have described social workers as having a host of negative responses to alcohol- and drug-abusing clients. Some found that substance abuse training increased social workers' sense of security and legitimacy in the therapeutic role with such clients. We report on 23 master's level social workers (MSWs) who completed an intensive 9-month substance abuse training program (trainees) and 22 MSW comparison subjects (comparisons). Both trainees and comparisons completed caseload forms identifying their clients by diagnosis and self-rated their competence to assess and treat each client. We predicted that workers trained in substance abuse, when compared with workers who lacked such intensive training, would (a) assess and treat more substance-abusing clients, (b) work with more complex substance-abusing clients (i.e., dually diagnosed clients), and (c) perceive themselves to be more competent to assess and treat substance-abusing clients. No significant differences were found between trainees and comparisons on relevant background variables. Using the t-test statistic to compare groups, we found that social workers trained in substance abuse had more substance abuse cases, with and without additional diagnoses, and rated themselves higher on two of six competency measures: in intervening with clients when all diagnoses were combined and in intervening when substance abuse only diagnoses were combined. This study takes the work a step further in demonstrating how social workers translate substance abuse training into practice. However, findings must be interpreted cautiously since training participants were not assigned randomly and selection bias may have been operating. The study is relevant for other health, mental health, and human service professionals for whom negative attitudes and behavior toward substance-abusing clients may be influenced by education and training.
以往的研究及该领域的报告称，社会工作者对酗酒和吸毒的客户有一系列负面反应。一些研究发现，药物滥用培训增强了社会工作者在对这类客户进行治疗时的安全感和合理性。我们报告了23名完成了为期9个月强化药物滥用培训项目的硕士水平社会工作者（受训者）以及22名硕士水平社会工作者作为对照对象（对照组）。受训者和对照组都填写了病例登记表，按诊断情况列出他们的客户，并对自己评估和治疗每位客户的能力进行了自评。我们预测，与缺乏这种强化培训的工作者相比，接受过药物滥用培训的工作者会（a）评估和治疗更多的药物滥用客户，（b）与更复杂的药物滥用客户（即双重诊断客户）合作，以及（c）认为自己在评估和治疗药物滥用客户方面更有能力。在相关背景变量上，受训者和对照组之间未发现显著差异。使用t检验统计量对两组进行比较，我们发现接受过药物滥用培训的社会工作者有更多的药物滥用案例，无论有无其他诊断，并且在六项能力指标中的两项上给自己的评分更高：在综合所有诊断情况时对客户进行干预，以及在仅综合药物滥用诊断情况时进行干预。这项研究在展示社会工作者如何将药物滥用培训转化为实践方面更进一步。然而，由于培训参与者并非随机分配，可能存在选择偏差，因此研究结果必须谨慎解读。该研究对其他健康、心理健康和人类服务专业人员也有意义，因为他们对药物滥用客户的消极态度和行为可能会受到教育和培训的影响。
