The acceptability of non-abstinent treatment goals among clinical social workers in the United States

Research on acceptability of non-abstinence goals has focused primarily on addiction counsellors and lacks representation of clinical social workers (SWs). We examined whether acceptability of non-abstinence varied as a function of a client's severity of substance use disorder (SUD) diagnosis (severe vs. moderate), finality of an outcome goal (intermediate vs. final), and type of substance (e.g. alcohol, cannabis) among clinical SWs in the US (United States). We surveyed a geographically representative sample of 309 SWs (Mean age = 48.9; Female = 76%; Mean years practicing = 14.6). For tobacco, alcohol and cannabis use, most SWs (51%-84%) rated non-abstinence as an acceptable goal regardless of finality of the outcome goal for clients with a moderate SUD; but smaller proportions rated non-abstinence acceptable for clients with severe SUD regardless of drug type or finality of the goal. Higher ratings of acceptability of non-abstinence were significantly associated with younger age and lower drug use stigma. Supporting clients who pursue non-abstinence is consistent with the values of the Social Work (SW) profession (e.g. self-determination, social justice, dignity/self-worth, importance/centrality of human relationships). Thus, SW education and training programmes should bolster understanding SUD recovery can take multiple pathways, should be self-directed and empowering, and may be defined in terms of improved health and wellness.

Automated summary

Research on acceptability of non-abstinence goals among clinical social workers in the US found that non-abstinence was generally acceptable for clients with moderate substance use disorder, irrespective of the finality of the outcome goal. However, acceptance of non-abstinence was less for clients with severe substance use disorder, regardless of drug type or finality of the goal. Younger age and lower drug use stigma were associated with higher acceptability ratings for non-abstinence.