Alcoholism and substance abuse training: A survey of graduate programs in clinical psychology.

Abstract

Although alcoholism and abuse of other mood-altering substances are major health and mental health problems in the United States, psychology's investment in these areas has been described as indifferent and sparse. This study surveyed the American Psychological Association 's approved clinical training programs in an attempt to quantify the extent of research activity, clinical course work, and clinical training offered or required of graduate students in these areas. Although results indicated a modest level of research activity, clinical training and course work were found to be minimal. This low level of training in the evaluation, treatment, and prevention of substances abuse was viewed as disproportionately low relative to the magnitude of these problems.Substance abuse in the form of alcoholism and other drug-related problems has become a major U.S. health problem (Califano, 1979). These problems permeate a broad range of social services, including medical, legal, and psychological, and exact an enormous cost to society. Changes at the federal level, namely the creation of the Alcohol, Drug Abuse, and Mental Health Administration, have suggested a rough equivalence of the magnitude and importance of substance abuse problems relative to traditional mental health (Goldberg, 1976). Such a national structure is not surprising, considering that an estimated one fourth of all Veterans Administration (VA) hospital patients have alcohol-related problems (Califano, 1979), and studies on medical hospital wards have indicated that in some hospitals as many as 60% of all male patients were alcoholic (Baekeland & Lundwall, 1977). Research has suggested that at least a quarter of all admissions to psychiatric hospitals are individuals experiencing alcohol-related problems (e.g., Crowley, Chesluck, Dilts, & Hart, 1974). Recent surveys by Cummings (1979) revealed that perhaps as many as 40% of all outpatients seeking psychotherapy are exibiting alcohol or other drug abuse problems, which are either the primary presenting problem or are significantly exacerbating other emotional problems. These and other similar findings suggest that substance abuse problems pervade the entire health care system at a total direct and indirect cost to society that exceeds $40 billion a year (Califano, 1979).This pervasiveness of drug-related problems means that mental health care professionals should have a basic understanding of the evaluation and treatment of alcoholism and drug-related problems. However, Cummings (1979) found that most drug and alcohol problems identified in his surveys of outpatient mental health centers went undetected by the clinic staff. Other researchers have reported similar findings that led Baekeland and Lundwall (1977) to conlude that the detection and treatment of alcoholism by professional health workers "must be one of the most dismal failures ... known to the field of public health" (p. 162).Such a surprising lack of recognition of these problems may partially reflect the inadequacy of training. Several resea...

The State of Substance Abuse Treatment Training in Counseling and Counseling Psychology Programs: What is and is Not Happening

“…Multiple studies throughout the years have consistently demonstrated that psychology training in SUDs is inadequate. Selin and Svanum (1981) were ñrst to demonstrate that although respondents suggested that training in SUDs was important, this training was offered as part of another course without offering a speciflc course. By replicating the Selin and Svanum study, Lubin, Brady, Woodward, and Thomas (1986) actually demonstrated that the importance ascribed to substance abuse training and the number of courses offered in doctoral psychology training decreased.…”

Perceived Self‐Efficacy of Licensed Counselors to Provide Substance Abuse Counseling

“…Renner (2007) reported that psychiatrists have not been adequately trained to care for individuals who present with substance use disorders. Although multiple groups of mental health professionals have noted the lack of substance abuse training as a concern, the presented study focused on the need for substance abuse training among licensed counselors (Carroll, 2000;Celluci & Vik, 2001;Chappel & Lewis, 1997;Harwood et al, 2004;Madson et al, 2008;Montgomery, 1993;Morgan & Toloczko, 1997;Selin & Svanum, 1981). Carroll (2000) examined counseling students' choice of initial clinical interventions with a described substance-dependent client and conceptions of substance dependence among students.…”

Substance abuse training in APA-accredited doctoral programs in clinical psychology: A survey.

“…It is not surprising, therefore, that doctoral programs in clinical psychology often do not include extensive coverage of the topic of substance abuse in the training they offer. Two mail surveys of APA-approved doctoral programs investigating the level of training they provided in the diagnosis and treatment of problems related to substance abuse were conducted during the last decade (Lubin, Brady, Woodward, & Thomas, 1986;Selin &Svanum, 1981). Selin and Svanum (1981) A majority of the responding programs covered the area of substance abuse as part of another course and made arrangements to assign students who had an interest in the topic to practicum placements dealing primarily with alcoholism or substance abuse.…”

“…Two mail surveys of APA-approved doctoral programs investigating the level of training they provided in the diagnosis and treatment of problems related to substance abuse were conducted during the last decade (Lubin, Brady, Woodward, & Thomas, 1986;Selin &Svanum, 1981). Selin and Svanum (1981) A majority of the responding programs covered the area of substance abuse as part of another course and made arrangements to assign students who had an interest in the topic to practicum placements dealing primarily with alcoholism or substance abuse. However, despite a mean rating indicating that training in this area was perceived as being necessary at the graduate level, none of the schools surveyed offered any required courses devoted exclusively to this area.…”

“…Note.The 1978The -1979The data and 1984 data are fromSelin and Svanum (1981) andLubin et al's (1986) studies, respectively. Adapted by permission. "…”