Identifying and Assessing Substance Use: Findings from a National Survey of Social Work and Social Care Professionals

Abstract

Social care practitioners regularly encounter problematic substance use among their service users. However, most social care practitioners do not specialise in substance use and there is limited evidence on their practice with it. Aims: This study aimed to explore the practice of social care professionals when they encounter substance use in the course of their work. This article focuses specifically on how they identify and assess substance use. Method: A web-based survey was disseminated to 3164 practitioners in adults' (AS) and children's (CS) social care in 11 different local authorities in England. Twelve focus groups were also held. Results: AS and CS practitioners identified substance problems by their impact on their service user's ability to fulfil their responsibilities or perform daily functions. Differences in relation to assessment were found between AS and CS practitioners. CS practitioners asked questions more frequently and were more likely to state that asking about substance use was a legitimate task. Very few practitioners had practice guidance or tools to help them assess substance use. Conclusion: Substance use is being identified and assessed in social care but often at a late stage with little to no guidance on how to do so effectively.

Alcohol brief interventions practice following training for multidisciplinary health and social care teams: A qualitative interview study

“…In children and families social work, concerns about parental misuse of drugs or alcohol are associated with poor outcomes for children [8], and the issues arising can be complex [9]. Assessment of parental substance use by social care professionals has been found to take place ‘often at a late stage with little to no guidance on how to do so effectively’ (p. 1) [10]. One randomised trial involving training for child‐care social workers showed that this was challenging [11].…”

Commentary on Berget al.(2016): Who's minding the children-do we need to focus on reducing intergenerational risk due to parents who drink problematically?

“…Having one parent without an alcohol problem in a household can offer some protection against adverse outcomes . However, children who live with two heavily drinking parents, and those living with lone parents with alcohol problems, are of significant concern . A further particularly vulnerable group are ‘looked‐after children’ who experience foster or state‐provided residential care .…”

“…Social workers report a sense of role legitimacy in asking parents about alcohol use, but also difficulty in identifying alcohol problems . This puzzling situation occurs because informal self‐assessment approaches are used typically, which may lead to under‐reporting of problems . Moreover, parents often do not receive alcohol intervention, as practitioners often place more focus on illicit drug use.…”

Brief Alcohol Interventions in Social Service and Criminal Justice Settings: A Critical Commentary

“…The motivational work inherent within some forms of brief intervention may offer an opportunity to work with the seemingly ubiquitous resistance found within child and families social work (Forrester et al, 2012). However, as the vast majority of social work contacts occur in non-substance specialist services, social workers often report difficulties in this role (Galvani et al, 2013) and a lack of knowledge on how to intervene to promote change (Galvani and Hughes, 2010). Brief interventions are designed to be delivered opportunistically, at the point of contact with non-substance specialists.…”