| Barrier |
Solution |
| 1. Lack of training |
Social workers currently receive little to no training on alcohol and drugs on social work qualifying programmes. It is therefore no surprise that social work practice with people who use alcohol and drugs is not as good as it should be. If you are among the majority of people who have not had qualifying training then you will need to seek it out. Raise the issue in supervision as a gap in your knowledge and an identified training need; contact the training department and ask if they have courses running or could arrange something; use web based resources for information; contact your local DAT/DAAT and ask about any training and courses available – these are often free; contact your local academic establishments and see what educational programmes they provide on the subject; take the initiative and organise a visit to some local alcohol and drug agencies and/or arrange a training exchange. Future PQ training looks set to include alcohol and drug issues but this is still likely to be limited. |
| 2. Ignorance about substance use |
Nobody is suggesting that social workers need to be experts in substance use. Knowing some basics about alcohol, drugs and their potential effects and the types of intervention available is a start. Basic knowledge can be learnt from this and other specialist websites and literature. If you think someone has an alcohol or drug problem, be prepared to talk to them about it but make sure this is done in a caring and non-judgemental way. Make sure you have some knowledge about what types of intervention local specialist drug and alcohol agencies offer and what the process of referral is. If your agency does not have an alcohol and drug service directory, you can find out what there is locally from the online directories published by Alcohol Concern or Drugscope, or contact your local Drug and Alcohol Action Team (see ‘How to find a service’ in the ‘Assessment and Treatment section). |
| 3. Stereotyped views of people who use substances |
It is really important that you reject the judgemental stereotypes about people with alcohol and drug problems often portrayed by the media. The social work values that define and underpin our profession must apply when working with people using alcohol and drugs. Making assumptions that a person’s mental ill health is due to their substance use or that a woman using drugs is an unfit mother, without any other evidence, is bad practice. There are many reasons people use substances (see section ‘Why people use substances’ under ‘Links between social work and substance use’) and nobody sets out to develop a problem. The attitude you take towards working with someone will be obvious immediately – make sure you have a degree of understanding and critical self-reflection about your views on substance use. |
| 4. Assuming that people using drugs or alcohol are putting others at risk |
Some people with alcohol or drug problems will place others at risk, but many will not. It is important to assess the behaviour resulting from substance use and its impact on others and not make snap judgements based on the fact that the person is using substances – whatever the substance. There is no simple hierarchy of substances in terms of their negative effects on other people. For example, you cannot assume that someone using heroin is going to put others at greater risk than a person using alcohol. It is the resulting behaviour that you need to assess. |
| 5. Assuming that stopping drug or alcohol use will reduce risk to self and others |
If you hold the assumption that people with alcohol or drug problems will suddenly be better parents or partners or neighbours etc when they stop using substances, you will probably be wrong. Stopping or reducing problematic substance use can be a very stressful, emotional, and physically uncomfortable time. Tensions and mood changes may increase as a result while the person struggles to deal without their substance. Many people report taking substances ‘to feel normal’ so removing the substance may leave the person feeling exposed and raw. Where other people are at risk from the person’s substance use it would be a mistake to assume things will automatically improve. More than ever, this period will be a time when your support is needed. |
| 6. Lack of confidence to intervene |
Talking to someone about their substance use does not require you to be hugely confident in terms of your knowledge of substance use. You are not expected to conduct a specialist intervention. As a social worker you will have good communication and listening skills and these are what you need to intervene if you think, or know, that substance use is a problem. You are not the expert on the person’s substance use, they are! You can confidently ask them to tell you about their substance use, the positive and negative effects it has on them, the circumstances in which they use, and how other people in their family cope with it. You can confidently ask if they have considered or tried changing their substance use before, how and what helped and didn’t help. And you can confidently ask them if they would like some support to change their substance use and tell them that you’ll support them if they do! |
| 7.Lack of partnership working |
Working with partners from specialist substance use agencies is essential both as a support for you but also to ensure that you can provide accurate information to service users. This partnership can be formal or informal. It may involve a quick call to ask for advice and information, and/or joint visits and assessments, regular joint meetings and training exchanges. With most partnership working there will be differences in focus, priorities and approach of the agencies involved. These differences need to be discussed in order for each agency to have some understanding of the other and avoid future tensions and frustrations that can get in the way of effective partnerships. |
| 8.Not wanting to feel foolish by saying 'I don't know' |
If you don’t know what general effects a drug has (remembering that everyone will experience these things differently), or the names of substitute prescribed drugs or what agencies are available locally and how long their waiting lists are etc, then you do what you’ve been trained to do. You say you don’t know, you’ll find out, and get back to them. Then you go away and do it. Remember the basics, service user feedback shows they want people who will listen to them and do what they say they’ll do to help. They don’t expect you to know everything. |
| 9. Lack of organisational ownership |
Managers can often send front line staff to training but not accept their own responsibility for attending the training in order to provide informed and supportive supervision. Managers also need to ensure that the training and subsequent good practice are embedded within the organisation’s policies and procedures and that the response is not a tokenistic one off training but a commitment to ongoing refresher training and managerial support. |
| 10. One specialist worker |
Having one person elected as a specialist within a team can be a helpful resource but it can also stop everyone else in the team engaging with the issues. It has a tendency to be tokenistic. Given the amount of people with alcohol and drug problems in touch with social services, everyone needs training and support. A specialist worker can provide that but not replace it. |
| 11. One size/model fits all |
Some social workers will have personal experience and/or views about substance use interventions and models. Where this is the case it is important not to impose one particular view or model on people. For example, not everyone will find AA or NA and other associated disease model approaches helpful. This does not mean they are unwilling to address their substance problems! Different types of intervention work for different people. Single focussed solutions are unhelpful therefore it is important to understand that there are a range of solutions available. |
