Behavioral Health Service Use Among Licensed Social Workers: A Qualitative Inquiry.

This paper presents qualitative data collected from 996 licensed social workers in the United States who reported mental health and/or alcohol and other drug problems and indicated the types of services they used to address these issues. Outpatient therapy was the most commonly accessed modality to treat mental health issues. Regarding problems with alcohol and other drugs, self-help groups were the most frequently utilized intervention. Qualitative findings suggest that behavioral health service use has influenced respondents' work with clients, personal and professional development, and career trajectories. Barriers to service use, such as stigma and limited access to care, were also identified. Implications for social work education and professional practice are discussed.

Racial and Age Disparities in Licensing Rates among a Sample of Urban MSW Graduates.

Forty-five U.S. states require social workers to pass an examination for entry-level MSW licensure, with all 50 states requiring it for clinical practice. All states use examinations created by the Association of Social Work Boards (ASWB) for this purpose. There has been concern that these exams may contribute to racial bias in social work licensing, as ASWB has historically not reported passing rates by demographic groups. In the present study, New York State licensing rates of over 5,000 graduates of three MSW programs of the City University of New York were analyzed according to race, gender, and age. Although passing rates on ASWB exams were not specifically examined, this study analyzed demographic disparities in licensure. In bivariate and multivariate analyses, White graduates had significantly higher rates of licensure than those who identified as Black, Latinx, Asian/Pacific Islander, mixed, or other. Furthermore, older Black and Latinx graduates had far lower rates of licensure than their younger counterparts. As a core value of social work is social justice, the results indicate the need for far more investigation into racial and age disparities in social work licensure.

Productive Aging in the Social Work Profession: A Comparison of Licensed Workers 60 Years and Older with Their Younger Counterparts.

This article reports the findings of an online survey in 13 U.S. states that compared the self-described demographics, wellness factors (mental health, physical health, and substance misuse), practice factors (fields of practice and work environment issues), and feelings about being a social worker (compassion satisfaction, workplace stress, being glad one chose social work and feeling valued as a professional in society) of 870 employed licensed social workers age 60 and older to 4076 licensed social workers under age 60. The results indicate that the older social workers were more likely to be male and white, less likely to report mental health problems, and more likely to work exclusively in private practice. Although older workers reported more serious physical health problems, they rated their physical health more favorably than their younger counterparts. In both bivariate and multivariate analyses, the older social workers scored significantly higher in compassion satisfaction, being glad they chose social work as a career, and feeling valued as a professional in society. The older social workers scored lower in workplace stress at levels that were statistically significant in a bivariate analysis, but not in a multivariate analysis.

The Persistent High Rates of Heroin Use Among the Puerto Rican Population in the United States: A Qualitative Study.

For a half- century, the Puerto Rican population in the United States has experienced very high rates of heroin usage with significant health ramifications. At substance misuse programs in the Bronx, New York, two focus groups consisting of a total of 13 Puerto Rican counselors, and four focus groups consisting of a total of 35 Puerto Rican clients, discussed the impact of heroin usage on Puerto Rican communities as part of a qualitative study using a phenomenological perspective. Societal marginalization and social dislocation were identified as major contributors to heroin usage in Puerto Rican communities. The findings indicate that full access to economic, vocational, and educational opportunities, along with a decrease in institutional racial discrimination, would appear to be the most effective way to decrease heroin usage among this population.

Wounded Healers: A Multistate Study of Licensed Social Workers' Behavioral Health Problems.

Studies indicate that helping professionals are disproportionately affected by behavioral health problems. Among social workers, the nature and scope of these problems are understudied. This article reports the findings of a 2015 survey of 6,112 licensed social workers in 13 states regarding their problems with mental health; alcohol, tobacco, and other drugs; and gambling. To ascertain whether these problems preceded or developed during their social work careers, the periods of time when these issues were experienced were identified. Results indicate that 40.2 percent of respondents reported mental health problems before becoming social workers, increasing to 51.8 percent during their social work career, with 28 percent currently experiencing such problems. Nearly 10 percent of the sample experienced substance use problems before becoming social workers, decreasing to 7.7 percent during their career. Analyses by race or ethnicity, sex, and age identified between-group differences in the prevalence of these problems. The article concludes with a discussion of the implications for the social work profession.

A postgraduation follow-up of social work students trained in "SBIRT": Rates of usage and perceptions of effectiveness.

Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based modality that can help social workers work with substance-using clients as part of an integrated health care approach. This study reports the findings of a post-graduation one-year follow-up survey of 193 master's and bachelor's social work students trained in SBIRT in practice courses at a Northeast urban college. Forty-three percent of the trainees who were practicing social work after graduation were using SBIRT. A content analysis of participants' comments found that the vast majority found SBIRT to be a valuable practice modality, with barriers to utilization of SBIRT identified.

The Perceptions of White Clients in a Substance Abuse Program in Which They Are in the Minority.

BACKGROUND: There is a large body of literature regarding the need for culturally-informed practice with non-white populations in substance abuse treatment. Virtually nothing, however, has been written regarding the needs of white clients when they represent a small minority in treatment programs. OBJECTIVES: The primary purpose of this study is to compare perceptions of treatment and completion rates between white and nonwhite clients in a substance abuse treatment program where white clients represent a small minority. METHODS: In New York City in 2009/2010, at a short-term inpatient program where white clients represented 12% of the population, 611 clients completed surveys that included scales measuring satisfaction, therapeutic alliance, social cohesion, and connection to the program. White and non-white clients were compared regarding results of these scales as well as program completion rates. Furthermore, demographic/background characteristics of the white and nonwhite clients obtained from the surveys were compared. RESULTS: White clients reported lower levels of connection to the treatment program than non-white clients at levels that were statistically significant. However, there were no statistically significant differences between them for the other scales and program completion rates. Although white clients reported greater frequency and number of substances used, they were far less likely to have had felony convictions. CONCLUSIONS: Although differences were not extreme, there was evidence that greater sensitivity to the needs of white clients in programs in which they are in the minority is needed. Furthermore, this study demonstrates racial disparities in criminal justice involvement between white and non-white substance users.

Attitudes of West African Immigrants in the United States toward Substance Misuse: Exploring Culturally Informed Prevention and Treatment Strategies.

There is a lack of literature exploring substance misuse issues of the West African-born population in the United States. Thirty-four participants born in West Africa participated in one of three focus groups in a U.S. city to discuss their attitudes toward alcohol and drug use. Based on a qualitative analysis of the discussions, stigmatization of substance abusers and negative attitudes toward U.S. substance abuse treatment were identified as barriers to service utilization for West African immigrants. Community cohesion, importance of family, and a strong sense of spirituality were identified as essential resources to inform substance misuse prevention and treatment strategies.

Self-identified heterosexual clients in substance abuse treatment with a history of same-gender sexual contact.

There is virtually no literature concerning the experiences of self-identified heterosexual clients in substance abuse treatment who have a history of same-gender sexual contact (HSGS). In a U.S. urban inpatient program in 2009-2010, 99 HSGS clients were compared to 681 other heterosexual and 86 lesbian, gay, and bisexual clients regarding background factors, program completion rates, and feelings about treatment. Male HSGS participants had lower completion rates than other male heterosexual participants. Qualitative data indicated that most male HSGS participants experienced difficult emotions regarding same-gender sexual encounters, particularly those involving trading sex for money or drugs. Implications for treatment are discussed.

Challenges and resilience in the lives of adults with sickle cell disease.

This qualitative study focused on the experiences of adults living with sickle cell disease (SCD) in the New York City area. Twenty-three individuals participated in one of three focus groups. The purpose of this study was to learn if appropriate health care for individuals with sickle cell disease, based on years of research, has been implemented. The findings indicate that best practices in the treatment of SCD are often not followed by medical personnel. Critical race theory provides a framework to understand the 10 emergent themes. The participants' responses illustrate resilience in facing adversity. Implications for social work practice are presented.

Are specialized LGBT program components helpful for gay and bisexual men in substance abuse treatment?

In the New York metropolitan area, a convenience sample of 187 men previously treated in substance abuse programs between 2000 and 2006 completed questionnaires regarding their reported outcomes, completion rates, and perceptions of treatment. The sample included 81 gay and bisexual ("gay/bisexual") men in "traditional" programs (with no specialized groups for gay/bisexual clients), 51 gay/bisexual men in "LGBT specialized treatment" (programs with specialized groups for gay/bisexual clients), and 55 heterosexual men. In bivariate and multivariate analyses, heterosexual men and gay/bisexual men in LGBT specialized treatment had more favorable results than did gay/bisexual men in traditional programs, suggesting the effectiveness of LGBT program components.

The effects of honesty and openness about sexual orientation on gay and bisexual clients in substance abuse programs.

A convenience sample of 183 gay, lesbian, and bisexual participants who were previously treated in substance abuse programs, completed surveys that included questions regarding their honesty and openness about their sexual orientation with counselors and clients in their programs, as well as in their personal lives. It was found that levels of honesty and openness in treatment positively correlated with reported program completion, satisfaction with treatment, feelings of therapeutic support, and feelings of connection to the program. However, there were no correlations between honesty and openness and reported abstinence from substances at the end of treatment and at the time of survey completion.