Stress and Working with Drug Misusers

Factors influencing social work students' motivation to work in drug treatment settings: the role of knowledge and attitudes

Given the continuing problem of drug use in the United States and the high risk of burnout among substance use treatment staff, this study focuses on examining the relationship between social work students' knowledge and attitudes toward individuals who use drugs and their motivation to work in drug treatment settings. A Multiple linear regression analysis was conducted, using a convenience sample of 229 social work students (age = 21 to 60, female = 82.5%, White = 79.9%, African American = 13.5%, Asian = 2.6%, Hispanic = 3.9%) at a large public university in an eastern state. Results revealed that knowledge and positive attitudes were key factors stimulating social work students' motivation to work with individuals who use drugs, and knowledge was the most influential factor. Social work students are more likely to want to work with individuals who use drugs if they have positive attitudes toward their clients and increased knowledge of drugs and drug-related problems. Interestingly, there is no significant difference in motivation between those who have negative attitudes and other people. Implications for social work education on substance abuse are discussed.

Prevalence of somatisation as a determinant of burnout amongst staff working in drug and alcohol services

Purpose

The purpose of this paper is to explore the prevalence of somatisation as a determinant of burnout amongst drug and alcohol staff in the UK.

Design/methodology/approach

The study employed a cross-sectional design utilising a self-completion online questionnaire. Data were collected from substance misuse workers across England and Wales. In total, 165 responses were eligible for analysis, yielding a response rate of 5 per cent. Burnout and somatization were measured with Maslach’s Burnout Inventory and the Physical Symptoms Inventory.

Findings

The prevalence of somatic symptoms was relatively low in the sample studied. The reported levels of burnout were moderate. Personal accomplishment remained high in the sample. There was a strong association between burnout and incidence of stress-related somatic symptoms, with higher levels of burnout correlating with multiple symptoms.

Research limitations/implications

It was not possible to determine the extent of non-response bias, as at the time of the study there was no information available relating to the characteristics of drug and alcohol staff in the selected services. Therefore, as the response rate was very low (5 per cent) it was recognised that non-response bias might have affected the findings, in such way that non-respondents may have differed in their experiences of work stress, satisfaction, burnout and health outcomes.

Practical implications

Despite the limitations, the study provided practical information relating to burnout vulnerability and associated physical symptoms in this specific occupational group. These findings can support employers to address staff wellbeing with a view to prevent burnout and reduce existing levels of burnout and related somatic symptoms, and improve job performance, job satisfaction and staff retention through making appropriate adjustments, such as developing staff-wellbeing programmes. These adjustments could potentially contribute to improvement in substance misuse practice, through maintenance of healthy and satisfied workforce.

Originality/value

There are very few studies looking at burnout in drug and alcohol staff. This study is also novel in a way that it reveals correlations between a variety of specific stress-related physical symptoms and the three components of burnout.

The impact of organizational stress and burnout on client engagement

This article explores the impact of organizational attributes on client engagement within substance abuse treatment. Previous research has identified organizational features, including small size, accreditation, and workplace practices, that impact client engagement (K. M. Broome, P. M. Flynn, D. K. Knight, & D. D. Simpson, 2007). This study sought to explore how aspects of the work environment impact client engagement. The sample included 89 programs located in 9 states across the United States. Work environment measures included counselor perceptions of stress, burnout, and work satisfaction at each program, whereas engagement measures included client ratings of participation, counseling rapport, and treatment satisfaction. Using multiple regression, tests of moderation and mediation revealed that staff stress negatively predicted client participation in treatment. Burnout was related to stress but was not related to participation. Two additional organizational measures--workload and influence--moderated the positive relationship between staff stress and burnout. Implications for drug treatment programs are discussed.

Influences on the provision of drug services in England: the experiences and views of front line treatment workers

Whilst service users' views of treatment have been explored, little research exists that has examined front line treatment workers' views on what they perceive are the facilitators and barriers to service provision. This study aimed to fill that gap using a qualitative methodology to explore the experiences of treatment workers. A purposive sample of four Drugs Action Teams or Drug and Alcohol Teams was selected and, in total, 32 front line treatment workers were interviewed across a range of services. Participants indicated that the influences on treatment delivery occurred at three levels. The first level was structural impacts. These included the degree to which services were resourced, the role of targets and a competitive tendering environment, and challenges to partnership working between criminal justice services and community-based services. At the second level, participants identified the influence of the local organisation of services, in particular, the importance of co-ordination in care planning and streamlining for complex cases. The final level was the impact of specific working practices. Good communication was seen as facilitating information sharing; however, a lack of support by management could undermine the benefits of both supervision and peer-support. Unmet training needs were identified by staff across a range of services and particular issues in the relationship between drug treatment and mental health services were identified. Overall, the participants indicated that drug treatment in England was delivered within a complex structure by services that had varied treatment philosophies and that sometimes competed for funding. Despite this, the system was seen as functioning due to the high level of commitment of the people who work within it.

Prevalence and associated factors in burnout and psychological morbidity among substance misuse professionals

Background

Studies of psychological stress among substance misuse professionals rarely describe the nature of burnout and psychological morbidity. The main aim of this study was to determine the extent, pattern and predictors of psychological morbidity and burnout among substance misuse professionals.

Methods

This study was a cross-sectional mail survey of 194 clinical staff of substance misuse services in the former South Thames region of England, using the General Health Questionnaire (GHQ-12) the Maslach Burnout Inventory (MBI) as measures of psychological morbidity and burnout, respectively.

Results

Rates of psychological morbidity (82%: 95% CI = 76–87) and burnout (high emotional exhaustion – 33% [27–40]; high depersonalisation – 17% [12–23]; and diminished personal accomplishment – 36% [29–43]) were relatively high in the study sample. High levels of alienation and tension (job stressors) predicted emotional exhaustion and depersonalisation (burnout) but not psychological morbidity. Diminished personal accomplishment was associated with higher levels of psychological morbidity

Conclusion

In the sample of substance misuse professionals studied, rates of psychological morbidity and burnout were high, suggesting a higher level of vulnerability than in other health professionals. Furthermore, pathways to psychological morbidity and burnout are partially related. Therefore, targeted response is required to manage stress, burnout and psychological morbidity among substance misuse professionals. Such a response should be integral to workforce development.

Burnout among corrections-based drug treatment staff: impact of individual and organizational factors

As a result of limited budgets, many treatment programs are forced to operate for extended periods at or beyond their capacity. The resulting pressure and stress on treatment staff can be taxing and lead to serious problems, including job burnout. Although the concept of burnout within other social service professions has been broadly researched, less attention has been given to burnout among drug abuse treatment staff, especially among corrections-based drug treatment staff. The goal of this article is to extend this area of research by exploring the impact of individual factors and organizational factors on burnout. Findings revealed that although a number of factors were related to staff burnout, younger counselor age, lower adaptability, poorer clarity of agency mission, and higher stress were most significant. Ways in which treatment programs might address these issues affecting staff burnout are discussed.