Lena Lundgren

The Affordable Care Act: New Opportunities for Social Work to Take Leadership in Behavioral Health and Addiction Treatment

An estimated 23 million individuals in the United States meet criteria for a diagnosis of substance abuse or dependence; however, only about 4 million people enter treatment each year. The Patient Protection and Affordable Care Act (ACA) is likely to increase access to addiction treatment through the integration of behavioral health and health care services. However, this integration effort is at risk of excluding the most vulnerable population groups with substance use disorders. Further, key health and government agencies report an urgent need for more health professionals to be trained in empirically supported methods for screening and treating patients for abuse and dependence of alcohol and other drugs. The implementation of an integrated care model is threatened by the shortage of social workers who are sufficiently trained in these methods. This article argues that in this era of implementing the ACA, it is key that social workers not only become leaders in the addiction health services research field but also translate their knowledge to social work practice. Further, the article presents research on the Swedish addiction treatment system as a model of an alternative system in which social workers fill a central role in implementing a coordinated care model.

Deciding to work less in a high-level profession: negotiating strategies and consequences of reduced-hours careers in medicine

Based on forty interviews with physicians who chose to work a reduced-hours career track, this paper explores the perceived consequences of this career track on career progression and satisfaction. Our study suggests that for this population, a reduced-hours career path is a strategy developed primarily on the individual physicians initiative, informally negotiated with the organization, and dependent upon factors such as relationships with supervisors and peers. The physicians believed that the non-standard and informal ways in which these alternative career paths were created lead to a flexible working situation. However, they also acknowledged that reduced-hours careers also resulted in less career mobility. In contrast to other research on the relationship between lack of standardized, formal workplace policies and career stigmatization, these physicians did not describe a relationship between these two factors. Instead, participation in tasks and activities defined as normative to the profession was a key factor affecting career mobility.

Advancing Alcohol and Other Drug Education among Social Work Faculty: An Evaluation of Social Work Faculty Immersion Training

This study is an educational evaluation of participants (N = 50) in a 4-day immersion training program funded by the National Institute on Alcohol Abuse and Alcoholism. Using a pretest–posttest design, clinical social work faculty participants showed statistically significant (p < .001) improvement in overall alcohol and other drug-related knowledge (baseline M = 8.75, SD = 2.44; postintervention M = 13.88, SD = 1.96, Cohen’s d = −2.16) in the domains of screening and assessment, brief intervention, medication-assisted treatment, and recovery and relapse prevention. Corresponding increases were also observed for faculty confidence in teaching clinical skills related to alcohol and other drug screening, assessment, and treatment.

The Alcohol and Other Drugs Education Program for Social Work Faculty: A Model for Immersion Training

This article presents the Alcohol and Other Drugs Education Program (ADEP) as a model for faculty training in evidence-based alcohol and other drug (AOD) identification and treatment. We make the case that AOD use is a serious social and public health issue and highlight faculty training as a strategic approach for addressing the pressing demand for clinical professionals who can provide AOD-related services. In turn, we describe the core elements of ADEP, including the program’s foundational assumptions and logic, guiding principles and design, situating ADEP within the context of other efforts to improve the quality of AOD-related clinical care.

Is Clinical Assessment of Addiction Severity of Individuals with Substance Use Disorder, Using the Addiction Severity Index, A Predictor of Future Inpatient Mental Health Hospitalization? A Nine-Year Registry Study

ABSTRACT Objective: In Sweden, the Addiction Severity Index (ASI) is the Swedish National Board of Health and Welfares recommended substance use disorder assessment tool and used routinely for patient intakes. Our study of 213 individuals assessed for substance use disorder with the ASI used nine years of the National Patient Register and examined whether clinical social workers assessments of addiction severity at baseline were associated with later hospitalizations for mental health disorder (MHD). Methods: ASI composite scores and interviewer severity rating were used to measure clients problems in seven areas (mental health, family and social relationships, employment, alcohol, drug use, health, and legal) at baseline. A stepwise regression method was used to assess the relative importance of ASI composite scores, MHD hospitalization two years prior to baseline, age, and gender for MHD hospitalization seven years post-baseline. Results: Almost two-thirds of the individuals (63%) were hospitalized at least once for MHD in the seven years post-baseline. At the multivariable level, MHD hospitalization prior to baseline was the strongest predictor of future MHD hospitalization, followed by ASI composite scores for drug use, employment, mental health and, last, male gender. Conclusions: A key finding is that higher ASI composite scores for drug use and mental health are predictors of future need for MHD treatment. Future studies will replicate this effort with a national population of individuals with substance use disorder.