Working with substance use: Levels and predictors of positive therapeutic attitudes across social care practitioners in England

Aims: To measure the attitudes of social care practitioners towards working with alcohol and other drug (AOD) use and to identify the factors which can be used to predict positive engagement. Methods: A cross-sectional online survey was completed by 646 front-line social care practitioners in 11 English Local Authorities. The survey included an adapted version of the Alcohol and Alcohol Problems Perceptions Questionnaire to measure overall therapeutic attitudes (OTAs). Using a principle component analysis, four attitudinal components were identified within the tool; role adequacy, role support, role legitimacy and role engagement. Findings: Analysis of 597 responses (sub-sample excluding specialists substance misuse workers) revealed an average OTA score of 4.68 (SD = 0.662; range: 1-7). The majority of scores (69%) fell in the middle range indicating that practitioners were neither positively nor negatively engaged with AOD-related work. Respondents reported more positive perceptions of role support and legitimacy (56% and 54%, respectively) than for role adequacy and role engagement (25% and 20%, respectively). A multiple regression model revealed that perceived preparedness by qualifying training, employing directorate, AOD-related practice experience and gender, were all predictors of OTAs. Conclusion: For these social care professionals, neither positive nor negative attitudes towards working with AOD dominated. However, this research identifies several factors important for converting the largely ambivalent attitudes of social care practitioners into positive engagement with AOD use.