Date of Conferral

2023

Degree

Ph.D.

School

Social Work

Advisor

Sean Hogan

Abstract

Although harm reduction (HR) and abstinence-based treatment approaches are both useful in addiction treatment, the former is less accepted and integrated into practice. Social workers who embrace an HR approach but who work at substance abuse treatment facilities that are abstinence based may experience cognitive dissonance because they perceive their work role to be incompatible with social work practice values and education. Little was known regarding how practitioners with a Master of Social Work (MSW) degree experience and reconcile cognitive dissonance related to their HR education and abstinence-only practice in substance use treatment centers. To address this gap in the literature, a generic qualitative study was conducted using Festinger’s theoretical framework of cognitive dissonance. A purposive sampling procedure was used to recruit eight participants, all of whom were MSWs at least 21 years old who had at least 1 year of experience working in a substance use treatment setting. Thematic coding was used to analyze data from semistructured interviews. Themes included challenges at the micro, mezzo, and macro level; the presence of other MSWs and years of working experience; use of social work practice skills; the practice of switching jobs; and engagement in self-awareness and cultural humility practices. The findings may inform clinical social workers about HR practices across systems and administrators about curriculum development in MSW programs. The findings may also be pertinent to advocates and policy makers who want to increase the use of HR. More acceptance of HR in substance abuse treatment facilities may help social workers to experience less cognitive dissonance, which may improve working environments.

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