Date of Conferral

5-15-2025

Date of Award

May 2025

Degree

Doctor of Social Work (DSW)

School

Social Work

Advisor

So'nia Gilkey

Abstract

Co-occurring mental health (MH) and substance use disorders (SUDs) pose a significant challenge for social work practice, especially for licensed clinical social workers (LCSWs) in private practice who often work with limited resources and support. The purpose of this basic qualitative study was to explore the service delivery, care coordination strategies, and challenges of LCSWs in private practice working with co-occurring MH and SUDs. Moore’s social work practice model of case management was used to explain how LCSWs in private practice settings manage complex cases within fragmented MH and SU care systems. Semistructured interviews were used to collect data from six LCSWs in private practice. Data were analyzed using thematic analysis. Key findings included the themes of (a) experience, education, and feelings of preparedness; (b) client disclosure and trust building; (c) common co-occurring disorders; (d) treatment approaches and efficacy; and (e) systemic barriers and care coordination challenges. Systemic barriers, particularly insurance limitations and resource constraints, were identified as significant challenges to care coordination. Findings indicated that LCSWs often feel prepared to address MH concerns but lack sufficient specialized training for managing co-occurring SUDs. Findings support social change as this study reveals the need for improved training opportunities for social work clinicians, policy changes related to insurance reimbursements, and enhanced access to resources for LCSWs who provide clinical services for individuals with co-occurring MH and SUD. Addressing these issues may strengthen service delivery, promote integrated care, and improve treatment outcomes for individuals with co-occurring MH and SUDs.

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