Service Providers'Treatment Model Choices For Cocaine-Using Clients

Maria Dinis

Division of Social Work - MRP 4021
California State University, Sacramento

6000 J Street
Sacramento, CA 95819-6090
(916) 278-7161
FAX: (916) 278-7167
dinis@csus.edu
Purpose: Professionals' clinical decisions are influenced by personal beliefs that ascribe causal explanations to alcohol/drug problems and inform the selection of treatment approaches for different populations. This study describes professionals' treatment model choice for women (pregnant and non-pregnant) and men who use cocaine. The predictors of treatment model choice included professionals' beliefs about the causes of drug addiction, educational background, and work setting.

Methods: A random sample of 610 service providers from alcohol/drug treatment settings, criminal justice, mental health, hospitals/medical services, and social welfare agencies was selected in a two-stage area probability sample.  In this cross-sectional study, 457 (73%) service providers were interviewed to examine their treatment model selection for all three-client groups.

Results: Logistic regression was used to examine the relationship of model selection with providers' beliefs of the etiology of drug addiction, profession, work setting, and demographic variables.  Regardless of their profession or work setting, most providers chose the medical model for pregnant women.  Providers selecting the sociocultural model were more likely to be women. Providers with college training and/or graduates were less likely to select the sociocultural model.  Providers believing in multiple causes of drug addiction were more likely to select the integrative model for all three groups: pregnant women (OR = 4.13); non-pregnant women (OR = 2.74); and men (OR = 3.31).  There were inconsistencies between providers' beliefs in genetic or social causes of drug addiction and their adoption of the corresponding treatment model.

Implications for practice: Findings indicate that pregnancy status itself is a determinant of medical model choice. The territory to treat pregnant cocaine-using women may belong to some professions (e.g., medical) and not others (e.g., social work). The inconsistency in beliefs and selecting models of treatment indicates that providers differentiate between groups and their beliefs may be an inconsistent predictor of model choice.