joe\'s case study and evidence based practice

Working with Clients with Dual Diagnosis: The Case of Joe," (n.d.) shows how social policies can directly affect the lives of individuals, impacting their access to and awareness of care options and the availability of specific services. Moreover, social policies can influence mental health practitioners, reinforcing stereotypes and stigmas toward patients with substance abuse disorders in particular.

A systematic review of the literature reveals "negative attitudes of health professionals towards patients with substance use disorders are common and contribute to suboptimal health care for these patients," (Boekel, Brouwers, van Weeghel & Garresten, 2013, p. 23). Social workers are at the forefront of substance abuse treatment, as social work professionals "regularly encounter individuals, families, and communities affected by substance use disorders," including co-occurring disorders as in Joe's case (NASW, 2013, p. 5).

Therefore, in addition to their role in reducing stigma and ensuring evidence-based practice in mental health care, social workers need to consider their role as catalysts for social policy reform. Joe's case demonstrates the importance of three core elements of social work: competency, evidence-based practice, and client confidentiality. All three of these issues are covered by the NASW (2013) in its specific approach to mental health and substance use disorders. Competency refers to a working command of recent health care policy as well as best practices.

Therefore, competency is linked with the concept of evidence-based practice. Evidence-based practice ensures that social workers rely on research to guide best practices, and that professional expertise is directly supported by scientific research. In fact, evidence-based practice is requisite in order for clients like Joe to qualify for third party payers (NASW, 2013). Client confidentiality is an ethical priority for all case workers. Preserving client confidentiality is a sign of respect for the client and helps engender the type of trust that can be conducive to healing.

Ideally, the social worker in Joe's case recognizes the inherent harm that the war on drugs creates, and advocate on behalf of Joe. Social work aims to reduce harm, which means refusing to place moral judgments on people like Joe and to especially refrain from criminalizing the client or diverting clients into the criminal justice system. However, social workers also understand how policies constrain their ability to take action to help people like Joe. Joe's case exhibits gaps in service delivery related to intersectionality and social class status.

Guiding principles of social work include understanding the patient in a systemic way, taking into account issues like social policy, social status in the community, and family status when working with clients. The NASW (2013) recommends a "supportive approach" that refrains from judgment and stigma while focusing on prevention and early intervention (p. 7). A social worker will understand how Joe can access substance use intervention programs financially, within the provisions of the Affordable Care Act.

Similarly, a social worker will understand the ramifications of harm reduction policies in Joe's state and help Joe to capitalize on these social programs. As the NASW (2013) points out, the trend is finally shifting away from punitive measures and towards a holistic model in which co-occurring disorders are treated compassionately and sensibly, relying on evidence instead of emotions. Strategy to help Joe would focus on activism in eliminating the war on drugs, which is not evidence-based practice at all.

On the contrary, the war on drugs is a failed policy and a harmful one, as it reinforces the negative stigma against clients like Joe (Boekel, Brouwers, van Weeghel & Garresten, 2013). Stigma prevents clients like Joe from being able to access the full range of mental health interventions.