Autonomy and the use of directive intervention in the treatment of individuals with serious mental illnesses: A survey of social work practitioners


Journal Article

Social workers in mental health settings struggle to support the principle of autonomy while weighing the need to directively intervene when there is a risk of harm or when clients are nonadherent to treatment. However, our understanding of this tension is incomplete. We therefore engaged in a survey of 193 social workers in North Carolina regarding attitudes toward autonomy and directive interventions, and examined correlates of these attitudes. Findings revealed that respondents having a client with a psychiatric advance directive were significantly more supportive of client autonomy. Respondents who were licensed, working in an inpatient setting, or had briefer client contacts were more likely to endorse the need for directive interventions, and those working in the public sector reported more use of warnings to improve adherence. Implications for practice, training, and research are discussed.

Full Text

Duke Authors

Cited Authors

  • Scheyett, A; Kim, M; Swanson, J; Swartz, M; Elbogen, E; Van Dorn, R; Ferron, J

Published Date

  • July 1, 2009

Published In

Volume / Issue

  • 7 / 4

Start / End Page

  • 283 - 306

Electronic International Standard Serial Number (EISSN)

  • 1533-2993

International Standard Serial Number (ISSN)

  • 1533-2985

Digital Object Identifier (DOI)

  • 10.1080/15332980802051979

Citation Source

  • Scopus