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

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.

Duke Scholars

Author Jeffrey W. Swanson Psychiatry, Child & Family Mental Health & Community Psychia ...

Author Marvin Stanley Swartz Psychiatry, Child & Family Mental Health & Community Psychia ...

Author Eric Bradley Elbogen Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...