Support for the psychosocial, disease and brain disease models of addiction: A survey of treatment providers' attitudes in Australia, the UK, and U.S.

Background: How addiction treatment providers view different models of addiction has implications for workforce development and addiction treatment, however research exploring their views is limited. This study examined Australian, UK and US treatment providers': (1) levels of support for the psychosocial, disease model of addiction (DMA) and brain disease model of addiction (BDMA); and, (2) individual demographic characteristics that were associated with support for these models. Methods: A total of 1438 treatment providers in Australia (n = 337), the UK (n = 165) and US (n = 936) completed an online survey. Support for the psychosocial and DMA were measured using the Short Understanding of Substance Abuse Scale (SUSS) (Humphreys et al., 1996) and BDMA support using a measure created by the authors. Hierarchical multiple linear regression analyses were used to analyze associations between treatment providers' demographic characteristics (i.e., previous addiction status, attended 12-step programmes, age, gender, education level) and level of support for each model. Results: There were no significant differences in treatment providers' support for the psychosocial model between the three country groups. US participants had significantly higher levels of support for the DMA than the UK group, and the UK group was higher than the Australian group. US participants had significantly higher levels of support for the BDMA than Australian and UK participants. Regression analyses found that being younger in all three country groups and a higher level of education in the UK group was associated with greater psychosocial model support. A personal experience of addiction and 12-step programmes was associated with stronger support for the DMA, as was older age in the Australian and US treatment provider groups. In the US group, a personal experience of addiction and 12-step programmes was associated with support for the BDMA. Conclusion: Treatment providers from different backgrounds and in different countries vary in how they view the etiology of addiction. How differences in views about addiction impact service delivery and clients' experience of care remains an important topic for future research. Furthermore, policy makers should consider treatment providers' heterogenous views about addiction and the implications for service delivery and workforce policy development.