Therapeutic orientations, professional efficacy, and burnout among substance abuse social workers in Israel Eugene Tartakovsky, Ph.D. ⁎, Slava Kovardinsky, M.S.W. School of Social Work, Tel Aviv University, P.O.B. 39040, Tel-Aviv 69978, Israel abstract article info Article history: Received 31 July 2012 Received in revised form 6 January 2013 Accepted 7 January 2013 Keywords: Substance abuse Social workers Therapeutic orientations Professional efficacy Burnout Israel This study investigates the therapeutic orientations of substance abuse social workers and the relationship between these orientations and burnout. Ninety-two social workers who provided outpatient treatment to people suffering from substance-related disorders in Israel participated in the study. The results obtained demonstrated that the substance abuse social workers adhere more to the psychodynamic and ecosystemic therapeutic orientations than to the cognitive–behavioral orientation. A greater adherence to the cognitive– behavioral orientation was associated with a higher sense of professional efficacy; a greater adherence to the psychodynamic orientation was associated with a higher level of exhaustion; and greater adherence to the ecosystemic orientation was associated with lower levels of exhaustion and cynicism. Female social workers reported lower levels of exhaustion and cynicism. The cognitive–behavioral orientation mediated the connection between the social workers' experience in the field of substance abuse and two dimensions of burnout—exhaustion and professional efficacy. Significance of the findings for improving the well-being of substance abuse social workers and for the advancement of psychosocial services is discussed. © 2013 Elsevier Inc. All rights reserved. 1. Introduction In many countries across the globe, the number of people who require psychosocial help due to substance abuse problems remains consistently high or is even increasing, while the health and welfare systems typically suffer financial constraints and a chronic shortage of qualified professionals (Isralowitz, Reznik, Spear, Brecht, & Rawson, 2007; Smith, Whitaker, & Weismuller, 2006). In their attempt to close the demand–supply gap, the organizations financing services in the field of substance abuse are shortening the allocated time for subsidized treatment and are increasing their demand for accountability and demonstrated treatment efficacy (Fahy, 2007). Therapists are required to prove the efficacy of their therapeutic methods, or to switch to the therapies whose efficacy has been confirmed. In this situation, empirical studies of different types of therapy are especially important. Numerous studies have investigated the efficacy of different therapeutic orientations, some of which were conducted in the area of substance abuse (Leichsenring, 2005; Miller & Wilbourne, 2002; Ouimette, Finney, & Moos, 1997; Shedler, 2010; Stiles, Barkham, Twigg, Mellor-Clark, & Cooper, 2006; Tolin, 2010). However, all of these studies have focused on treatment outcome for the clients. Surprisingly, the effect of practicing different types of psychotherapy on the therapists has been rarely studied. This is an important area of research, since adherence to different therapeutic orientations may affect the therapists' sense of professional efficacy, as well as their other work-related cognitions and emotions (Coleman, 2004; Poz- nanski & McLennan, 1995; Prochaska & Norcross, 2009). The present study focuses on substance abuse social workers in Israel, measuring their adherence to different therapeutic orientations and examining how these orientations relate to the social workers' sense of professional efficacy and burnout. 1.1. Therapeutic orientations According to Poznanski and McLennan (1995, p. 412), “theoretical orientation refers to an organized set of assumptions, which provides a counselor with a theory-based framework for (a) generating hypothe- ses about a client's experience and behavior, (b) formulating a rationale for specific treatment interventions, and (c) evaluating the ongoing therapeutic process.” Therapists' theoretical orientations form the basis of their therapeutic practice; however, the particular therapeutic behaviors may be a function of a variety of other factors, including the agency's policies and procedures, client needs, and the counselor's experience (Coleman, 2004; Poznanski & McLennan, 1995). The two most influential and widely used approaches in counseling and psychotherapy are psychodynamic therapy (PDT) and cognitive–behavioral therapy (CBT) (Boswell, Castonguay, & Journal of Substance Abuse Treatment 45 (2013) 91–98 ⁎ Corresponding author. The Bob Shapell School of Social Work, Tel-Aviv University, P.O.B. 39040, Tel-Aviv 69978, Israel. E-mail address: etartakov@hotmail.com (E. Tartakovsky). 0740-5472/$ – see front matter © 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jsat.2013.01.002 Contents lists available at SciVerse ScienceDirect Journal of Substance Abuse Treatment