Perceived Readiness and Clinical Confidence in Providing Substance Use Disorder Care Among Behavioral Health Providers
Khary K. Rigg, Steven L. Proctor, Kayleigh B. Faber, Lily C. Steed, Laura CurranBackground
Substance use disorders (SUDs) are common in behavioral health settings; however, many providers report limited training in addiction. Although previous research has documented gaps in SUD education, less is known about behavioral health providers’ perceived readiness for SUD practice and the factors that shape clinical confidence in treating individuals with SUDs.
Objectives
To examine behavioral health providers’ readiness for SUD practice and identify factors shaping clinical confidence.
Design
Multi-method study.
Methods
Surveys (n = 160) and in-depth interviews (n = 40) were conducted with licensed providers in Florida across four disciplines: psychology, social work, mental health counseling, and marriage and family therapy between September and November 2025.
Results
Quantitative findings indicated relatively low levels of readiness for SUD practice. Fewer than half of participants reported adequate training in evidence-based SUD practices (44.4%), satisfaction with their SUD training (40.0%), or feeling prepared upon graduation to work clinically with individuals with SUDs (38.8%). Qualitative findings identified three interrelated factors shaping provider confidence in care: SUD severity, substance type, and perceived safety risks.
Conclusion
Many behavioral health providers reported limited readiness for SUD practice and described lower confidence when working with moderate to severe SUDs, substances beyond alcohol and marijuana, and situations involving heightened safety concerns. Strengthening the behavioral health workforce may require more than general SUD education. Targeted training focused on high-risk clinical decision-making, diverse substance-related presentations, and acute management of safety-related concerns may better prepare providers to deliver effective SUD care.