How social work clients construct and negotiate boundaries between acceptable and problematic alcohol use

Background: Social work professionals frequently meet clients who engage in hazardous or harmful drinking. However, social workers and their clients may have different perceptions regarding what problematic alcohol use means and how to define it. This paper explores how social work clients construct boundaries between acceptable and problematic alcohol use in the context of alcohol screening and counselling.

Methods: The interviews with social work clients (N = 14) were conducted and analysed using a qualitative attitude approach. Clients were asked to comment on eight statements concerning alcohol screening and counselling. The analysis identified explicit stands taken towards each statement together with arguments intended to justify these stands. Taking a stand is an evaluative act that constructs an attitude object in a particular way. Here, the primary objective is to explore how boundaries between acceptable and problematic alcohol use were constructed as attitude objects.

Results: The clients defined their own alcohol use either as problematic or justified it as non-problematic. On the contrary, perceptions of boundaries between the acceptable and problematic alcohol use of other people were characterized by ambiguity; interviewees pondered how much is too much, what type of social consequences are , whether alcohol-related problems can be hidden, and who has such problems defined by medical terms. Clients argued that answers to these questions vary from one socioeconomic group to another; for upper status groups, the boundaries of acceptable alcohol use are looser than for unemployed clients of social work.

Conclusion: For themselves, clients used the binary framing of acceptable and problematic alcohol use, whereas for others the boundaries were blurred and constructed based on medical, social, and especially socio-economic aspects. Knowledge of different ways of constructing boundaries between acceptable and problematic alcohol use can serve to develop the early identification of alcohol-related problems in social work.