The profession of social work has a unique role in preventing and trea
ting alcohol and other drug problems. In human services settings share
d beliefs or ideologies of care are expected to have substantial influ
ence over the way in which problems ave perceived and the types of ser
vice technologies used. Thus, it is important that social work profess
ionals be cognizant of what beliefs they hold and how their beliefs ab
out substance abuse treatment and prevention may affect practice. This
article discusses current ideologies of care in the substance abuse a
rena, including the disease/abstinence, psychosocial, ecological, and
harm-reduction approaches. In addition, this article examines managers
' beliefs about substance abuse programs to determine if there are dif
ferences between those who have a social work background (that is, hol
d at least one social work degree) and those who do not. Suggestions f
or social work practice and future research also are provided.