NASW Foundation News

How to Talk About Alcohol Use with Clients: Frequently Asked Questions

How often do you talk with clients about their alcohol use? Do you know how much drinking is too much, or what counts as a standard drink?


April is Alcohol Awareness Month, an invitation to social workers to make conversations about alcohol use part of routine practice—and to make sure they’re armed with the facts. As the nation’s largest group of mental health services providers, social workers are uniquely positioned to help clients make significant positive changes in their health and well-being by taking time to talk with them about their drinking.


These conversations can have a major impact. In a 2021 study, 83 percent of healthcare providers reported positive behavior change in patients after conducting alcohol screening and brief intervention with them. Helping clients discuss their alcohol use can also reduce the risk of prenatal alcohol exposure, a leading preventable cause of lifelong behavioral, intellectual, and physical disabilities known as fetal alcohol spectrum disorders (FASDs).


Here are some common questions and answers that can help you discuss alcohol with clients.

How much drinking is too much?


Many people have misconceptions about alcohol use. These include thinking that drinking has health benefits, and the belief that a small amount of alcohol during pregnancy is safe.


The U.S. Dietary Guidelines for Americans defines moderate drinking as:


  • One drink or less a day for women who are not pregnant; and,

  • Two drinks or less a day for men.


In addition, there is no known safe amount of alcohol use and no safe time to drink during pregnancy. There is also no safe type of alcohol to drink while pregnant, since all types of alcohol can be harmful to a developing baby, including wine, beer, and liquor.

What is one drink?


One standard drink contains about 14 grams of pure alcohol, the amount found in a single beer (12 ounces); a single shot (1.5 ounces); and a single glass of wine (5 ounces).

What is alcohol screening, brief intervention, and referral to treatment (SBIRT)?


Alcohol screening and brief intervention is an evidence-based practice recommended by the U.S. Preventive Services Task Force for all adults, including those who are pregnant. Alcohol SBI is also endorsed by major medical professional organizations as well as the Centers for Disease Control and Prevention (CDC). Using a validated screening tool can take as little as one minute, followed by a brief conversation with those who are drinking too much, and referral to treatment when appropriate.

How can social workers help clients feel comfortable discussing their drinking?


Fear, stigma, and misconceptions about alcohol use can prevent clients from seeking needed support or treatment. These “Words Matter” posters, developed in collaboration with the Medical Assistant Partnership for Healthy Pregnancies and Families, can help social workers reduce bias and improve communication in conversations about alcohol.


The NASW Foundation and the Health Behavior Research and Training Institute at The University of Texas at Austin Steve Hicks School of Social Work are partners in the FASD National Partner Network. This CDC initiative aims to help health professionals across disciplines reduce prenatal alcohol and other substance use.





This initiative, Engaging Social Workers in Preventing Alcohol- and Other Substance-Exposed Pregnancies, is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services as part of a financial assistance award totaling $560,000 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. Government.




Article by Diana Ling, MA, Program Manager; and Anna Mangum, MSW, MPH, Senior Health Strategist; Health Behavior Research and Training Institute, Steve Hicks School of Social Work, The University of Texas at Austin.