Activity 5: Self-recognition (awareness) of attitudes and beliefs towards substance use and substance use disorders

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Substance use carries a strong public (societal) stigma, which when internalized by someone with a substance use disorder, can affect help-seeking behaviours. As Bathje and Pryor (2011) point out in their article, public stigma can be viewed as essentially a form of prejudice resulting in cognitive, affective, and behavioural reactions. While it is important not to endorse stereotypes, it is important to be aware of the public stigma associated with substance use.

Continuing with the theme of self-awareness in this first lesson, this activity asks you to consider the concept of stigma, to increase your awareness of public stigma, and to become aware of your own biases and attitudes that may affect (unconsciously) your practice. Becoming aware of your biases and attitudes is important. We all have them; however, the ones we are aware of are not usually a big problem, since we can learn to “suspend” or “bracket” them in practice. The stigmas that we are not aware of are potentially re-stigmatizing for our service users.

Language is an important tool in maintaining and perpetuating stigma, and our own language use is one measure of how we present our beliefs and values. As identified earlier, in this course, we will use the terms substance use, substance use disorder, and concurrent disorder whenever possible. Understanding the ideology behind our language is an important measure of self-awareness.


  1. Read: Bathje, G., & Pryor, J. (2011). The relationships of public and self-stigma to seeking mental health services. Journal of Mental Health Counseling, 33(2), 161–176.
  2. Complete the webinar course on Stigma provided by CAMH at:
  3. Read the following and consider the following question:
    • Perry, S., & Reist, D. (2006). Words, values and Canadians: A report on the dialogue at the national symposium on language. Victoria, BC: Centre for Addictions Research of BC.
    • Wakeman, S. (2013). Language and addiction: Choosing words wisely. American Journal of Public Health, 103(4), 1–2.Think about your language. Do you refer to “addicts” or “gamblers” or do you talk about “people with substance use problems” or “people with gambling problems”? Try the latter approach, which puts the person ahead of the problem. This use of language helps to show that you know that there is more to a person than a problem.

      Become aware of your own biases/stereotypes. Using the subscales and items from the Bathje and Pryor (2011) article, identify (for yourself) some of your biases. Using the Factor of 1 (as extremely likely) and Factor 6 (as extremely unlikely), identify some characteristics associated with your differential response, for example:

      How likely is it that you would help _____?

      For me, I am a woman and I recognize that I am more likely to help a woman on the street than a man on the street. I also am more likely to help a younger person than a middle-aged person.


      How frightened of _____ would you feel?

      For me, I know that I am more frightened when someone is showing aggressive behaviour. This is more so, if it is a man. Shouting, incoherently is more frightening, particularly, if I do not know the individual.

Remember: The point of considering these biases for yourself is that you can learn to manage your known biases. However, a lack of awareness of the biases and stigmas that we associate with certain people and their circumstances perpetuates public stigma and impacts our acceptance and work with them.