Counselors at substance use disorder treatment programs say violence against them is common, a new study finds. More than half said they personally experienced violence, 44 percent witnessed violence, and 61 percent had knowledge of violence directed at a colleague.

The study is the first to measure the extent of workplace violence in treatment programs across the United States, according to News-Medical.net.

“We know that workplace violence disproportionately impacts health care and social service providers,” lead author Brian E. Bride of George State University said in a news release. “Our goal was to quantify its existence in substance abuse treatment centers, identify personal and institutional responses, and identify any characteristics that may put counselors at greater risk.”

Bride and colleagues found 29 percent of counselors reported that exposure to workplace violence led to an increased concern for personal safety, while 15 percent said it affected their treatment of patients and 12 percent said it impaired their job performance.

In response to patient violence, 70 percent of treatment centers have increased training on de-escalating violent situations, and 58 percent have increased security measures, the researchers found.

The study appears in the Journal of Substance Abuse Treatment.

“Workplace violence has been shown to interfere with a clinician’s ability to manage his or her workload,” Bride said. “Additionally, these professionals suffer lower mental energy. They are less likely to participate in work decisions and more likely to offer a decreased quality of care.”