Background. Psychiatric advance directives (PADs) allow competent individuals to state their preferences for future mental health treatment through advance instructions (AIs). PADs also allow these individuals to appoint a proxy decision maker through a health care power of attorney (HCPA) during times when they are no longer capable of making treatment decisions. This study explored factors influencing social workers' support for PADs. Methods. The study gathered attitudinal and decision-making data from 193 social workers providing services to adults with serious mental illnesses in North Carolina. Results. , 38.3% agreed that AIs would be helpful to consumers, while 42.5% indicated that they thought HCPAs would be helpful. In multivariate analyses, the endorsement of AIs was positively associated with social workers who reported more than 7 years of mental health practice experience and who reported having psychotic patients constitute 10% or more of their caseload. Neither of these two variables was significant in predicting endorsement of HCPAs: instead, endorsement of HCPAs was positively associated with prior experience with HCPAs, the belief that involuntary treatment violates the NASW Code of Ethics, and the social worker's assessment of the importance of the patient's family's opinion. Conclusion. The results from the current study are consistent with three themes that emerge from this literature: (1) there is some front-line provider resistance to sharing power with the patient; (2) providers' attitudes and values have some influence on their practice decisions; and (3) mental health providers often must choose between competing values when working with clients.