Couple questions:

1) How much therapy training does your average masters level S.W. get?
2) Are they held to similar ethical standards around practice & competence? (i.e. can they go to a seminar on NLP and then decide to start using it?)

I ask because a great deal of the child "intervention work" done in this area is referred to S.W.'s. Out of curiosity, I called a popular outpatient setting and asked about qualifications and treatment modalities - some pretty 'fishy' treatment approaches were listed (i.e. EMDR), and I wasn't really left with a good impression. How much theory/training/experience do they really have anyway?

I am admittedly biased (from having worked with a number of less than adequate SW's), but overall I was not very impressed with their training. I have worked with some very good LCSWs also....so it isn't across the board.

EMDR.....really? I am not a fan of it in general, but i'd also question if they would be able to receive proper 'training' in it.

-t

Couple questions:

1) How much therapy training does your average masters level S.W. get?
2) Are they held to similar ethical standards around practice & competence? (i.e. can they go to a seminar on NLP and then decide to start using it?)

I ask because a great deal of the child "intervention work" done in this area is referred to S.W.'s. Out of curiosity, I called a popular outpatient setting and asked about qualifications and treatment modalities - some pretty 'fishy' treatment approaches were listed (i.e. EMDR), and I wasn't really left with a good impression. How much theory/training/experience do they really have anyway?
This is taken from the California Society for Social Workers Ethical Standards:




California Legal Description of Practice
Section 4996.9 of the California Business and Professions Code defines the practice of clinical social work as:

“. . . a service in which a special knowledge of social resources, human capabilities, and the part that unconscious motivation plays in determining behavior, is directed at helping people to achieve more adequate, satisfying, and productive social adjustments. The application of social work principles and methods includes, but is not restricted to, counseling and using applied psychotherapy of a nonmedical nature with individuals, families, or groups; providing information and referral services; providing or arranging for the provision of social services; explaining or interpreting the psychosocial aspects in the situations of individuals, families, or groups; helping communities to organize, to provide or to improve social or health services; or doing research related to social work.”




Clinical Social Work Defined
by the American Board of Examiners in Clinical Social Work
Clinical social work is a practice specialty of the social work profession. It builds upon generic values, ethics, principles, practice methods, and the person-in-environment perspective of the profession. Its purposes are to:

diagnose and treat bio-psycho-social disability and impairment, including mental and emotional disorders and developmental disabilities.
achieve optimal prevention of bio-psycho-social dysfunction
support and enhance bio-psycho-social strengths and functioning.
Clinical social work practice applies specific knowledge, theories, and methods to assessment and diagnosis, treatment planning, intervention, and outcome evaluation.

Practice knowledge incorporates theories of biological, psychological, and social development. It includes, but is not limited to, an understanding of human behavior and psychopathology, human diversity, interpersonal relationships and family dynamics; mental disorders, stress, chemical dependency, interpersonal violence, and consequences of illness or injury; impact of physical, social and cultural environment; and cognitive, affective, and behavioral manifestations of conscious and unconscious processes.

Clinical social work interventions include, but are not limited to, assessment and diagnosis, crisis intervention, psychosocial and psychoeducational interventions, and brief and long-term psychotherapies. Theses interventions are applied within the context of professional relationships with individuals, couples, families, and groups. Clinical social work practice includes client-centered clinical supervision and consultation with professional colleagues.

Adopted February 12, 1995

This is taken from the California Society for Social Workers Ethical Standards:




California Legal Description of Practice
Section 4996.9 of the California Business and Professions Code defines the practice of clinical social work as:

“. . . a service in which a special knowledge of social resources, human capabilities, and the part that unconscious motivation plays in determining behavior, is directed at helping people to achieve more adequate, satisfying, and productive social adjustments. The application of social work principles and methods includes, but is not restricted to, counseling and using applied psychotherapy of a nonmedical nature with individuals, families, or groups; providing information and referral services; providing or arranging for the provision of social services; explaining or interpreting the psychosocial aspects in the situations of individuals, families, or groups; helping communities to organize, to provide or to improve social or health services; or doing research related to social work.”




Clinical Social Work Defined
by the American Board of Examiners in Clinical Social Work
Clinical social work is a practice specialty of the social work profession. It builds upon generic values, ethics, principles, practice methods, and the person-in-environment perspective of the profession. Its purposes are to:

diagnose and treat bio-psycho-social disability and impairment, including mental and emotional disorders and developmental disabilities.
achieve optimal prevention of bio-psycho-social dysfunction
support and enhance bio-psycho-social strengths and functioning.
Clinical social work practice applies specific knowledge, theories, and methods to assessment and diagnosis, treatment planning, intervention, and outcome evaluation.

Practice knowledge incorporates theories of biological, psychological, and social development. It includes, but is not limited to, an understanding of human behavior and psychopathology, human diversity, interpersonal relationships and family dynamics; mental disorders, stress, chemical dependency, interpersonal violence, and consequences of illness or injury; impact of physical, social and cultural environment; and cognitive, affective, and behavioral manifestations of conscious and unconscious processes.

Clinical social work interventions include, but are not limited to, assessment and diagnosis, crisis intervention, psychosocial and psychoeducational interventions, and brief and long-term psychotherapies. Theses interventions are applied within the context of professional relationships with individuals, couples, families, and groups. Clinical social work practice includes client-centered clinical supervision and consultation with professional colleagues.

Adopted February 12, 1995
One example"
USC Masters of Social Work Degree Requirement

Degree Requirements

All students must satisfactorily complete the following course work with a cumulative GPA of 3.0 or higher:

Course work:
63 units (includes foundation and concentration courses and field education)

Field work:
1,050 hours (minimum)

Foundation field education: 450 hours

Concentration field education: 600 hours

All students must satisfactorily complete the following course work with a cumulative GPA of 3.0 or higher:

Course work:
63 units (includes foundation and concentration courses and field education)

Field work:
1,050 hours (minimum)

Foundation field education: 450 hours

Concentration field education: 600 hours

How in does one complete 63 "units" in a masters program?

The field and program descriptions don't really help very much - they don't tell how many courses were taken and how in-depth the learning is. I just don't understand how you can learn sufficient clinical skills in a two year social work program - it seems to me that in S.W. the emphasis would be more on family and program levels of intervention than specializing in individual therapy - how do you train in these skills in such a short amount of time?

Couple questions:

1) How much therapy training does your average masters level S.W. get?
That's a difficult question to answer, as SW is so diverse. First, keep in mind that a large number of SWs don't even work in the mental health arena, so they frequently do not pursue any therapy training since they will never use it. They might be in administration, community organization, etc. There is a push in several states to diversify masters-level licensing options, to add a non-clinical masters-level license. The scope of practice of these SWs would NOT include treatment interventions. Yes, another layer of bureaucracy, but I think it's actually a good thing as it would prevent someone from randomly deciding one day that they want to hang out a shingle.

As was previously posted, the MSW is generally a 2-year degree if pursued full-time, although there are exceptions to thisi. It usually amounts to about 64 credit hours. There is a mandated core curriculum laid out by the Council on SW Education (http://www.cswe.org/), which means that all graduates of all accredited programs should have the same core knowledge base. Several of these courses are psychological theory-heavy. A concentration is chosen in 2nd year, which is where you'll see the differences- the split into Administration, Policy, Research, Clinical, School, Children and Families, Health, or whatever combination a particular school may offer. My school was 100% clinical, with a bent toward psychodynamics, ego psychology, and object relations. That's quite unusual for a MSW program. I know of others which are heavily CBT. So what you'd want to see from someone in a clinical track is that the electives chosen are heavily practice-based. I had a rather intensive psychopathology and diagnostics course (from what I understand, not all MSW programs mandate this, which is a tragedy IMO), courses in work with individuals, families, and groups (all with the psychodynamic slant), substance abusers, and crisis & short-term counseling. During this time, you're doing practica- during the first year, it's 2 semesters of a generalized program, and during the second year, it's 2 semesters within your specific concentration. Again, you'd want to see someone with the goal of doing therapy actually doing therapy in their 2nd year practicum. Mine was at a metropolitan hospital as an EAP counselor. There are minimum requirements for hours, again mandated by CSWE, which I believe are 600/year.

So then we're graduated, and looking for that first job. Theoretically, a newly-minted MSW with an interest in doing therapy needs to find something at a mental health agency- case management, crisis work, other similar "cutting your teeth" work. I believe it is technically possible to establish a therapy practice while unlicensed, but no one would reimburse for that- not Medicaid, Medicare, or any private managed care company. I've never seen anyone do that. So you have to pursue a license through your state- which typically involves a minimum 3000 hours of PAID employment supervised by a LCSW (or whatever it's called in that state), attestation by the supervisor that you're ready to be licensed, and passing the clinical level of a national standardized exam. That process is two years minimum, and you have up to four to complete it from the time you start.

Ongoing training will be covered in the next part...

2) Are they held to similar ethical standards around practice & competence? (i.e. can they go to a seminar on NLP and then decide to start using it?)

Yes. The National Association of Social Workers (http://www.nasw.org) has its own Code of Ethics, which is actually somewhat more stringent than some of the other professions. Where other Codes dictate that it has to be 2, 5, etc., years since the last date of service until you can have a personal relationship with a former patient, the NASW Code says "once a client, always a client".

The Code does also address practice competence, and for licensed clinicians, the state licensing boards mandate a minimum amount of annual (or biannual) continuing education which must be completed prior to renewal. Some states, mine included, are beginning to mandate the content of the CEUs. For right now, my only requirement before next renewal will be an Ethics course, but I think they are considering adding others. There are all kinds of options available, from basic "Learn the Medicare System" to clinical skill-building, such as EMDR, etc. LCSWs doing therapy should really be doing only clinical hours to enhance their practice capabilities. For myself, I tend to look for things on DBT (since I see a lot of Axis II cluster Bs) and psychopharmacology.

Given that, I have to be honest- unless you've gone through the entire certification procedure for DBT, EMDR, etc, I don't think you can say "I'm a DBT therapist" or whatever. I've got a good grounding in DBT, but I don't have the resources available to run the groups or get fully certified, therefore I tell people that I draw heavily from DBT and leave it there. I know a LCSW with no more training than me in it (possibly less), who has his own website touting himself as a DBT therapist. I don't refer to him. Ever.

All of that said, I do recognize that some SWs do not keep up adequately with their education after graduation, and that's sad. It sounds like many of you have worked with SWs whose clinical skills have left a lot to be desired. I'll be the first to say that I think the schools need much more structured screening of applicants upon admission, and could certainly learn from other professions on that. However, there are some really good MSWs and/or LCSWs out there, and many of us recognize that there is still much we can learn from the psychologists and psychiatrists, so rather than complain- TEACH! Please! Hopefully it will benefit everyone. :thumbup:

jlw - that was a totally kick-@ss response.

Thanks for the enlightenment:thumbup:

jlw,

That was a GREAT post!

I agree with your suggestion about splitting out licensure and non-licensure degrees. I believe one reason why LSWs are so popular are because of the numerous job opportunities out there. I know the gov't and quasi-gov agencies hire a lot of LSWs. The other side to a wide variety of opportunities, is being able to get adequate training in these areas. Of course, in clinical psych, we have a similar issue, and it isn't easily addressed. As for the teaching part.....I have seen some great CE, CME, and related events that have a range of MH providers, so there are definitely learning opportunities out there.

-t

thanks, guys! I'm happy to try to answer other questions re: BSSW/MSW/LCSW stuff, since I'm officially all three. I know a bit about MA/LPC stuff from friends but it's not my forte.


so from here on out, any LCSW-bashing shall have the caveat "excepting jlw", right? :D :laugh:

so from here on out, any LCSW-bashing shall have the caveat "excepting jlw", right? :D :laugh:

Of course! ;)

We try to avoid bashing, but people sometimes get caught up with anecdotal examples (myself included). We are glad to have you and your experiences here. I hope to learn more about this area; I am admittedly still learning the nuances of the other related jobs in the field.

-t

As for the teaching part.....I have seen some great CE, CME, and related events that have a range of MH providers, so there are definitely learning opportunities out there.

-t

I missed this earlier. We're probably talking about the same CE stuff. When I meant teach us, what I really meant is in the field. I don't have the opportunity to work with many psychologists, but I value their feedback and suggestions when I can get them. Or psychiatry, which is more likely for me. If there is stuff out there I should be reading that isn't making it into the clinical SW lit, tell me. Ask me if I've heard about the new treatment intervention which is being developed. Be open to questions in areas where my training and experience is not as rich as a psychologist's so that I can continue to grow clinically.

In my real-world experience, psychologists and social workers are quite collegial and collaborative.

When I meant teach us, what I really meant is in the field. I don't have the opportunity to work with many psychologists, but I value their feedback and suggestions when I can get them.

In my real-world experience, psychologists and social workers are quite collegial and collaborative.

I would love for some of this to happen on here (and not just in our daily lives). We have a lot of great professionals across a diverse collection of fields. I think what would be really helpful is having people bring up common (or unique) dilemmas they have run into, and then get some feedback. It would offer an opportunity for discussion, and also might provide some insight (for some or all involved).

-t

I would love for some of this to happen on here (and not just in our daily lives). We have a lot of great professionals across a diverse collection of fields. I think what would be really helpful is having people bring up common (or unique) dilemmas they have run into, and then get some feedback. It would offer an opportunity for discussion, and also might provide some insight (for some or all involved).

-t
sounds like an excellent idea :thumbup:

Wow....this thread really took off...in a very positive direction!!!
I signed up for this site a couple of days ago because I found a great deal of information here that will help me decide what direction to take next in terms of my career; I am finishing a MS in Marriage and Family Therapy. Everyone's comments is very valuable and based on real life experiences....thank you for creating this community where everyone can benefit from it!

Glad you found us. SDN is definitely a great place to find some great information and get real world feedback. Remember to take everything with a grain of salt, bc we all come from diff backgrounds, and have our own baggage.......er experiences. :laugh: .

-t

Thanks t.....love the therapist humor as well! :)

Is there a social work thread on SDN?

No there is not as it was mainly set up as a webiste for students of doctoral professions. It has certainly expanded beyond that. When we made 2 forums in psych I assumed MSW's could share the MA, BA forum. Let me know your thoughts on this.

I think keeping it combined will offer more traffic through the sub-forum.

-t

Like in any other field, social workers decide how well trained they want to be. Yes, you finish your MSW with 60 units in 2 years, lots of work. One takes theory classes and starts placement from day one! After your MSW you need two more years of clinical practice to get your LCSW license and therefore have overall more training (practical) than an MFT. How well developed ones clinical skills are depends on the placements you choose and what kind of a learner you are. Some LCSW's are very well trained clinicians as well as having knowledge and skills in policy, research, case work, ect.

I am in a MSW program and have a B.A. in psychology. I chose this path because it is a very diverse degree and allows for more employment options than any Masters degree in psychology.

Hope that helps

I appreciate that you had set up two forums. I believe it makes it easier to check out threads that related to the appropriate topics in a much more organized fashion.

Thanks

I've never understood why social workers feel they are qualified to practice psychology. They have little to no training, and yet they try to cut in on the field of psychology everywhere you look these days. Try getting a job as a social worker if you are a psychologist, though. You will run right up against a locked door. Social workers will NOT let psychologists work in their field, but they erroneously feel qualified to practice psychology.

There are too many professions that are trying to practice outside of their scope these days, and they should be stopped. It is dangerous for patients.

This answer proofs that you don't know what you are talking about.
There are diverse MSW-programs out there, some that train you on the same levels as any MFT, others which don't do that at all, so, what are you saying??

This answer proofs that you don't know what you are talking about.
There are diverse MSW-programs out there, some that train you on the same levels as any MFT, others which don't do that at all, so, what are you saying??

Social workers are not psychologists, and should not practice psychology. Period. They are not qualified. They don't allow psychologists to practice social work. Kind of selfish and aggravating of them.

jlw- that was a totally kick-@ss response.

Thanks for the enlightenment:thumbup:

Totally agreed. :thumbup:

My views on this issue would probably be a bit controversial in my field. A bit of background info on me: I am a doctoral candidate in social work specializing in mental health, trauma, and behavioral genetics. I chose social work over psychology for a number of reasons (and those reasons have nothing to do with my GRE scores, GPA, and history of research experience). I had approximately 6 years of direct practice under my belt prior to returning to school to pursue doctoral studies.

Let me preface my statement on this issue by saying that there are some incredible LCSW psychotherapists out there who are as good as if not better than many of their psychologist counterparts.

Having said that, however, I am of the opinion that in general, MSW's are not adequately trained to provide psychotherapy. My view on this issue is based on a couple of factors. First, despite the supposed standardization of social work education imposed by the CSWE, MSW programs vary dramatically in the quality of education and practical experience they provide to their students. Secondly, I have taught a course on psychopathology to MSW students at one of the top social work programs in the country, and my experience doing so has made it painfully clear that many of these students have no understanding of the concept of "empirically validated practice".

The reason these students lack an understanding of EVP is because they are not provided with enough training in statistics and research methodology. Until the MSW curriculum is revised to address this gap, we should not act surprised when many of these students become enamored with pseudoscientific therapies like EMDR, thought field therapy, and primal scream therapy. While clinical psychologists certainly are not immune to being duped by quackery, it appears to me that master's level therapists tend to be overrepresented as practitioners of these sorts of questionable therapies.

Furthermore, the required post-master's training leading to LCSW licensure is an unregulated no-man's land of unstandardized training and experience that varies state to state. The quality of the budding LCSW's training depends entirely upon the supervisor, who may be a devotee of any number of absurd new age therapies.

What really frightens me is that many of my MSW students were provided with just enough information on psychopathology and psychotherapy to be quite dangerous. They are often taught that they are equal to psychologists and psychiatrists in their diagnostic and treatment abilities, which I find to be completely laughable. Nonetheless, they gladly pontificate at length as "experts" on topics they seem to know little about.

My view is that until this gap in MSW training is filled, social workers should only be able to practice psychotherapy at the doctoral level. This will never happen, of course, lol. I say this with no vested interest, because I have no intention of ever practicing psychotherapy either in private practice or in an agency based setting, although my research may eventually entail a small degree of psychotherapy research.

I am a strong proponent of the clinical scientist model of psychology and psychotherapy, and MSW's are not equipped with the tools to engage in the symbiotic tasks of research and practice.

Despite the above diatribe, I would nonetheless encourage my clinical/counseling psychologist colleagues to refrain from judging their LCSW colleagues based solely upon their degree. Get to know the individual and his/her level of knowledge and competency before forming any judgments. There are some really good LCSW therapists out there who have made an effort to learn and practice evidence-based psychotherapy, and I consider those folks to be total gems.

I feel the need to address the above comments that "social workers will not allow psychologists to work in their field." There are a number of problems with that statement:

1) First, as an MSW I have worked with clinical psychologists who functioned as case managers in the exact same fashion as I did.
2) After all the time you clinical psychologists spend in grad school, do you
really want to function in the capacity of a master's-level case manager?
3) When I worked at a Department of Children's and Family Services in a large urban area, the director was....you guessed it, a clinical psychologist, not a social worker.
4) Psychotherapy is not the exclusive domain of clinical psychologists (although I will concede that they do have superior training compared to master's-level therapists). In fact, Psychiatrists were once the sole practitionersof psychotherapy. Psychotherapy is not synonymous with psychology, and social workers are NOT practicing psychology. We practice social work which includes psychotherapy among other modalities of intervention.
5) As a social worker, I cannot be licensed as a psychologist. Similarly, as a psychologist, you cannot be licensed as a social worker. I see no problem there.

There isn't one, he is a troll.

I feel the need to address the above comments that "social workers will not allow psychologists to work in their field." There are a number of problems with that statement:

1) First, as an MSW I have worked with clinical psychologists who functioned as case managers in the exact same fashion as I did.
They are legally not allowed to be called a social worker, at least in my state. My wife is a case manager with a BS in psych, but she cannot call herself a social worker. Jobs posted for social work positions say "must have MSW or BSW." Jobs posted for psychologists say "must have MS or PhD in psychology or counseling, or MSW."
2) After all the time you clinical psychologists spend in grad school, do you
really want to function in the capacity of a master's-level case manager?
I can't agree more.
3) When I worked at a Department of Children's and Family Services in a large urban area, the director was....you guessed it, a clinical psychologist, not a social worker.
That would be an executive position, not necessarily requiring ANY professional licensing.
4) Psychotherapy is not the exclusive domain of clinical psychologists (although I will concede that they do have superior training compared to master's-level therapists). In fact, Psychiatrists were once the sole practitionersof psychotherapy. Psychotherapy is not synonymous with psychology, and social workers are NOT practicing psychology. We practice social work which includes psychotherapy among other modalities of intervention.Only psychologists, counselors, and psychologists are educationally qualified to practice psychotherapy. Even sociologists cannot do this, and, unlike social work, their discipline is a behavioral science. Psychiatrists were the only practitioners only before the fields of psychology and counseling were created.
5) As a social worker, I cannot be licensed as a psychologist. Similarly, as a psychologist, you cannot be licensed as a social worker. I see no problem there.
Many psychologist job postings say "must have MS or PhD in psychology or counseling, or MSW."

There isn't one, he is a troll.

I hope you are not calling me a troll. I can have several mods and an admin back me up on not being a troll.

They are legally not allowed to be called a social worker, at least in my state. My wife is a case manager with a BS in psych, but she cannot call herself a social worker. Jobs posted for social work positions say "must have MSW or BSW." Jobs posted for psychologists say "must have MS or PhD in psychology or counseling, or MSW."

The reason social workers have title protection in your state is the direct result of a push from NASW-MO after the title "social worker" got dragged through the mud in the media on some really nasty child abuse cases. (Find articles from KC on the Bass triplets, 2 of whom died at the hands of their caregivers.. it was horrific.) The DFS child protection workers were called "social workers" when their degrees were NOT BSW/BSSWs. DFS is better now, but historically, they have hired any warm body who had a bachelors- didn't matter- economics, art history, English.. no human service training whatsoever. As psychologists want to retain their professional identity, social workers want to retain theirs. So yes- it is now a misdemeanor to identify yourself as "social worker" unless you have the BSSW, LSW, MSW, or LCSW in MO, because econ and art history majors, although wonderful people, do not have the same background I do. BSSW majors are required to do a year-long practicum of about 600 hours. My school's psychology majors could do an elective internship of 45 hours per semester. This is a huge difference in training.

And to reiterate- neither the BA/BS Psych nor the BSSWs should be doing anything remotely construed as "psychotherapy".

Only psychologists, counselors, and psychologists are educationally qualified to practice psychotherapy. Even sociologists cannot do this, and, unlike social work, their discipline is a behavioral science. Psychiatrists were the only practitioners only before the fields of psychology and counseling were created.

It is explicitly written into the MO State Statutes (Section 337 if you care to look it up) that it is within the scope of a clinical social worker (meaning LCSW) to do psychotherapy. Also assessment and diagnosis.

Ironically, it is NOT written into the LPC statutes that diagnosis is within their scope of practice, which created quite the brouhaha several years ago when some group tried to lobby that because it didn't say they COULD do it, that meant they weren't ALLOWED to do it. It wound up dying down with no changes made to the statutes.

It is explicitly written into the MO State Statutes (Section 337 if you care to look it up) that it is within the scope of a clinical social worker (meaning LCSW) to do psychotherapy. Also assessment and diagnosis.

Do they define it further? This seems vague.

Ironically, it is NOT written into the LPC statutes that diagnosis is within their scope of practice, which created quite the brouhaha several years ago when some group tried to lobby that because it didn't say they COULD do it, that meant they weren't ALLOWED to do it.

Just because it says explicitly I can't be a vet while being licensed as a psychologist, doesn't mean I should do it.

-t

Do they define it further? This seems vague.



Just because it says explicitly I can't be a vet while being licensed as a psychologist, doesn't mean I should do it.

-t

To the first part, the definition of "clinical social work" in Missouri is "the application of methods, principles, and techiques of case work, group work, client-centered advocacy, community organization, administration, planning, evaluation, consultation, research, psychotherapy and counseling methods and techniques to persons, families and groups in assessment, diagnosis, treatment, prevfention and amelioration of mental and emotional conditions"

"Practice of clinical social work" is defined as rendering, offering to render, or supervising those who render to individuals, couples, groups, organizations, institutions, corporations, or the general public any servie involving the application of methods, principles, and techniques of clinical social work"

I'm sure it's left intentionally vague, and it will vary by state. Also, as mentioned above, the LMSW is under consideration to reserve the LCSW only for those who practice clinically (vs administration, community, etc). That will alter the LCSW laws somewhat, and it already exists in some form in several states.

To the second part- the vet laws would say that you can't. :D

What the laws do require are minimum educational and practice requirements prior to becoming licensed, for both LPC/LCPC and LCSW/LISW/LICSW. Theoretically, this translates into all licensed masters-level therapists having achieved at least basic competency in assessment, diagnosis, and treatment.

Then again, theoretically, pigs can fly. :rolleyes:

It is explicitly written into the MO State Statutes (Section 337 if you care to look it up) that it is within the scope of a clinical social worker (meaning LCSW) to do psychotherapy. Also assessment and diagnosis.

Ironically, it is NOT written into the LPC statutes that diagnosis is within their scope of practice, which created quite the brouhaha several years ago when some group tried to lobby that because it didn't say they COULD do it, that meant they weren't ALLOWED to do it. It wound up dying down with no changes made to the statutes.
Just because the law explicitly defines it that way doesn't mean they are qualified or competent to do it, nor does it mean that it is in the scope of their practice. It just means that social workers have a powerful lobbying arm.

You wrote:

"They are legally not allowed to be called a social worker, at least in my state. My wife is a case manager with a BS in psych, but she cannot call herself a social worker. Jobs posted for social work positions say "must have MSW or BSW." Jobs posted for psychologists say "must have MS or PhD in psychology or counseling, or MSW."

reply: The advertisements you see reflect the reality that in most cases, LCSWs do the same work that you psychologists do. However, they are forbidden by law to call themselves psychologists''

you wrote:
That would be an executive position, not necessarily requiring ANY professional licensing.

reply: Actually, the requirement for the position DID require professional licensing. I know because I worked there.


You wrote:
Only psychologists, counselors, and psychologists are educationally qualified to practice psychotherapy. Even sociologists cannot do this, and, unlike social work, their discipline is a behavioral science. Psychiatrists were the only practitioners only before the fields of psychology and counseling were created.

My reply: I hope you are not a psychologist or a psychology student. If you think this is the case, your ignorance is inexcusable. Psychology existed for quite some time before their lobbying organizations helped them gain the right to practice psychotherapy, much to the dismay of the psychiatrists. Furthermore, social work IS a behavioral science, particularly at the PhD level. I know, because I took all of the same courses in stats and research methodology that you take.


you wrote: Many psychologist job postings say "must have MS or PhD in psychology or counseling, or MSW."

If the job involves counseling, psychotherapy, and case management, then this type of job posting makes perfect sense. Even if a social worker gets this job, s/he cannot call himself/herself a psychologist. That would be illegal.

You seem quite paranoid and bitter. Social workers are not out to get you. We are not trying to call ourselves psychologists, and even if we were, the laws in every state would prevent us from doing so. Get over it.

You wrote:

"They are legally not allowed to be called a social worker, at least in my state. My wife is a case manager with a BS in psych, but she cannot call herself a social worker. Jobs posted for social work positions say "must have MSW or BSW." Jobs posted for psychologists say "must have MS or PhD in psychology or counseling, or MSW."

reply: The advertisements you see reflect the reality that in most cases, LCSWs do the same work that you psychologists do. However, they are forbidden by law to call themselves psychologists''
LCSW's do the same work, but it is outside of their scope and educational preparation.
you wrote:
That would be an executive position, not necessarily requiring ANY professional licensing.

reply: Actually, the requirement for the position DID require professional licensing. I know because I worked there.
Great, but an executive position still doesn't necessarily need professional licensing for any legal requirements. Also, that is pretty anecdotal.
You wrote:
Only psychologists, counselors, and psychologists are educationally qualified to practice psychotherapy. Even sociologists cannot do this, and, unlike social work, their discipline is a behavioral science. Psychiatrists were the only practitioners only before the fields of psychology and counseling were created.

My reply: I hope you are not a psychologist or a psychology student. If you think this is the case, your ignorance is inexcusable. Psychology existed for quite some time before their lobbying organizations helped them gain the right to practice psychotherapy, much to the dismay of the psychiatrists. Furthermore, social work IS a behavioral science, particularly at the PhD level. I know, because I took all of the same courses in stats and research methodology that you take.
I have a BS in psychology with Psi Chi honors. I know what I am talking about. Psychology has only been around for about as long as psychologists have been doing psychotherapy. Social work is neither behavioral, nor is it a science. Taking stats and research methodology doesn't make one a scientist. Taking a class or two in psychology doesn't make one a qualified psychotherapist.
you wrote: Many psychologist job postings say "must have MS or PhD in psychology or counseling, or MSW."

If the job involves counseling, psychotherapy, and case management, then this type of job posting makes perfect sense. Even if a social worker gets this job, s/he cannot call himself/herself a psychologist. That would be illegal.
But they can practice outside their scope and educational qualification by practicing psychotherapy, that's my point.
You seem quite paranoid and bitter. Social workers are not out to get you. We are not trying to call ourselves psychologists, and even if we were, the laws in every state would prevent us from doing so. Get over it.
Not paranoid nor bitter. I just don't like professionals scamming the public by practicing outside their scope. I am a med student, and I don't like doctors practicing psychology either, unless they have a degree in psychology. I don't like nurses practicing medicine without going to med school. I don't like psychologists writing scripts unless they go to med school. Too many professions are trying to move in on other professions' areas of competence without equivalent or adequate training.

You wrote: I have a BS in psychology with Psi Chi honors. I know what I am talking about. Psychology has only been around for about as long as psychologists have been doing psychotherapy.


Reply: You know very little about your field. In 1879 (http://en.wikipedia.org/wiki/1879), Wilhelm Wundt (http://en.wikipedia.org/wiki/Wilhelm_Wundt) (1832-1920), known as "the father of psychology", founded a laboratory for the study of psychology at Leipzig University (http://en.wikipedia.org/wiki/Leipzig_University) in Germany (http://en.wikipedia.org/wiki/Germany). The American philosopher William James (http://en.wikipedia.org/wiki/William_James) published his seminal book, Principles of Psychology (http://en.wikipedia.org/wiki/Principles_of_Psychology), in 1890, laying the foundations for many of the questions that psychologists (http://en.wikipedia.org/wiki/Psychologist) would focus on for years to come. Other important early contributors to the field include Hermann Ebbinghaus (http://en.wikipedia.org/wiki/Hermann_Ebbinghaus) (1850–1909), a pioneer in the experimental study of memory (http://en.wikipedia.org/wiki/Memory) at the University of Berlin (http://en.wikipedia.org/wiki/University_of_Berlin); and the Russian (http://en.wikipedia.org/wiki/Russia) physiologist (http://en.wikipedia.org/wiki/Physiology) Ivan Pavlov (http://en.wikipedia.org/wiki/Ivan_Pavlov) (1849-1936), who investigated the learning (http://en.wikipedia.org/wiki/Learning) process now referred to as classical conditioning (http://en.wikipedia.org/wiki/Classical_conditioning).

It wasn't until 1917 that clinical psychologists began to organize under that name, when the American Association of Clinical Psychology was organized, leading to the Section on Clinical Psychology of the American Psychological Association. This section certified clinical psychologists until 1927, but would not allow clinical psychologists full membership in APA.
Slow growth of the field continued in the 1930s as several scattered, applied psychological organizations in the US formed an alliance under the American Association of Applied Psychology. This group became the primary forum for clinical and applied psychology in the U.S. until APA reorganized in 1945, creating its division of clinical psychology, today known as Division 12.
Before the 1940s, individual psychotherapy was conducted by psychiatrists (http://en.wikipedia.org/wiki/Psychiatrist), leaving clinical psychologists to focus on assessment. This changed during World War II (http://en.wikipedia.org/wiki/World_War_II), however, when the military gave greater recognition to the condition they termed "shell shock" which eventually came to be called Post Traumatic Stress Disorder (http://en.wikipedia.org/wiki/Post-traumatic_stress_disorder). The military called upon psychotherapists and clinical psychologists to help administer treatment.



from wikipedia



But hey, congrats on getting into psi chi!


You wrote: Social work is neither behavioral, nor is it a science. Taking stats and research methodology doesn't make one a scientist. Taking a class or two in psychology doesn't make one a qualified psychotherapist.

My reply: A class or two??? Social work is an applied social science, particularly at the PhD level. I believe that my training in regression, structural equation modeling, HLM, categorical data analysis, systems dynamics, GIS, conducting clinical trials, qualitative research methods, philosophy of science (not to mention my training in advanced psychopathology, personality disorders, social theory, and behavioral genetics) all qualify me to label myself a social scientist, regardless of what you think. Also, to assert that social work is not behavioral is laughable. We have doctoral-level social scientists in our field who subscribe to a variety of theoretical perspectives, with a number of radical behaviorists in our ranks.

Here's a very tiny sampling of some articles by social work researchers who "aren't social scientists":

Auslander, W.F.; Thompson, S.; Dreitzer, D.; White, N.; & Santiago, J.V. (1997). "Disparity in Glycemic Control and Adherence between African American and Caucasian Youths with Diabetes: Family and Community Contexts," Diabetes Care 20 (10), 1569-1575.

McMillen, J.C.; North, C.S.; & Smith, E.M. (2000). What Parts of PTSD are Normal: Intrusion, Avoidance, or Hyperarousal? Data From the Northridge, California Earthquake, Journal of Traumatic Stress 13, 57-75.

Pollio, D.E.; North, C.S.; Thompson, S.; Paquin, J.W.; & Spitznagel, E.L. (1997). Predictors of Achieving Stable Housing in a Mentally Ill Homeless Population, Psychiatric Services 48 (4), 258-260.

Vosler, N.R. & Page-Adams, D. (1996). Predictors of Depression Among Workers at the Time of a Plant Closing, Journal of Sociology and Social Welfare 23 (4), 25-42.


Stiffman, A.R., Hadley-Ives, E., Elze, D., Johnson, S., & Doré, P. (1999). Impact of environment on adolescents’ mental health and behavior: Structural Equation Modeling. American Journal of Orthopsychiatry, 69(1), 73-86.



Pitner, R., & Moore-McBride, A. (in press). Social psychological theory and the potential for ethnonational cooperation in civic service programs. In M. Sherraden and A. Moore-McBride (Eds.) Civic service worldwide: Impacts and Inquiry

Associations of trauma, early home environment, and genetic effects with risk for depression: Towards an examination of gene-environment interplay by McCutcheon, Vivia Van Dyne, PhD, WASHINGTON UNIVERSITY, 2005, 273 pages; 3181188



Behavior Modification, Vol. 15, No. 3, 310-325 (1991). Diagnosis and Treatment of Child and Adolescent Anxiety Disorders

The Relative Effectiveness of EMDR Versus Relaxation Training With Battered Women Prisoners (http://scholar.google.com/url?sa=U&q=http://bmo.sagepub.com/cgi/content/abstract/24/5/719) -SD Colosetti, BA Thyer - Behavior Modification, 2000


Discriminant and Concurrent Validity of Two Commonly Used Measures of Test Anxiety (http://scholar.google.com/url?sa=U&q=http://epm.sagepub.com/cgi/content/abstract/42/4/1197) - group of 2 » (http://scholar.google.com/scholar?hl=en&lr=&cluster=2612274501795135742)
BA Thyer, JD Papsdorf - Educational and Psychological Measurement, 1982



If that's not behavioral science, please explain to me what you think behavioral science is. Do some research before making uninformed statements.











You wrote: But they can practice outside their scope and educational qualification by practicing psychotherapy, that's my point.

my reply: No, your original complaint was that social workers can take psychologists' jobs but that the reverse was not true. You are wrong.

You wrote: Not paranoid nor bitter. I just don't like professionals scamming the public by practicing outside their scope. I am a med student, and I don't like doctors practicing psychology either, unless they have a degree in psychology. I don't like nurses practicing medicine without going to med school. I don't like psychologists writing scripts unless they go to med school. Too many professions are trying to move in on other professions' areas of competence without equivalent or adequate training.[/quote]

My reply: As a psi chi member, I am sure that you are familiar with the number of studies which indicate that the effectiveness of psychotherapy outcomes is not associated with the discipline of the practitioner.

Social work is an applied social science, particularly at the PhD level.

I believe that my training in....(etc)....advanced psychopathology, personality disorders, social theory, and behavioral genetics) all qualify me to label myself a social scientist, regardless of what you think.

You are generalizing a small minority of social workers; the vast majority of SW'ers are MS level, and fail to have that type of background. I think if you compare an average LCSW curriculum to that of a clinican...it wouldn't be comprabable in regard to clinical/psychological education....not even close, and it shouldnt' be. The training goals are different.....but why are LSCWs trying to make the practical application the same?

You wrote: But they can practice outside their scope and educational qualification by practicing psychotherapy, that's my point.

my reply: No, your original complaint was that social workers can take psychologists' jobs but that the reverse was not true. You are wrong.

....but they *DO* practice outside of their scope. I frequently hear, "but we can do everything you can do". This misinformation is dangerous.


My reply: As a psi chi member, I am sure that you are familiar with the number of studies which indicate that the effectiveness of psychotherapy outcomes is not associated with the discipline of the practitioner.

LCSWs have their areas, and i think they do very well in the areas of core competence....but that is not where they stay. They insist on pushing for more, WITHOUT proper education and training.

It is very difficult to quantify effectiveness of treatment. If you want to talk about things that are measurable (course work, training, supervision hours, experience, etc) then psychologists would win across the board. If you want to talk about expertise....psychologists. Dealing with severe pathology....psychologists. Assessment......etc.

-t

You are generalizing a small minority of social workers; the vast majority of SW'ers are MS level, and fail to have that type of background. I think if you compare an average LCSW curriculum to that of a clinican...it wouldn't be comprabable in regard to clinical/psychological education....not even close, and it shouldnt' be. The training goals are different.....but why are LSCWs trying to make the practical application the same?



....but they *DO* practice outside of their scope. I frequently hear, "but we can do everything you can do". This misinformation is dangerous.


LCSWs have their areas, and i think they do very well in the areas of core competence....but that is not where they stay. They insist on pushing for more, WITHOUT proper education and training.



Do we agree that there are areas of overlap? I don't hear the "we can do everything you do" piece... I wouldn't agree with it if I did hear someone say it. I'm more than willing to believe that some people think that way, it's just not an attitude I've come across.

Can you give an example of what you mean when you say "insist on pushing for more"? We discussed the idea of psych testing in another thread, and as I said, I know that there is no national push for that. Since we're in different states, it's possible that FL is seeing some lobbying that my state is not.

Also curious whether the concern here is with all masters-level therapists, or just the MSW LCSWs. I ask that as the curricula are extremely similar regarding amount of theory and practice to get the degree. The road to the LCSW is actually a straight-shot MSW--> LCSW, whereas the LPC can be obtained via several different routes- MEd Couns, MA Couns, MA MFT, etc etc. There was even a MA Rehab Couns here which was "qualified" to sit for the LPC for a time, until people wised up and realized that there is no psych or MH couns theory or practice involved in the practice of Rehab Couns. Just a lot more variability going into that license- kind of like Forrest Gump's box of chocolates.

As an esteemed member of psi chi, you are undoubtedly aware of the multitude of studies which indicate that there are no differences in psychotherapy outcomes based on discipline.

LCSW's can practice psychotherapy effectively, although I will concede that there are some poor MSW programs out there. The same is true for psych (the Adlerian School of Prof Psych comes to mind, not to mention the California School of Professional Psychology).

We are not practicing outside of our scope of practice by practicing psychotherapy. Sure, you guys are better at cognitive and intellectual assessment, although LCSW's are within their scope of practice to make DSM diagnoses. They receive coursework in diagnosis and assessment, various psychotherapeutic treatment modalities, basic research methodology, etc. and they complete 2 years of pre-master's internships. Furthermore, they go through (in some cases) 3 years of post-master's training prior to receiving the LCSW.

Are they social scientists? No. If they receive the proper training in the form of learning about evidence-based treatment, then yes, they are every bit as qualified to perform therapy as PhD clinical psychologists. Deal with it. The scientific literature speaks for itself. Sorry if that bugs you.

If I need a psych assessment or testing, I'd see a clinical psych. If I need therapy, an LCSW CAN do the same thing psychs do. There are plenty of psychs who practice quack therapies (thought field therapy comes to mind), and I would take a well-trained LCSW over such a fool any day. And let's not even get into the whole proprietary PsyD school phenomenon.

MSW's and LCSW's are the largest providers of mental health counseling in the US. You psychs have been slowly pushed out of that market, and for good reason. Psychotherapy isn't rocket science. Stick to neuropsych testing and consultation. That's about all you guys have left, and hey, it can be quite lucrative.

And once more: LCSW's are NOT pushing for the right to do your precious psych testing. If we wanted to do that, we would have become psychologists.

If they receive the proper training in the form of learning about evidence-based treatment, then yes, they are every bit as qualified to perform therapy as PhD clinical psychologists. Deal with it. The scientific literature speaks for itself. Sorry if that bugs you.

I'd want something more than reading a book about a specific intervention. Also, the training is different. The coursework is different, and the interventions are different. different...different...different = same?

As for the literature....it doesn't really say anything definitive.


If I need therapy, an LCSW CAN do the same thing psychs do.

So you'd be comfortable referring a severe case like an actively psychotic schizophrenic to an LCSW instead of a clnical psychologist? I'd think the clinician would have more experience dealing with this type of population, and is better equipped to handle it.

MSW's and LCSW's are the largest providers of mental health counseling in the US.

Quantity doesn't equal quality.

You psychs have been slowly pushed out of that market, and for good reason. Psychotherapy isn't rocket science.

What is the good reason? I know HMOs look to cut costs so they try and go with the lowest cost option....which doesn't always equate to better patient care.


Stick to neuropsych testing and consultation. That's about all you guys have left, and hey, it can be quite lucrative.

A rather short-sighted quip. I mean, who needs doctoral trained clinicians in academia, businesses, supervisors of MS therapists, conducting research, etc. Thankfully hanging a shingle is merely one opportunity.

And once more: LCSW's are NOT pushing for the right to do your precious psych testing. If we wanted to do that, we would have become psychologists.

LCSWs and clinicians fill different needs. As I noted above.....we have plenty of areas to work in. It is about being competent and working within the applicable scope of practice.

-t

You wrote: So you'd be comfortable referring a severe case like an actively psychotic schizophrenic to an LCSW instead of a clnical psychologist? I'd think the clinician would have more experience dealing with this type of population, and is better equipped to handle it.

reply: Well actually, I'd prefer to refer a case like that to a psychiatrist who can prescribe the appropriate anti-psychotic. Social Workers tend to work with people who are socioeconomically disadvantaged and who therefore are usually not linked up with appropriate mental health care. The LCSW providing psychotherapy in the homeless shelter is probably more adept at managing an actively psychotic schizophrenic than a psych in private practice who treats neurotic housewives.

you wrote: A rather short-sighted quip. I mean, who needs doctoral trained clinicians in academia, businesses, supervisors of MS therapists, conducting research, etc. Thankfully hanging a shingle is merely one opportunity.

my reply: did I not mention consultation? Plus, MS therapists don't need your supervision.

you wrote: LCSWs and clinicians fill different needs. As I noted above.....we have plenty of areas to work in. It is about being competent and working within the applicable scope of practice.

My reply: Like it or not, LCSWs ARE clinicians who are operating within the applicable scope of practice when they perform diagnosis and psychotherapy.

you wrote: I'd want something more than reading a book about a specific intervention. Also, the training is different. The coursework is different, and the interventions are different. different...different...different = same?
?
my reply: The interventions are different? Hmmm....so you wouldn't use cognitive therapy for depression or Barlow's treatment for social anxiety? The only difference in the coursework is that you guys receive training in psychological testing. That is IT. How do I know this? Because I've taken most of the required classes in the clinical psych dept as my cognate along with the psych PhD students with the exception of their courses in intellectual and neuropsych assessment. However, like these students, I completed a one year internship as part of my MSW (on an inpatient psych ward) providing individual and group therapy under the supervision of an LCSW. So the training far exceeds merely "reading a book". In fact, I would be willing to bet that as a social worker, I dealt with much more florid psychopathology in my first year of practice than you've seen in your entire career.

Master's level therapists are here to stay. like it or not. While there are certainly areas in their training that could use some improvement such as increased training in research methods (and what about psych....are you clinical scientists, scientist-practitioners, scholar-practitioners or what?), they are nonetheless psychotherapists and they are often hired to do your job. You don't have to like it, but you do have to live with it.

The LCSW providing psychotherapy in the homeless shelter is probably more adept at managing an actively psychotic schizophrenic than a psych in private practice who treats neurotic housewives.

Yeah, private practice clinicians are obviously catering to neurotic housewives, and ignore the more severe cases.....that we were specifically trained to handle. I'm very thankfully I took Housewives, Executives, and Country Club Interventions.

MS therapists don't need your supervision.

It depends on the state. I was making a more general reference to Director positions, 99% of them require a licensed clinician.


Like it or not, LCSWs ARE clinicians who are operating within the applicable scope of practice when they perform diagnosis and psychotherapy.

As long as they had proper training and proper supervision, I have no problem with an LCSW performing diagnosis and psychotherapy. My gripe has to do with many LCSWs who 'stretch' their scope and treat populations. Some clinicians do this, so i'm not fully excluding them....but in my experience, I've seen it more with SWs.

The interventions are different? Hmmm....so you wouldn't use cognitive therapy for depression or Barlow's treatment for social anxiety?

It was more of a generalization on having a wider range of interventions available, like tools from a toolbox. CBT is one framework or tool to work with. It is a popular approach, and has been shown to be very effective approach for certain interventions, i'm not arguing that. I was commenting on a clinician probably having more 'tools' from their toolbox to choose from, bc of a greater length and depth of training and supervision.


I would be willing to bet that as a social worker, I dealt with much more florid psychopathology in my first year of practice than you've seen in your entire career.

Great additude to have. :laugh:


While there are certainly areas in their [Master's level therapists] training that could use some improvement......

At least we are in agreement with something. ;)


....they are nonetheless psychotherapists and they are often hired to do your job.

Again, i'm fine with properly trained LCSWs doing therapy....there are definitely populations in need of services. I think there is some crossover, but not in that many areas.


You don't have to like it, but you do have to live with it.

Thank you for your permission to not like it, and having to live with it. :laugh:

-t

FYI, it is unethical to refer to yourself as a PhD candidate professionally; here it is fine. By your logic, as an RxP trained psychologist with years of medical psych experience I can say that I can do everything a psychiatrist can do. I know enough about meds, clinical medicine etc, to know that is, and never will be the case; I wish you did.

It depends on the state. I was making a more general reference to Director positions, 99% of them require a licensed clinician.

Actually, it doesn't depend on the state. Every state that has social work licensure has it set up that it is a license to practice independently. Each state may call it something different (ie, in OH it's the LISW and in KS it's the LICSW), but it's still an independent license, no supervision required post-licensure. Strongly recommended when needed, certainly, but not required. Licensure supervision for MSWs can only be done by LCSWs, but not by psychologists. Psychologists or professional counselors can supervise counselors for their LPC.

I think 99% is a tad high of an estimate, unless again- that could be a state-by-state thing. The clinical director of our state psychiatric hospital is a LCSW. He supervises the psychologists.



As long as they had proper training and proper supervision, I have no problem with an LCSW performing diagnosis and psychotherapy. My gripe has to do with many LCSWs who 'stretch' their scope and treat populations. Some clinicians do this, so i'm not fully excluding them....but in my experience, I've seen it more with SWs.

It was more of a generalization on having a wider range of interventions available, like tools from a toolbox. CBT is one framework or tool to work with. It is a popular approach, and has been shown to be very effective approach for certain interventions, i'm not arguing that. I was commenting on a clinician probably having more 'tools' from their toolbox to choose from, bc of a greater length and depth of training and supervision.

Again, i'm fine with properly trained LCSWs doing therapy....there are definitely populations in need of services. I think there is some crossover, but not in that many areas.

So given the information we've provided regarding SW education (I never saw my question answered about whether we're only talking about SWs or including counselors as well), and given that the masters-level programs won't be lengthened and licensure statutes won't change significantly barring a minor act of God, what changes would you suggest within the current educational/training framework? And for those of us who have already jumped through the hoops, what is your opinion of what we could/should do to be "properly trained"?

FYI, it is unethical to refer to yourself as a PhD candidate professionally; here it is fine. By your logic, as an RxP trained psychologist with years of medical psych experience I can say that I can do everything a psychiatrist can do. I know enough about meds, clinical medicine etc, to know that is, and never will be the case; I wish you did.
I never said LCSW's can do anything a psychologist can do. In fact, I made it clear that psych testing is well out of our scope of practice. If you read the previous posts, you'd know that.

Oh, and thanks for telling me I can't refer to myself as a PhD Candidate professionally. Fortunately, I already knew that.

Yet you chose to do it here.....

you wrote: Yeah, private practice clinicians are obviously catering to neurotic housewives, and ignore the more severe cases.....that we were specifically trained to handle. I'm very thankfully I took Housewives, Executives, and Country Club Interventions.

reply: So you're implying that homeless people with florid psychopathology and no insurance or ability to pay for private therapy are coming to your office in droves?

You wrote: It depends on the state. I was making a more general reference to Director positions, 99% of them require a licensed clinician.

reply: wrong. Licensed master's clinicians do not require psychologist supervision, which is what you originally stated.



you wrote: As long as they had proper training and proper supervision, I have no problem with an LCSW performing diagnosis and psychotherapy. My gripe has to do with many LCSWs who 'stretch' their scope and treat populations. Some clinicians do this, so i'm not fully excluding them....but in my experience, I've seen it more with SWs.

reply: Earlier, you stated that LCSWs were not clinicans. Glad to hear you changing your tune. Education works wonders.



you wrote: It was more of a generalization on having a wider range of interventions available, like tools from a toolbox. CBT is one framework or tool to work with. It is a popular approach, and has been shown to be very effective approach for certain interventions, i'm not arguing that. I was commenting on a clinician probably having more 'tools' from their toolbox to choose from, bc of a greater length and depth of training and supervision.

reply: When it comes to psychotherapy, LCSW's are legally your equals. Some may not be as competent as they should be (much like the grads of the professional schools in your ranks), but they can provide psychotherapy to any population. I'm curious...since you were "specifically" trained to treat schizophrenia, are you implying that LCSW's aren't? Because of the populations most of us naturally gravitate towards, we are well-equipped to manage schizophrenia in conjunction with a psychiatrist.



you wrote: Great additude to have. :laugh:

Well, if you knew anything about SW, you'd know it's the truth.:idea: Clearly you know nothing about the field.



you wrote: At least we are in agreement with something. ;)

reply: true. Our MSW's need more training in research methods, and you guys really need to get your **** together regarding the PsyD and all those diploma mill proprietary schools churning out a bunch of halfwits with doctorates.:eek:



you wrote: Again, i'm fine with properly trained LCSWs doing therapy....there are definitely populations in need of services. I think there is some crossover, but not in that many areas.

reply: I'm so relieved that you are fine with it:laugh: Of course, this is a complete 180 from what you said earlier. So do LCSW's qualify as "clinicians" now in your book? Besides psych testing, where does the "cross over" end?



reply: Thank you for your permission to not like it, and having to live with it. :laugh:

reply:You are welcome. Now get back to administering the WISC, consoling the worried well, and feeling bitter about your professional identitiy:laugh:

-t[/quote]

I meant to add this before, but forgot.


Master's level therapists are here to stay. like it or not. While there are certainly areas in their training that could use some improvement......

Maybe here is a good start.....

.......the required post-master's training leading to LCSW licensure is an unregulated no-man's land of unstandardized training and experience that varies state to state. The quality of the budding LCSW's training depends entirely upon the supervisor, who may be a devotee of any number of absurd new age therapies.

and here.....


What really frightens me is that many of my MSW students were provided with just enough information on psychopathology and psychotherapy to be quite dangerous. They are often taught that they are equal to psychologists and psychiatrists in their diagnostic and treatment abilities, which I find to be completely laughable.

Which leads me to be concerned when......


they are nonetheless psychotherapists and they are often hired to do your job.

-t

ps. jl...i didn't forget about your post, and I appreciate the q's. I want to encourage others to jump in and offer their suggestions while I get some other stuff done; I'll post something in a bit.

[quote=Therapist4Chnge;4592563]I meant to add this before, but forgot.



Maybe here is a good start.....



and here.....



Which leads me to be concerned when......



-t




I critique my profession because I want it to see it improve. You should consider doing the same with the quacks in your ranks.

You also conveniently left out the section where I wrote that I consider LCSW's who strive to practice EVP are gems.

reply: So you're implying that homeless people with florid psychopathology and no insurance or ability to pay for private therapy are coming to your office in droves?

I was commenting on the fact that psychologists treat a range of patients, and often treat more complex cases. Whether or not someone decided to see certain populations in their private practice is up to them. Many people need services, not just the destitute and suburban housewife.

Licensed master's clinicians do not require psychologist supervision, which is what you originally stated.

My mistake. In most (with very few exceptions) they, and not MS trained practioners, act in a director or supervisor role at places like a CMHC.

you wrote: As long as they had proper training and proper supervision, I have no problem with an LCSW performing diagnosis and psychotherapy. My gripe has to do with many LCSWs who 'stretch' their scope and treat populations. Some clinicians do this, so i'm not fully excluding them....but in my experience, I've seen it more with SWs.

reply: Earlier, you stated that LCSWs were not clinicans. Glad to hear you changing your tune. Education works wonders.

I meant clinician to be doctoral level clinician. I was commenting that doctoral level clinicians are not excluded from practicing out of scope, but in my experience...it happens less than the LCSWs. I don't believe i've said clinician and said LCSW....I'd probably refer to them as therapist or practioner.


When it comes to psychotherapy, LCSW's are legally your equals. Some may not be as competent as they should be.

You covered this well in your comments i quoted in my previous post.

I'm curious...since you were "specifically" trained to treat schizophrenia, are you implying that LCSW's aren't? Because of the populations most of us naturally gravitate towards, we are well-equipped to manage schizophrenia in conjunction with a psychiatrist.

I was commenting on the fact that some LCSWs are not as well trained to deal with severe pathology. (ref. your quotes in my previous post) Just because they are the populations you commonly treat, doesn't mean it is the ideal treatment plan.


Well, if you knew anything about SW, you'd know it's the truth.:idea: Clearly you know nothing about the field.

If you believe that, I would welcome you (and others) to have some open discussions to help better inform others. jl and I were talking earlier in this thread about a number of things, and I encourage you to join us.


reply: true. Our MSW's need more training in research methods, and you guys really need to get your **** together regarding the PsyD and all those diploma mill proprietary schools churning out a bunch of halfwits with doctorates.:eek:

Adequate training (at the minimum) should be a requirement for all programs, and any program that doesn't meet this should be axed.....whether it is an MS, PhD, PsyD, etc. I fully agree with you on this, and do not want sub-par people in my field or related fields.


you wrote: Again, i'm fine with properly trained LCSWs doing therapy....there are definitely populations in need of services. I think there is some crossover, but not in that many areas.

reply: I'm so relieved that you are fine with it:laugh: Of course, this is a complete 180 from what you said earlier. So do LCSW's qualify as "clinicians" now in your book? Besides psych testing, where does the "cross over" end?

I answered the clinican quip above.

As for where the cross over ends.....how about academia? There may be a handful of exceptions, but doctoral level clinicians fill those positions. Neuropsych consult, forensics consults, etc.

Now get back to administering the WISC, consoling the worried well, and feeling bitter about your professional identitiy:laugh:

Please watch your tone, there is no need to be rude.

As an aside, i think it is disconcerning that you make quips about 'the worried well'. There are large portions of the population that would benefit from therapy, and just because they aren't all outwardly noticable cases, doesn't make them any less important. One of our major goals in therapy is to improve our patients / clients lives....whether it is a housewife or a homeless person.

As for feeling bitter.....:laugh: project much? Hearing your jaded responses would throw up a red flag if I heard it in a professional setting. I happen to love what I do, and wouldn't change it.

-t

you wrote: I was commenting on the fact that psychologists treat a range of patients, and often treat more complex cases. Whether or not someone decided to see certain populations in their private practice is up to them. Many people need services, not just the destitute and suburban housewife.


reply: Ok, I'll bite. Give me an example of a more "complex case" that an LCSW is not competent to treat (keeping in mind that I've conceded that testing is well outside of our scope)


you wrote: My mistake. In most (with very few exceptions) they, and not MS trained practioners, act in a director or supervisor role at places like a CMHC.

reply: In my experience, it is usually LCSW's or MFTs/LPC's who act in this role when supervising therapists. Usually psychiatrists are the ones in charge though.. It would be interesting to find out the truth of the matter.eply:

you wrote: I meant clinician to be doctoral level clinician. I was commenting that doctoral level clinicians are not excluded from practicing out of scope, but in my experience...it happens less than the LCSWs. I don't believe i've said clinician and said LCSW....I'd probably refer to them as therapist or practioner.

reply: Earlier you referred to "clinicians", and you excluded LCSWs

You wrote: I was commenting on the fact that some LCSWs are not as well trained to deal with severe pathology. (ref. your quotes in my previous post) Just because they are the populations you commonly treat, doesn't mean it is the ideal treatment plan.

reply: Again, give me an example of a case with severe psychopathology and I'll tell you how we would deal with it.

you wrote: As for where the cross over ends.....how about academia? There may be a handful of exceptions, but doctoral level clinicians fill those positions. Neuropsych consult, forensics consults, etc.

There are more than a handful of exceptions. MSW's frequently teach practice courses at a lot of universities, while the sw PhD's conduct research. I've already conceded that you guys are the experts at consulting re: psych testing.



You wrote: Please watch your tone, there is no need to be rude.

The derision you've expressed towards social workers naturally inspires such responses. If you mess with the bull, you're likely to get the horns.

You wrote:'. There are large portions of the population that would benefit from therapy, and just because they aren't all outwardly noticable cases, doesn't make them any less important. One of our major goals in therapy is to improve our patients / clients lives....whether it is a housewife or a homeless person.

reply: The "quip" about the worried well was made in response to your inaccurate assumption that LCSW's do not nor are they capable of dealing with florid psychosis and other forms of severe psychopathology

As for feeling bitter.....:laugh: project much? Hearing your jaded responses would throw up a red flag if I heard it in a professional setting. I happen to love what I do, and wouldn't change it.

When you attack people, expect to be responded to in kind:meanie:

Simple phobia, OCD. Sure you can read up and tell us what we would do, but could you do it??

Ok, I'll bite. Give me an example of a more "complex case" that an LCSW is not competent to treat (keeping in mind that I've conceded that testing is well outside of our scope)

I don't think throwing a case out there and saying, "XXXXXXXXX" can / can't be treated is fair, it depends on the practioner.


you wrote: My mistake. In most (with very few exceptions) they, and not MS trained practioners, act in a director or supervisor role at places like a CMHC.

reply: In my experience, it is usually LCSW's or MFTs/LPC's who act in this role when supervising therapists. Usually psychiatrists are the ones in charge though.. It would be interesting to find out the truth of the matter.

I'd like to encourage others to share their experiences in regard to this.


you wrote: I meant clinician to be doctoral level clinician. I was commenting that doctoral level clinicians are not excluded from practicing out of scope, but in my experience...it happens less than the LCSWs. I don't believe i've said clinician and said LCSW....I'd probably refer to them as therapist or practioner.

reply: Earlier you referred to "clinicians", and you excluded LCSWs

Correct. I was using clinician to refer to doctoral level people. Typically when LCSW is used, it implies MS level, unless otherwise specified. I'm going by what i've seen in write-ups, job postings, etc.


you wrote: As for where the cross over ends.....how about academia? There may be a handful of exceptions, but doctoral level clinicians fill those positions. Neuropsych consult, forensics consults, etc.

There are more than a handful of exceptions. MSW's frequently teach practice courses at a lot of universities.

I wasn't aware of this.


You wrote: Please watch your tone, there is no need to be rude.

The derision you've expressed towards social workers naturally inspires such responses. If you mess with the bull, you're likely to get the horns.

Way to take ownership of your comments; I'd like to keep this a civil conversation.


As for feeling bitter.....:laugh: project much? Hearing your jaded responses would throw up a red flag if I heard it in a professional setting. I happen to love what I do, and wouldn't change it.

When you attack people, expect to be responded to in kind:meanie:

I don't believe I was personally 'attacking' anyone, though some of your comments I thought were a bit out of line. Please refrain from such colloquialisms as 'asshat'.

-t

So given the information we've provided regarding SW education (I never saw my question answered about whether we're only talking about SWs or including counselors as well), and given that the masters-level programs won't be lengthened and licensure statutes won't change significantly barring a minor act of God, what changes would you suggest within the current educational/training framework? And for those of us who have already jumped through the hoops, what is your opinion of what we could/should do to be "properly trained"?

"barring a minor act of god"

:laugh:

I think they need to split out SW practioners from those who do more case management and related jobs. There is such a wide range of opportunities for SW (a good thing), but because of this, it really is hard to get trained in all of the areas. I think clinical psych programs might run into some similar challenges, depending on the areas of focus.

As for currently licensed practitioners.....I think CEs are great, more collaboration, and a tighter scope of practice. I've worked with some great LCSWs who really developed their skills with certain populations. Being able to focus on those populations would be the ideal, but for practical reasons, it isn't always easy.

I've found in-service trainings to be great for everyone involved. MSs, LCSWs, PhDs, PsyDs, MD, etc. Everyone can learn from them, though I wish they were more widely available to practioners.

-t

"barring a minor act of god"

:laugh:

I think they need to split out SW practioners from those who do more case management and related jobs. There is such a wide range of opportunities for SW (a good thing), but because of this, it really is hard to get trained in all of the areas. I think clinical psych programs might run into some similar challenges, depending on the areas of focus.

I think subspecialization is actually better done than you guys may realize. Doing your concentration in the second year of the MSW program does kind of lock you into a field.. As an example, most hospitals will only hire MSWs for the medical floors who have gone through a health concentration program. Having been licensed for 5 years, the ONLY reason I was able to snag a PRN medical SW job last year was due to a good connection through a previous psych SW job I did. Multiple other applications I put in at other hospitals always resulted in the same response- "No hospital SW experience", even though I had done ER-based psych intake for two years.

I don't observe a lot of clinicians doing lateral shifting between types of SW practice. I only did it due to a change in career plans and wanting more medical/non-psych exposure. The medical SWs with whom I work have no interest in doing anything psych-related and tell me that almost every time I see them. :rolleyes: They also recognize that they do not have the knowledge base or training to do psychotherapy, because that is not where they concentrated. Typically the shifts I see are moves up the chain of the organization into supervisory positions, but usually within the same general area of practice.

As for currently licensed practitioners.....I think CEs are great, more collaboration, and a tighter scope of practice. I've worked with some great LCSWs who really developed their skills with certain populations. Being able to focus on those populations would be the ideal, but for practical reasons, it isn't always easy.

I've found in-service trainings to be great for everyone involved. MSs, LCSWs, PhDs, PsyDs, MD, etc. Everyone can learn from them, though I wish they were more widely available to practioners.

-t
I'm not sure where we are on this, but my state is working toward mandatory licensure supervision certification courses (16 CEs iirc) in order to supervise a MSW toward the LCSW. This would reduce the number of available supervisors, but hopefully improve consistency and quality of supervision. Regarding collaboration, I agree that's essential. However collaboration is a 2-way street. It doesn't help me (or the patient) when my private practice patient's psychiatrist doesn't call me back.

As I said in a much earlier post, CEs are available on many levels from Basic to Advanced/Clinical. It's encumbent on the individual clinician to seek out opportunities which will enhance their practice skills. Part of me thinks it wouldn't be a bad idea to mandate that X% of your CE hours need to be on topics which directly relate to your area of practice. They've already put limits on how much you can do online or via mail-order courses. And as I also said earlier, the big push in many states is to tier licensure into MSW clinical and MSW non-clinical. Given what we were discussing above re: subspecialization, would it be wise to then divide the MSW clinical into "therapy" and "non-therapy"? Given the lack of crossing over that I see, this would feel a bit like overkill to me.

Finally, and I have said this ever since I was a grad student, the single greatest thing I think MSW programs can do is to have a more rigorous application and interviewing process and quit being diploma factories. My school graduated 300+ in my class, and to use your word from earlier, I really don't know how some of those asshats got in. If you pay attention to USN&WR rankings, then I currently live near one of the top schools in the country, so I get to work with many of their grads. Some of them are the worst SWs I have ever met. A friend who earned her PhD there has awful stories about teaching MSW students and the school's attitude. I'd love to see the schools focus more on quality than quantity of students.

Was Virginia Satir competent?

No she is considered a total kook..

The typical social work program from afar appears very inadequate for what is often claimed as a skillset. My understanding is these programs generally have one year of clinical focus and one year of "social justice" political focus. They are basically learning to practice on the fly, much like a nurse learns medicine. Meaning, if we played the ask a nurse what they would do in a particular doctorally reserved medical situation, they might get the question right after some years of experience in a hospital watching doctors, but I still wouldn't want them doing the procedure. I've often maligned PsyD programs for their horrid entrance requirements, effectively obliterating the bar of entry into the field, but social work is truly scraping the bottom of the barrel. In my opinion, they should do nothing beyond supportive therapy and case management (e.g., setting up services for people, connecting someone with mental illness to a qualified provider - psychologist or psychiatrist, etc. . .). Granted, there are all very important functions. Social work is an important and valuable field. They are substantially over-reaching their training (successfully I might add for a plethora of reasons).

Nice to see you around again Jon. I happen to agree with you about (most) social work training and scope of practice issues. There are many things you will experience and learn 'on the job' (in any profession), but it should be on top of a existing solid training....and not a major component of that critical training.

-t

I know enough about meds, clinical medicine etc, to know that is, and never will be the case; I wish you did.

That's the problem with the incompetent and what makes them dangerous. They don't know enough to know they are ignorant.

The typical social work program from afar appears very inadequate for what is often claimed as a skillset. My understanding is these programs generally have one year of clinical focus and one year of "social justice" political focus. They are basically learning to practice on the fly, much like a nurse learns medicine. Meaning, if we played the ask a nurse what they would do in a particular doctorally reserved medical situation, they might get the question right after some years of experience in a hospital watching doctors, but I still wouldn't want them doing the procedure. I've often maligned PsyD programs for their horrid entrance requirements, effectively obliterating the bar of entry into the field, but social work is truly scraping the bottom of the barrel. In my opinion, they should do nothing beyond supportive therapy and case management (e.g., setting up services for people, connecting someone with mental illness to a qualified provider - psychologist or psychiatrist, etc. . .). Granted, there are all very important functions. Social work is an important and valuable field. They are substantially over-reaching their training (successfully I might add for a plethora of reasons).

You clearly know little about social work training. Most programs allow students to specialize at the outset, so those social workers aspiring to be therapists start individualizing their curriculum in their first year. There are some classes that are "required". At my school, they are Foundations of Social Work Practice (which is not all about social justice, although that is part of it), Human Behavior in the Social Environment (which involves a review of a variety of theoretical orientations towards individual and group treatment), and Research Methods. If they are specializing in mental health, they then have to take a variety of courses (and they have the chance to take many electives) such as Differential Diagnosis,Cognitive Therapy, Family Therapy, Biological Basis of Human Behavior, Geriatric Psychology, Assessment and Treatment of Personality Disorders, and many more.

Yes, the quality of training varies by sw program just as it does in psych (ever heard of the California Institute of Integral Studies?) I find it amusing how some of you psychologists act like treating an anxiety disorder or phobias is rocket science. And in reply to the earlier poster, yes I would know what to do b/c I've DONE it. I think it is wrong to state that LCSW:Nurse::Psychologist:Physician.

In a previous post, I stated that MSW's should not be practicing psychotherapy unless they receive better training in research and had a more standardized post-MSW licensure process. This is happening in some quarters. To state that social work is "scraping the bottom of the barrel" is not only insulting, it's wrong. Again, you are well aware that studies show that a clinician's particular profession is unrelated to psychotherapy outcome. An LCSW can provide therapy just as effectively as you can. Just like in psychology, social work is making a strong push towards educating its students to use evt's. You guys are the ones who create that knowledge in academic settings. Any clinician can learn to apply the therapy.

Having said that, I recognize that psychs are THE experts in assessment and testing. But you don't receive much more didactic and practical psychotherapy training than we do to get licensed. What social work DOES need is something akin to APA-accredited internship programs for post-masters training prior to receiving the LCSW.

I understand the frustration felt by psychs when some LCSWs act like they know everything there is to know about psychotherapy. Most psychologists don't have that attitude (well, some do, but they usually come from professional schools).

Before you dismiss an LCSW's ability to treat the same range of disorders you treat, I suggest getting to know that LCSW individually. The same is true of psychs. Some of you guys are doing crazy **** like EMDR, and I think it was a psych who "invented" thought field therapy.

What matters when it comes to therapy competence is the individual therapist, regardless of the discipline.

By "scraping the bottom of the barrel," I'm referring to the quality of student (university background, GPA, GREs, etc. . .). Just because the clinical study hasn't been done (because it's difficult to do) differentiating quality of treatment by clinical psychologists, social workers, and psychiatrists doesn't mean there isn't a difference. Professional standards are not made that way. You don't just keep lowering the standards until people start dying.


I agree, there are some ****heads in clinical psychology doing EMDR and thought-field therapy. Professional schools suck.

Wow

Seems like some of you are truly incapable of having a fruitful discussion. Therapists, huh?:thumbdown

Therapists, huh?

I'm not a therapist :) What's your definition of fruitful anyway?

Clinician. :) Docs like to make that clarification.

-t

Clinician. :) Docs like to make that clarification.

-t
curiosity- southern thing? haven't heard any of the psychologists know use that semantic distinction around here.

I don't think it is a regional thing, though I could be wrong.

-t

I don't think it is a regional thing, though I could be wrong.

-t
ok.

I'll just go back to doing online billing as a network "clinician", as this managed care company refers to me.

:D :meanie:

All funny, but I just meant I don't do therapy anymore.

I'm not a therapist :) What's your definition of fruitful anyway?

See, that sort of response is what I meant, thanks for expopsing it one more time. You seem to be one of those posters who always have something negative to add to any post in a readily manner.

I don't feel I am at all negative and I don't attack other posters. Your post on the other hand is a rebuke, yes?

- haughtily - . . ". . .and you consider yourself therapists. . . pfft."

My question was serious and not intended to inflame. What's your definition of fruitful? Is, "I'm ok, you're ok," a necessary component of your version of a civilized discussion?

Clinician. :) Docs like to make that clarification.

-t

Yeah right,

that seems to be more important than the issue; oh my....

What is it about SDN that brings out such competitiveness and "drawing lines in the sand"? MD's knock DO's, pre-meds insist some medical schools "suck," and on here people who don't reflect the real world of psychotherapy that I know argue about who is better!

In the states I am familiar with (NY, NJ and MA), there are different levels of social work licenses requiring different types of training and experience ( 3 different licenses within each of these 3 states.) In all 3 states I mentioned, a national clinical exam at an advanced level is needed for the highest license, as well as a number of years in a clinical setting ( in NY, it is 6 years of supervised practice by a SW licensed to practice at an independent level OR a licensed psychologist OR a psychiatrist) before one can practice independently. In social work, psychology and psychiatry alike, one is not supposed to practice out of one's expertise/training, and in all 3 fields, there is no outside policing of this...just a professional code/code of ethics.

My husband is a psychiatrist of 25+ years' duration who has some psychotherapy patients, but who primarily is a psychopharmacologist and also is an expert witness in malpractice/injury cases. I have asked him on various occasions about the therapists with whom he often shares patients. Some are LCSW's, some psychologists, and some pastoral counselors. His summary over the years has always been "there are good therapists and bad therapists." He swears that he often does not even remember what someone's degree is...but he damn well knows who's good, and it has never fallen along the lines of training type.

I ascribe this turf-war stuff to plain insecurity. My husband is extremely in demand and has a practice that most people envy...we have a great life. He doesn't seem to have any need to put anyone else down. Maybe there's a lesson to be learned here.

No one is putting anyone down, at least not really. Turf concerns are an issue. You don't want psychiatry, social work, and clinical psychology to all be equal and cover the same turf. It will substantially degrade pay and there will be serious flight of brain power to other fields. Maybe that works for psychiatry at the moment since they have prescription priv, I don't know.

By "scraping the bottom of the barrel," I'm referring to the quality of student (university background, GPA, GREs, etc. . .). Just because the clinical study hasn't been done (because it's difficult to do) differentiating quality of treatment by clinical psychologists, social workers, and psychiatrists doesn't mean there isn't a difference. Professional standards are not made that way. You don't just keep lowering the standards until people start dying.


I agree, there are some ****heads in clinical psychology doing EMDR and thought-field therapy. Professional schools suck.

To me this did indeed sound like putting others down..sorry if I misinterpreted it. Even though I hate when people quote "studies" without citation, I'm going to do it here. The largest single factor I've seen in most studies that measure "success" in therapy (I know, there's a real problem in defining one's terms) talks about something that comes down to "quality of the therapeutic relationship." Nothing I've ever seen ties that to a specific type of training.

In terms of lowering pay, the reality is that many who need mental health services in this country don't get them, and that the number of psychologists and psychiatrists we have/can reasonably expect to have could not adequately treat all those with severe mental illness. Now I know that this is a separate issue from competence, which I feel I already addressed, but you have to understand the realities of the marketplace if you are going to fashion an argument...fighting market realities just never works. When my husband first went into private practice after residency, many of his colleagues were complaining that "non-MD's" were allowed to treat patients. He sat down and asked himself what he thought his particular training uniquely allowed him to do and went with that, correctly anticipating years in advance how things would head. Although there is a lot of overlap among psychiatrists/psychologists/clinical SW's and counselors, there are different emphases, and more than enough patients to go around. Look at the growing and inevitable increase of PA's and NP's in medical fields; whatever tends to reduce health care costs will inevitably win. Figure out how to use this knowledge to build your practice.

By "scraping the bottom of the barrel," I'm referring to the quality of student (university background, GPA, GREs, etc. . .). Just because the clinical study hasn't been done (because it's difficult to do) differentiating quality of treatment by clinical psychologists, social workers, and psychiatrists doesn't mean there isn't a difference. Professional standards are not made that way. You don't just keep lowering the standards until people start dying.


I agree, there are some ****heads in clinical psychology doing EMDR and thought-field therapy. Professional schools suck.

Again, you are showing your ignorance about MSW programs. Most (not all) are extremely competitive in terms of GPA and GRE scores. Kinda sounds like psych, doesn't it? Anyone with a pulse can get into the Pacific Graduate School of Psycholgy, but the University of Wisconsin is a different story.

And what do you mean the "clinical study hasn't been done"? It HAS been done repeatedly. Use that PhD and do a lit review.:laugh:

Actually I would rather have a PsyD from PGSP/Stanford than any degree from the Univ of Wisconsin...I am failing to see your point at all. MSW programs are hard to get into because there are not that many of them, but they have a similar scope of practice to an LPC, MFT etc..., AND they are totally different than the scope of practice of a licensed psychologist.

The only MH professionals who can't be replaced (yet) are the psychiatrists because they can prescribe medications. Whether or not that makes them superior mental health clinicians is up for debate, but they have the Magical Degree (MD) and so they can provide the Huxleyan Soma to whomever needs it. And apparently a lot of people need it.

Also, I need to qualify my earlier statement re: the competitiveness of MSW programs. I am in no way implying that they are as difficult to get into as clinical psych PhD programs housed in real universities. But it actually is quite competitive at most schools because so many people want to be therapists.

After I got my MSW at a pretty decent school, I decided I wanted to do research. I applied to clinical psych programs as well as PhD programs in social welfare. I got accepted at a very respectable psych program, but I ended up choosing the PhD program in social welfare for a # of reasons: 1) 5 years of funding with a very generous stipend; 2) My goal is to be a prof, and there is a greater demand in sw...in fact, I am almost guaranteed a tenure-track position upon graduation and have already been offered jobs in my 2nd year; 3) PhD-level social work programs will afford me the chance to do the exact same type of research I wanted to do as a psych. 4) The research training is equally rigorous: I have taken the same basic courses in basic stats and multiple regression, but I've also taken the same courses you've taken. I've taken structural equation modeling, a course on clinical trials, measurement, HLM, systems dynamics, item response theory, factor analysis, GIS, and categorical data analysis.

Plus my PhD social welfare program was much more difficult to gain admission to than many clinical psych programs.

I say this not to say "I rule", but to let you know that there is much you don't know about our field. And people like me, with research training who have completed a year-long internship at the master's level providing psychotherapy in mental health settings at VA hospitals, large urban psychiatric hospitals, etc, are training these students. And we are constantly improving their training.

The sky is not falling, Chicken Little, and we are not trying to encroach on your territory. We don't want psych testing and interpretation in our scope of practice. But hey, good luck getting rx privileges without going to med school (or PA/NP school).

Actually I would rather have a PsyD from PGSP/Stanford than any degree from the Univ of Wisconsin...I am failing to see your point at all. MSW programs are hard to get into because there are not that many of them, but they have a similar scope of practice to an LPC, MFT etc..., AND they are totally different than the scope of practice of a licensed psychologist.


You clearly haven't looked at the rankings of PhD programs in clinical psych lately, and you sound like a great candidate for the PsyD program. :laugh: U of Wisconsin has one of the top clinical psych programs in the country. I know a lot about PGSP/Stanford's little PsyD program. One of my colleagues was attending their program, and he said PGSP had to pay out the ass to get Stanford to associate with them. Stanford did quite well financially due to this deal since the students at PGSP pay roughly $30,000/year in tuition.

And for you to say there aren't many MSW programs? :laugh:
I counted 118 American MSW programs on this site ( I may be off by one or two): http://cosw.sc.edu/swan/univ.html

And they are all housed within actual colleges and universities.

Has the PGSP/Stanford PsyD program even gained accreditation yet? I'll have to look.

Again, you are showing your ignorance about MSW programs. Most (not all) are extremely competitive in terms of GPA and GRE scores. Kinda sounds like psych, doesn't it? Anyone with a pulse can get into the Pacific Graduate School of Psycholgy, but the University of Wisconsin is a different story.


whoa- hold on here. GRE scores? now, I hate to be the one to add fuel to the already blazing anti-MSW flame we've got going on here, but I do not recall any schools requiring me to take the GRE. (I did take it, but I wound up not needing it.) and because I applied 10 years ago and things change, I just did a quick double-check of my alma mater on the East Coast, 2 local schools (including the current #2 in the country..), and -because it was brought up- UWisc. Not one of those required the GRE, and only UWisc mentioned it as optional if you have a sub-par GPA.

this would be one of my 1) pet peeves about SW and 2) recommendations for changing the current admissions process.


Actually I would rather have a PsyD from PGSP/Stanford than any degree from the Univ of Wisconsin...I am failing to see your point at all. MSW programs are hard to get into because there are not that many of them, but they have a similar scope of practice to an LPC, MFT etc..., AND they are totally different than the scope of practice of a licensed psychologist.

back to the question I asked a while ago- is this entire discussion encompassing MA Counseling and MFT degrees? the programs are extremely similar, and around here, MSWs are required to do more supervised fieldwork prior to graduation. I would never argue the distinction between training of psychologists and masters-level, however I'm not seeing scrutiny of the LPC/LMFT-oriented programs here as is being done with SW.

also- not that many of them? really? not my experience. and the classes can be huge. my MSW class was over 300, and there were multiple (close to 10) programs in the metro area where I attended. compare that to my BSSW class- 24 grads total.

And what do you mean the "clinical study hasn't been done"? It HAS been done repeatedly. Use that PhD and do a lit review

Eh . . . no. The problem is specificity. The published studies are very general and not of much utility in evaluating the stated question.

whoa- hold on here. GRE scores? now, I hate to be the one to add fuel to the already blazing anti-MSW flame we've got going on here, but I do not recall any schools requiring me to take the GRE. (I did take it, but I wound up not needing it.) and because I applied 10 years ago and things change, I just did a quick double-check of my alma mater on the East Coast, 2 local schools (including the current #2 in the country..), and -because it was brought up- UWisc. Not one of those required the GRE, and only UWisc mentioned it as optional if you have a sub-par GPA.

this would be one of my 1) pet peeves about SW and 2) recommendations for changing the current admissions process.




back to the question I asked a while ago- is this entire discussion encompassing MA Counseling and MFT degrees? the programs are extremely similar, and around here, MSWs are required to do more supervised fieldwork prior to graduation. I would never argue the distinction between training of psychologists and masters-level, however I'm not seeing scrutiny of the LPC/LMFT-oriented programs here as is being done with SW.

also- not that many of them? really? not my experience. and the classes can be huge. my MSW class was over 300, and there were multiple (close to 10) programs in the metro area where I attended. compare that to my BSSW class- 24 grads total.

I was referring to the University of Wisconsin at Madison's clinical psych program.

There are a few schools that don't require the GRE due to what they consider the test's inherent bias against minority students. Most MSW programs do in fact require it. Yes, there are a lot of them out there.

Eh . . . no. The problem is specificity. The published studies are very general and not of much utility in evaluating the stated question.

Effectively quantifying the outcomes, and being able to answer any real questions were two areas those studies lacked. For a more direct answer, i'd compare a doctoral level clinician with the same # of years experience as a SW, and I think the clinician would fair much better.

-t

Effectively quantifying the outcomes, and being able to answer any real questions were two areas those studies lacked. For a more direct answer, i'd compare a doctoral level clinician with the same # of years experience as a SW, and I think the clinician would fair much better.

-t

Based on what scientific evidence?

2 years in an MSW program (which includes over a year of internship training) + 2-3 years of supervised post-MSW psychotherapy practice prior to licensure. That's not too shabby given that masters'-level mental health clinicians don't learn psych testing.

Psychs are the gods of testing. Depending on the quality of their pre-doctoral internship experience, however, they may have superior OR inferior psychotherapy training to LCSW's. I'd prefer an LCSW who got her MSW at University of Michigan and trained at the Center for Cognitive Therapy to a PhD psych who did his/her internship at a crappy non-APA accredited program any day.

This acrimony between the professions must stop. The reality is that LCSW's are the largest group of clinicians in the country. Instead of whining about how they aren't good enough, why not try to do something positive, like disseminating evt research to MSW programs and the post-MSW internships? Psychs are the experts at psychotherapy research. Instead of caterwauling about how masters' level clinicians are encroaching on your territory like you guys are doing with psychiatry, why not recognize and accept the reality of psychotherapy practice in the US today and try to improve the deficiencies you perceive in the training of masters'-level mental health clinicians?

Masters'-level clinicians will never replace you guys. You have a skill set (psych and neuropsych testing, not to mention research skills) that is invaluable and will never be replicated by LCSW's and other masters'-level mental health clinicians.

Putting aside the larger debate about the general competence of MSWs as psychotherapists (temporarily, anyhow!), I'm wondering if people can offer any insight into a few related questions I have:

1) As someone who is definitely interested in becoming a psychotherapist (and yes, I'm also applying to several Ph.D.s and Psy.D.s, but I'm also considering MSW programs for financial and time reasons), which MSW programs in the Northeast are more clinically oriented? With a couple of notable exceptions, such as NYU, I'm having a hard time discerning from many schools' websites just how clinical their focus really is. And within that, again with the exception of NYU, I'm having a lot of trouble discerning programs' clinical orientations (I'm particularly interested in therapy that integrates psychodynamic thinking to a certain extent). Does anyone have any specific knowledge about this topic or know how to get it?

2) Should someone like me really care how clinically oriented an MSW program is, or should I see any great MSW program as a means to an end? In other words, I'm well aware that to become a strong and qualified psychotherapist, I'm going to need several years of post-MSW clinical training and supervision, so how much does it really matter how clinical the MSW program itself is?

3) Finally, in preparing my applications, I'm also trying to determine whether discussing my clear interest in psychotherapy in general and psychodynamics in particular (as I've done throughout my statement for Psy.D. programs) is the kiss of death for MSW programs. That is, do I need to essentially "pretend" that my focus is much more clearly on broader community/social/justice issues? As it happens, I care about all those things a great deal, but they're not the principal reaosn I'm going back to school.

The SDN community has been incredibly helpful at every turn, and I'm hoping I can go to that well once more for any advice any of you might have.

Many, many thanks,
Mitch

Mitch,

Those are some great questions, and I hope you can get some answers bc I think many people could benefit from them. I don't know much about MSW programs, so I can't help in that area, but I'd love to learn more...so any MSW'ers out there, i'd love to hear your input.

-t

1) As someone who is definitely interested in becoming a psychotherapist (and yes, I'm also applying to several Ph.D.s and Psy.D.s, but I'm also considering MSW programs for financial and time reasons), which MSW programs in the Northeast are more clinically oriented? With a couple of notable exceptions, such as NYU, I'm having a hard time discerning from many schools' websites just how clinical their focus really is. And within that, again with the exception of NYU, I'm having a lot of trouble discerning programs' clinical orientations (I'm particularly interested in therapy that integrates psychodynamic thinking to a certain extent). Does anyone have any specific knowledge about this topic or know how to get it?

It was always my understanding that NYU was something of an anomaly in their clinical (psychodynamic/object relations) orientation. (Public confession time- yes, I'm a NYU grad. Go Violets! :rolleyes: ) I'm not aware of any other MSW programs which have that focus, although many will offer at least an overview of those orientations- probably as an elective though. In a quick Google search of "psychodynamic object relations social work", it looks like Smith in MA does quite a bit of psychodynamic teaching.

In NYC, Hunter is known for their administrative SW track, Columbia for their research and some clinical (not sure of their orientation), Fordham for their social justice and some clinical (again, not sure of orientation). I believe Yeshiva also has a strong clinical program as well, with some depth into psychodynamics, just not to the level of NYU. Don't know much about Adelphi or Stony Brook.

2) Should someone like me really care how clinically oriented an MSW program is, or should I see any great MSW program as a means to an end? In other words, I'm well aware that to become a strong and qualified psychotherapist, I'm going to need several years of post-MSW clinical training and supervision, so how much does it really matter how clinical the MSW program itself is?
Yes, you need a clinically oriented program, but I think clinical orientation of the program is less important. A couple of reasons- if you wander into an administrative track, there will be little to no opportunity to do clinical electives, or a clinical practicum. These are extremely important to have. Also, it may be possible to counter-balance your school's orientation with your practicum's orientation. As an example, despite my psychodynamic coursework, my practicum was in an EAP- so my clinical supervision was in CBT/short-term/crisis models. Especially in the NYC area, there are plenty of opportunities to do more psychodynamic practica, so you could get that training even if your school does not provide the depth you were looking for.

NYC also has a multitude of post-grad training institutes (the names of which are all escaping me right now b/c it's been so long..) which could be options for additional clinical supervision and training.

3) Finally, in preparing my applications, I'm also trying to determine whether discussing my clear interest in psychotherapy in general and psychodynamics in particular (as I've done throughout my statement for Psy.D. programs) is the kiss of death for MSW programs. That is, do I need to essentially "pretend" that my focus is much more clearly on broader community/social/justice issues? As it happens, I care about all those things a great deal, but they're not the principal reaosn I'm going back to school.

Given your geographic preferences of NYC and the Northeast, I don't think your desire to do psychotherapy would be a "kiss of death". About the psychodynamics.. I really couldn't say. I would not pretend that your focus is on something you are not really interested in. Check the schools' websites for whether or not they have a Mental Health concentration. If they don't, I wouldn't apply to that school.

Regarding social justice, the only social justice class I ever took was as a theology elective in undergrad. Social policy history is a mandated social work class... but not social justice.

The beauty of social work is in its diversity which allows us to practice on many levels- individual, group, family, community, system- and in many capacities- clinical, administrative, community organizing, public policy, health, children and families, etc etc etc. The heart of social work will be "person in environment"- the functioning of a person within the systems of which they are a part. You're more interested in working with the person, rather than the environment, to effect change. Totally acceptable and well within the scope of what social work is all about.

Mitch, before moving on to a different degree and a different healthcare role, I was a field instructor for NYU and Columbia, and interacted with students from the other NY schools. My observation is that much depends on the class choice and profs you happen to get, as well as the internships. In most schools, you have input into the second year internship, but not the first. Columbia's degree tends to be the most respected of the schools you mentioned, but graduates of any of the schools should get a few years extra training, involving Institute training and/or excellent supervision, even if you have to contract for it privately. I have heard from several people that Smith's training is outstanding, but don't have first hand knowledge. Good luck!

As an esteemed member of psi chi, you are undoubtedly aware of the multitude of studies which indicate that there are no differences in psychotherapy outcomes based on discipline.

LCSW's can practice psychotherapy effectively, although I will concede that there are some poor MSW programs out there. The same is true for psych (the Adlerian School of Prof Psych comes to mind, not to mention the California School of Professional Psychology).

We are not practicing outside of our scope of practice by practicing psychotherapy. Sure, you guys are better at cognitive and intellectual assessment, although LCSW's are within their scope of practice to make DSM diagnoses. They receive coursework in diagnosis and assessment, various psychotherapeutic treatment modalities, basic research methodology, etc. and they complete 2 years of pre-master's internships. Furthermore, they go through (in some cases) 3 years of post-master's training prior to receiving the LCSW.

Are they social scientists? No. If they receive the proper training in the form of learning about evidence-based treatment, then yes, they are every bit as qualified to perform therapy as PhD clinical psychologists. Deal with it. The scientific literature speaks for itself. Sorry if that bugs you.

If I need a psych assessment or testing, I'd see a clinical psych. If I need therapy, an LCSW CAN do the same thing psychs do. There are plenty of psychs who practice quack therapies (thought field therapy comes to mind), and I would take a well-trained LCSW over such a fool any day. And let's not even get into the whole proprietary PsyD school phenomenon.

MSW's and LCSW's are the largest providers of mental health counseling in the US. You psychs have been slowly pushed out of that market, and for good reason. Psychotherapy isn't rocket science. Stick to neuropsych testing and consultation. That's about all you guys have left, and hey, it can be quite lucrative.

And once more: LCSW's are NOT pushing for the right to do your precious psych testing. If we wanted to do that, we would have become psychologists.

I haven't been keeping up with this thread and just happen to read it today...

come'on, you have got to be kiddn' me... look, if you are getting a doctorate in sw, good for you... you are among one of the few... in fact, I know of no doctorate level sw who practice... if they do, they have a small private practice and try to separate themselves from MSW's... are you a social scientist, if you have a doctorate than I say so... but calling the whole field of social work science is simply a joke... there is no science involved, most msw don't even understand scientific literature and the required course in methodology in msw's curriculum are completely washed down... and most students just want to skip these courses... you know that's true... look at the quality of students who get msw's... as far as I know (maybe changed now), most school's don't require GRE's (even top ones like columbia and NYU), maybe for a doctorate they do but come'on now... not to say GRE's are good predictors but they do serve as a filter, those who want it easy will be attracted to programs who don't require them...

btw, what kind of treatment is specifically social work? supportive therapy? I don't even think that that kind of tx was distinctively derived from the SW field. My impression is that most SW practice a combination of case management and supportive psychotherapy (in the widest sense of its definition). Some obtained additional training which are derived from psychology and psychiatry.

Psychologist being pushed out... yeah, we are by social workers who accept the lowly payments that insurance companies throw at them... cognitive dissonance, most psychologist feel that it's unacceptable to take those payments... social workers feel justify to take them given their limited training.

You alluded that sw can provide treatment like psychologist... dream on... maybe some who have gone through intensive training while comparing to a basically trained psychologist... this is what gets me fumed... I have encountered so many sw who claim this and yet does not even have a clue what they are talking about... most sw that I know continue to practice supportive psychotherapy, continue to provide 'treatment' under no specific theory, continue to be outdated and claim to be advocating for their patients but as soon as they are in an administrative position, completely forget their advocating roots. In most community based clinics, a large number of pt's stay FOREVER... due to their dependence on the sw's case managing and lack of emphasis on independence...

Couple questions:

and asked about qualifications and treatment modalities - some pretty 'fishy' treatment approaches were listed (i.e. EMDR), and I wasn't really left with a good impression. How much theory/training/experience do they really have anyway?

EMDR isn't fishy, although admittedly it sounds like the hokiest thing ever when you first read about it. And it isn't only LCSWs that do it. There are PhD psychologists and MD psychiatrists who also do it.

Anyway I think how good a therapist is has more to do with them as individuals as opposed to their credentials. It makes things harder, but it seems that's how things generally work out anyway.