A little off-topic: LCSW vs. LPC

[Deslok]

In what capacities do people with these licenses function? What're the main differences?

---

Members don't see this ad.

 

[Deslok]

Anyone? Anyone? I talked to my bro-in-law a little, who's a MFT. He said Medicaid will pay for someone to see a LCSW but not an LPC. He also said that there's some kind of law requiring that jobs aren't limited to just, say, LCSWs but are open to LCSWs, MFTs, and LPCs. What exactly does this mean though? Isn't there still a preferred license when hiring for a particular job?

 

[50960]

LCSW's have alot more access to reimbursement.

 

[pingouin]

Anyone? Anyone? I talked to my bro-in-law a little, who's a MFT. He said Medicaid will pay for someone to see a LCSW but not an LPC. He also said that there's some kind of law requiring that jobs aren't limited to just, say, LCSWs but are open to LCSWs, MFTs, and LPCs. What exactly does this mean though? Isn't there still a preferred license when hiring for a particular job?

Check on the Medicaid thing- in my state, Medicaid will reimburse both LCSWs and LPCs. Medicare, however, will not reimburse LPCs- only LCSWs and psychologists. It's my understanding that the LPCs (NBCC maybe? or ACA?) are lobbying to have this changed, but it hasn't happened yet. Most of the insurance companies I work with have both LCSWs and LPCs on panel- but I'm in the Midwest, and my understanding is that this may vary depending on your geography.

I'm an LCSW, and have many LCSW and LPC friends. I think one of the biggest differences between the two is the type of degree. In order to get an LCSW (or whatever it's called in a particular state), a person has to have a MSW from a CSWE-accredited program, plus the standardized test through ABSWE, plus the supervised hourse, etc etc. And to be CSWE-accredited, a school has to include certain core classes in the curriculum. On the flip side of that, at least in my state, to sit for the LPC exam there is less standardization- I know people who have MEd in Counseling, MA in Counseling, MA in Rehab Counseling, MA in MFT, and on and on. Because of all the different backgrounds, I think the LPCs are less cohesive and have less strength when it comes to advocacy. I've also wondered if the lack of consistency within the license makes a difference in hiring practices? You hire a MSW, you know EXACTLY what core classes they took. MA/LPC? Might vary depending on where the person went to school. Just a thought.

Another difference is program content- from my friends' (and other colleagues') descriptions, most of the LPC-geared classes focus on counseling theories and techniques. In the MSW clinical programs, the same is taught- but depending on the program, you also get a healthy dose of advocacy and policy background. I can't remember if my LPC friends took research stats, but I know I had to take 2 semesters.

As far as job opportunities, there are plenty for both licensure types in private agencies, managed care organizations, private practice, etc. In hospitals, I've only seen LPCs working in behavioral health and chemical dependency programs. LCSWs can work in those too, but also have medical and emergency room social work positions available. I think it's a holdover of the "social workers know the resources" way of thinking, but that's just speculation on my part.

Good luck in your decision

 

[RobinA]

Actually, the Medicare situation has recently changed and LPCs are now reimbursed. The next frontier is DoD, which is what I'm hoping for, because I want to work for the VA when I graduate.

LPCs, in PA anyway, have to have had certain courses in order to sit for the test. Yes, research stats is one of them. You can have one of several degrees, but they all have to include the core courses.

You're right, LPCs don't take policy or advocacy courses. I wish the advocacy courses made more of an impression on some MSWs. Me and my '70s era BSW just spent four years at a social service agency where the administrative MSWs couldn't (or wouldn't) advocate their way out of a wet paper bag. I was the only one pounding the table to get kids effective services. I said good-bye to all that and went for the psychology Masters. I figured if they weren't going to push for better services I could at least try to PROVIDE better services to those that come my way when I graduate.

 

[pingouin]

Actually, the Medicare situation has recently changed and LPCs are now reimbursed. The next frontier is DoD, which is what I'm hoping for, because I want to work for the VA when I graduate.

LPCs, in PA anyway, have to have had certain courses in order to sit for the test. Yes, research stats is one of them. You can have one of several degrees, but they all have to include the core courses.

You're right, LPCs don't take policy or advocacy courses. I wish the advocacy courses made more of an impression on some MSWs. Me and my '70s era BSW just spent four years at a social service agency where the administrative MSWs couldn't (or wouldn't) advocate their way out of a wet paper bag. I was the only one pounding the table to get kids effective services. I said good-bye to all that and went for the psychology Masters. I figured if they weren't going to push for better services I could at least try to PROVIDE better services to those that come my way when I graduate.

When did the LPC Medicare bill pass? I hadn't heard about that. One of my friends is pretty on top of it, and as of July she told me it was still being lobbied. Medicare reimbursement for individual sessions isn't spectacular, but scary as it is, it's more than some of the private MBHOs pay. (Plus, my Medicare clients tend to keep things lively b/c they always have a lot of stuff going on. )

*sigh* I think you're right about the advocacy- to some degree, it's falling by the wayside. From my own experience, I think I learned more about it during my BSSW years than my MSW. On the other hand, my state's NASW was the first to get the state legislature to give social workers title protection, which is very cool for us. So now if you don't have a BSW, LBSW, MSW, or LCSW and you use the title "social worker" or say you do "social work", you're committing a felony (class F I think?). They're hoping that this helps with image issues- example, it may not be a "social worker" removing your child from your home due to abuse/neglect, it may be a "child protection worker" with an English degree.

one thing I have been uncomfortable with regarding the variety of degrees that can sit for the counseling degree- some of them (ie, rehab counseling) have fairly different philosophies of counseling, even from each other. but also, in regards to professional education- maybe it's because of the diversity, I don't know, but they don't have as stringent requirements about field placement/practicum supervision as the MSWs do. MSWs can ONLY be supervised by MSWs; and you have to be careful about that here, b/c there is a contingent of people who got their LCSWs via "grandfathering" when the state started issuing licenses in '91 who have counseling, psychology, or nursing degrees. But a few years ago when I was working at a CMHC, I supervised a couple students- one rehab counseling, one MFT. It struck me as somehow wrong that these guys were supervised by someone from a professional in a similar yet really quite different field. any thoughts?

 

[RobinA]

Don't get me started on supervision. Because LPC is relatively new, they can't say we have to be supervised by an LPC or higher (this is coming, but there's a date that hasn't been reached yet), so we can be supervised by any related Masters, including LCSW. For my money, I want to be supervised by someone with a HIGHER degree than mine, as I think everyone should be. No LPC, no LCSW, no related degree. I want to be supervised by a psychologist. God forbid somebody of a higher degree should give anybody with a lower degree the time of day. One of my major disappointments in this field is the rigid hierarchy that exists. You can often see it on this board. I didn't expect it, I don't know why.

I currently work in-patient for my internship. Here are the Masters students, here are the social workers, here are the MDs, here are the med students. It's ridiculous.

Oh, the medicare bill passed sometime this summer. I will say that the NASW does a FAR better job of promoting social work that anybody (nobody) does of promoting LPCs. The APA doesn't acknowledge our existence. When you get right down to it, amount of education aside, we're all herd animals and we don't like anybody from the other herd. Moooo.

 

[pingouin]

Don't get me started on supervision. Because LPC is relatively new, they can't say we have to be supervised by an LPC or higher (this is coming, but there's a date that hasn't been reached yet), so we can be supervised by any related Masters, including LCSW. For my money, I want to be supervised by someone with a HIGHER degree than mine, as I think everyone should be. No LPC, no LCSW, no related degree. I want to be supervised by a psychologist. God forbid somebody of a higher degree should give anybody with a lower degree the time of day. One of my major disappointments in this field is the rigid hierarchy that exists. You can often see it on this board. I didn't expect it, I don't know why.

I currently work in-patient for my internship. Here are the Masters students, here are the social workers, here are the MDs, here are the med students. It's ridiculous.

Oh, the medicare bill passed sometime this summer. I will say that the NASW does a FAR better job of promoting social work that anybody (nobody) does of promoting LPCs. The APA doesn't acknowledge our existence. When you get right down to it, amount of education aside, we're all herd animals and we don't like anybody from the other herd. Moooo.

Double-check your state laws regarding licensure supervision. From the Missouri state statutes (where I am):

4 CSR 95-2.021 Supervisors and Supervisory Responsibilities
PURPOSE: This rule provides guidelines to licensed practitioners concerning supervising a counselor-in-training or a provisional licensed professional counselor.
(1) For the purpose of these rules, a registered supervisor for a counselor-in-training or provisional licensed professional counselor in Missouri shall be currently licensed either as a professional counselor, psychologist or
psychiatrist.

4 CSR 263-2.031 Acceptable Supervisors and Supervisor Responsibilities
PURPOSE: This rule defines an acceptable supervisor and supervisor responsibilities.
(1) An acceptable supervisor for clinical social worker licensure is a Missouri licensed clinical social worker or licensed clinical social worker from another state whose licensure laws, as determined by the committee, are equivalent to Missouri. An acceptable supervisor for baccalaureate social worker licensure is a Missouri licensed clinical social worker or licensed clinical social worker from another state, or a Missouri licensed baccalaureate social worker or licensed baccalaureate social worker from another state, whose licensure laws, as determined by the committee, are equivalent to Missouri. The acceptable supervisor cannot be a relative of the supervisee.

From a social work standpoint, I like the consistency of only being supervised by a social worker. Although lines have started to blur, what has been historically unique about social work is the concept of looking at "person-in-environment", and that's what I can give to my supervisees. I understand what you're saying regarding being supervised by a doctoral-level psychologist or psychiatrist, but I can't say that I totally agree with it, as then the supervision may not be "true" to your profession's beliefs and values.

Regarding treatment between the different levels of professionals, sure- some people don't treat others very well because of degree or licensure or whatever.. but I have worked with many wonderful LCSWs, LPCs, PhD/PsyDs, NPs and MD/DOs who value the effectiveness of working as a treatment team rather than a monarchy. I've found the best way to be treated with respect is to be competent at what you do and respect the limits of what your role is. (Although I didn't post at the time, I've seen threads here about LCSWs doing neuropsych testing- that appals me. We shouldn't be doing that as we don't have the training.)

I'm trying to get out of the herd right now. (Moo.) Loving private practice on most days. My boss even let me take today off just because I wanted to!

 

[Annakei]

Double-check your state laws regarding licensure supervision. From the Missouri state statutes (where I am):

4 CSR 95-2.021 Supervisors and Supervisory Responsibilities
PURPOSE: This rule provides guidelines to licensed practitioners concerning supervising a counselor-in-training or a provisional licensed professional counselor.
(1) For the purpose of these rules, a registered supervisor for a counselor-in-training or provisional licensed professional counselor in Missouri shall be currently licensed either as a professional counselor, psychologist or
psychiatrist.

4 CSR 263-2.031 Acceptable Supervisors and Supervisor Responsibilities
PURPOSE: This rule defines an acceptable supervisor and supervisor responsibilities.
(1) An acceptable supervisor for clinical social worker licensure is a Missouri licensed clinical social worker or licensed clinical social worker from another state whose licensure laws, as determined by the committee, are equivalent to Missouri. An acceptable supervisor for baccalaureate social worker licensure is a Missouri licensed clinical social worker or licensed clinical social worker from another state, or a Missouri licensed baccalaureate social worker or licensed baccalaureate social worker from another state, whose licensure laws, as determined by the committee, are equivalent to Missouri. The acceptable supervisor cannot be a relative of the supervisee.

From a social work standpoint, I like the consistency of only being supervised by a social worker. Although lines have started to blur, what has been historically unique about social work is the concept of looking at "person-in-environment", and that's what I can give to my supervisees. I understand what you're saying regarding being supervised by a doctoral-level psychologist or psychiatrist, but I can't say that I totally agree with it, as then the supervision may not be "true" to your profession's beliefs and values.

Regarding treatment between the different levels of professionals, sure- some people don't treat others very well because of degree or licensure or whatever.. but I have worked with many wonderful LCSWs, LPCs, PhD/PsyDs, NPs and MD/DOs who value the effectiveness of working as a treatment team rather than a monarchy. I've found the best way to be treated with respect is to be competent at what you do and respect the limits of what your role is. (Although I didn't post at the time, I've seen threads here about LCSWs doing neuropsych testing- that appals me. We shouldn't be doing that as we don't have the training.)

I'm trying to get out of the herd right now. (Moo.) Loving private practice on most days. My boss even let me take today off just because I wanted to!

Same here. I have always heard about the "totem pole" syndrome at various agencies but not where I work. I have to say that we are all a team as opposed to anyone person feeling as though they are ABOVE another. My supervisor (LICSW) is always telling our psychiatrists how to do their jobs which I find hillarious, its a personality thing with her.

Our psychiatrists are very litigation weary and my supervisor always has to remind them of the laws by which they are bound...lil off topic but if you're there you'd get a kick out of it!

 

[RobinA]

Double-check your state laws regarding licensure supervision. From the Missouri state statutes (where I am):

4 CSR 95-2.021 Supervisors and Supervisory Responsibilities
PURPOSE: This rule provides guidelines to licensed practitioners concerning supervising a counselor-in-training or a provisional licensed professional counselor.
(1) For the purpose of these rules, a registered supervisor for a counselor-in-training or provisional licensed professional counselor in Missouri shall be currently licensed either as a professional counselor, psychologist or
psychiatrist.


In PA the LPC license is too new to require one for supervision. I've worked in mental health for four years now and have never even met one. We don't even have the provisional license, which would be nice. PA is not exactly cutting edge in ANY respect.

 

[pingouin]

Same here. I have always heard about the "totem pole" syndrome at various agencies but not where I work. I have to say that we are all a team as opposed to anyone person feeling as though they are ABOVE another. My supervisor (LICSW) is always telling our psychiatrists how to do their jobs which I find hillarious, its a personality thing with her.

Our psychiatrists are very litigation weary and my supervisor always has to remind them of the laws by which they are bound...lil off topic but if you're there you'd get a kick out of it!

Annakei-

That is funny! I used to work in managed care (key words: USED TO), and one thing that our psychiatrist medical director was very firm about was that we were not to tell the doctors how to treat their patients- and that included her, too. Of course, one of my coworkers used to do that anyway, which ticked off all the psychiatrists to the nth degree (as it should), and they used to call and complain about her to our supvs.

There were times when I wished some of the docs would be more worried about liability- I had an inpatient whose doc is one of those people RobinA described who can't give you the time of day if you don't have a MD. Long story short, the patient alleged that she had been sexually assaulted and forcibly drugged (while not taking her psychotropics, of course) by her boyfriend and his friends over the course of several weeks. She is also a known personality DO and polysubstance abuser, and to hear her entire story, there were holes you could drive a Mack truck through. I was told via the UR nurse that the MD was demanding I leave him alone after I questioned for three days why no rape/sexual assault exam nor urine drug screen had been performed yet. I finally told the UR nurse to give the doc my apologies for intruding. And that if he wasn't concerned about his liability in immediately starting Tegretol without UDS results on a patient whose record reflects she had recently been injected with unknown substances, and he's willing to take the fall if she has a harmful drug interaction, then I shouldn't be so worried for him and looking out for his and the patient's best interests.

(as for the rape kit, I was informed it was over 48 hours since she had escaped her situation. to which I pointed out that even though no fluids would remain, 2 solid weeks of sexual assault by multiple perpetrators is likely to leave SOME kind of a mark that was worthy of photographing, wouldn't you think?)

 

[pingouin]

In PA the LPC license is too new to require one for supervision. I've worked in mental health for four years now and have never even met one. We don't even have the provisional license, which would be nice. PA is not exactly cutting edge in ANY respect.

If it helps, NY just got the LCSW established last year. So PA's not the only state that's just working things out now.

We have PLPC and PLCSW out here. I didn't bother- wasn't worth my time or money. The only thing it's good for is if you're in a position where you can see Medicaid patients under supervision of a licensed person. Medicaid is the only payor source I know of (other than self pay) which will reimburse a provisional. And I forget how it works, but I think the money has to go to the supervisor, who can then pay the supervisee? I'd have to ask.

 

[Deslok]

Thanks for the replies. I think I'll probably apply to the LPC program at my current school as a "backup plan." I'm not sure I'd actually do it if I did get in, but I like to keep my options open. I assume the program is less competitive than most doctoral programs in clinical psychology, but will I have a very good chance of getting in with all three of my letters coming from research professors? I only have about a year of clinical experience on a volunteer basis.