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I asked a Psychologist on another board what he thought of MSW/LCSW clinical training, this was his response:
Are MSW/LCSWs really that incompetent? It's worrisome but doesn't really seem to jive with what I've heard from others in the field...
Almost all of them lack solid clinical training as a PhD psychologist understands clinical training. They take one or two clinical sounding courses on the DSM, for example, and claim to know psychopathology but the absence of knowledge of developmental psychopathology and abnormal psych courses taught by clinical psychologists whilst one is also taking courses in psychodiagnostics clearly shows them up. After a few years some of them, the more diligent ones, learn to avoid big pitfalls, for example the studious minority realize that suicide attempt does not equal depression, that cutting does not mean borderline, but they continue to diagnose paranoid schizophrenia and antisocial pers disorder at the same time at age 22, say, and do not know differential dx. They confuse reactive types of depression with dysthymia. Also, they lack a scientific approach. They cannot understand the limitations of research, the demand characteristics of the therapy session, they value the clinical over the actuarial prediction, they want to do good but do not want to minimize harm, they lack Occam's Razor in their thinking.
The marketplace employs more of them since PhDs are expensive and hence the LCSWs and MSWs really are convinced they are worthy clinicians but I find them lacking. Finally, they do not really know what is normal so everything is pathology. Someone comes in and cries over the death of someone close to them that happened 1.5 years ago and the dx is complicated bereavement, etc. It is difficult to convince them that this person works, has a full life but was suddenly overwhelmed by the loss, so please say No Dx, it is but momentary sadness...One social work supervisee of many years's standing saw a pt for the first time, then told me the pt had bipolar dis. There was no history, no indicator. I asked her why she thought so. "But she cried, then she laughed..". I told her, "You are the therapist, that's what clients do in the therapy session, she had a good cry, and then got composed, even laughed, now she can face the world again.." She had no comprehension. This pt according to her had wild mood swings. I asked her, "where is the evidence of flight of thought, grandiosity, dark depression etc" and She had no idea what I was talking about.
Are MSW/LCSWs really that incompetent? It's worrisome but doesn't really seem to jive with what I've heard from others in the field...