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Are MSWs/LCSW really this incompetent?

Discussion in 'Psychology [Psy.D. / Ph.D.]' started by biogirl215, Dec 17, 2008.

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  1. biogirl215

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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...
     
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  3. WannaBeDrMe

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    Honestly, I'm not even going to dignify that with a response. No offense to you, of course, just saying that there are incompetent people in all fields.
     
  4. myelin

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  5. pingouin

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    I'll dignify it only to say that overgeneralization and using n=1 anecdotes to attempt to make a point don't seem much like a scientific approach, either.

    And biogirl, I really hope you recognize how inflammatory the title of this thread is.
     
  6. WannaBeDrMe

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    Changed my mind... going to speak... and offer this...

    Are all clinical psychologists as incompetent as the one you quoted in your post?

    No well trained scientist would take personal experiences and try to pawn that off as formal measurement of an outcome... much less generalize that to an entire population.

    To be so closed minded and limiting in one's thought would lead to multiple potential difficulties with working with individual clients. I suppose his 3 o'clock makes him feel that all grocery store workers are closet cutters and his 5 o'clock prevents him from taking his children to Olive Garden because of what all waiters do to the food.

    There are many crappy social workers and there are many crappy psychologists. I take huge offense to those statements b/c I am a damned good clinician, I keep up with research, I keep an open mind, I focus intensely on evolving assessments and differential diagnosis, I take issue and absolutely challenge psychiatrists and psychologists who pass on an insurance bill based on a 15 minute assessment of a patient...

    To you, biogirl, I'm not angry with you in any way but the way you posted the question really doesn't suggest a good understanding for professional communication. You are going to hear/see a lot of things in this field... you have got to be able to filter out what's important and what can be stored for later and what can be trashed. You say that this is worrisome but doesn't "jive" with what else you've heard... well, if it's n=1, why on earth would that make you jump to the conclusion that an entire group of people are incompetent?

    This field is very divided... psychiatrists talk crap about psychologists... psychologists talk crap about social workers... social workers talk crap about counselors... counselors talk crap about somebody... your responsibility is ONLY to you to be the BEST clinician you can be... it will be your choice which kind of counselor, social worker, or psychologist you become once you leave school. Don't choose the field because of how others perceive it... choose it because of the opportunities you see for yourself inside of it...
     
  7. WannaBeDrMe

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    Ha. I changed my mind and couldn't keep my mouth shut... errr... fingers still.
     
  8. biogirl215

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    I'm sorry if the title of this thread came across as inflammatory, as that REALLY, REALLY wasn't my intent--I have a ton of respect for MSWs and could very well become one. I was shocked by what the quoted poster said and also that he seemed to be speaking based off a large (though not randomized) "n." I really meant the title in a more incredulous
    way than an inflammatory one, and I sincerely apologize for any offense!

    Forgive me?
     
  9. WannaBeDrMe

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    Nothing to be forgiven... I wasn't upset with you but people are going to say things like that about your career regardless of what you choose... lawyers are the devil, teachers do nothing but play with cheerios and hershey bars, doctors are pill monkeys with no human skills... it's everywhere...

    I know the first person I ever herad bash a social worker was an undergrad mentor. My psych profs were devastated when I told them I was only applying to PsyD's and an MSW program. I think everyone expected me to have gone neurosci and not clinical at all... so, I heard alllll sorts of bashing. In fact, I probably only applied to the MSW program to spite some of them... ha.

    I've done the same thing your source has done... but I'm trying really really hard to be more mindful of that now... and honestly, I've always tried really hard to speak to individuals and not broad generalizations... still, if I bad mouth another professional... what does that say about this field... if we have problems we one another, we need to report it to the appropriate licensing boards... end of story. I once talked crap about a (for the record horrible) psychiatrist to my patients... I never got in trouble for it, but I should have... I should have BIG time. As I "grew up" in the field, I realized how damaging that could have been to my patients... I can meet them where they are and give up the expert role all day long but the fact is that they still look to me for stability...and if I split staff as well as my patients w/borderline, I'm no good to anyone on my team.

    Ok, end rant. My fave professor from grad school in my dept was a MSW and phd clinical psych (from a TOP program, TOP internship, etc)... so, obviously, she thought enough of social workers to come back and offer to train them (she turned down a position in the HIGHLY funded psych dept for the social work appointment w/leadership position)... The undergrad prof who told me to go for a MSW program was a MSW and phd psych... both of those women were brilliant before they ever went on for the second degree... and they clearly likely wouldn't have fit that dude's mold.

    Ok, end rant for real. Writing here is SO much easier than packing, wrapping, cleaning, looking for a new house, etc.
     
  10. BohuMSW

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    I'm a social worker, and there are a lot us who unfortunately meet the above description. On the other hand, it's applicable to an equal number of psychologists as well (except for the part about what classes we take). In mental health, you will never have to look far to find incompetence. This has nothing to do with the initials after one's name.
    On the other hand, you can do a great job no matter what your background.
     
  11. Therapist4Chnge

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    N=1 is a slippery slope.

    There are definitely good and not so good practitioners out there (of all degrees). I think one of the pitfalls that comes from a discussion between two (or more) training areas is that we don't know what we don't know.

    I've been lucky enough to work with some amazing Ph.D.s, Psy.D.s, and MA/MSs level people during my training, and I've also worked with people on the other end that made me wonder how someone could be so disconnected from some of the more basic things.

    This is an N=1, so obviously just anecdotal.....so take with a large grain of salt....

    I have an LCSW colleague who I trust above most others that I work with, and we actually had a discussion about training variances awhile back (I was scoring an assessment and she had a question about one of the scales....which started us talking about what kind of exposure she had with various assessment tools). The gist of the conversation was "familiarity" v. "competency" v. "mastery". She shared that when she first came out it was pretty overwhelming because she worked in a niche area and really had some ground to make up (something that I think many people may feel when they first came out). The difference seemed to be in the foundational work. Because we at the doctoral level have so much more time to be grounded in the theory, research, and assessment portions of the training, I think we are better prepared to take on the learning curve.....but we still need to commit to it. My colleague is the type of person who is ALWAYS asking questions, digging for information, and trying to better herself.....and I think that is why she is so good at what she does. Though conversely, I think many people aren't willing to put in that work, and try and get by. It may or may not be noticeable, but I think the doctoral level people have a bit more to fall back on before deficiencies show up....though they definitely still show up.

    Okay...so what do I mean with my long rambling rant.....yes I think there are differences, but ultimately it comes down to the person.
     
  12. mslinzyann

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    This is a perfect example of anecdotal evidence, and therefore in no way empircal- completely my opinion. I have seen about 4 therapists in my life and each time, the level of understanding, assessment, and the sophistication of therapy has been far more advanced with the 2 psychologists than the 2 licensed counselors. In some ways I think that licensed counselors are more able to deal with 'everyday' problems than with people who have severe/moderate psychopathology- and that is a valuable niche in the mental health system and perhaps the intent of the licensed counselor/MSW role.
    One of the most interesting things about MSWs and social work in general is that, from what I understand, you learn about the legal ins and outs of access to social services. I'm not 100% sure about this, but I do know that social workers need to be able to navigate the law. Is this, then, the niche of the social work role?
    I guess my point is that in the mental health field, there must be many niches for all...many roles to fill, ect. However, in my experiences, psychologists have been more effective therapists.
     
  13. pingouin

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    Uh, no, it would not be the "niche of the social work role". It would be one role that social workers should learn, as should any practicing counselor, psychologist, or psychiatrist. Certainly not every professional needs to know every detail about accessing services for patients/clients, but they do need to have a rudimentary understanding of what types of services are out there, what the general criteria are for accessing them, and when/how/where to refer.

    As advocacy is one of the core competencies of social work, an argument could be made that it is a role we take on more strongly than other professions, but it is certainly not our only role. In most social service agencies you're about as likely to find counselors as social workers, working at an equal level.

    If, God forbid, your post was referring to "social workers" working in state agencies to determine eligibility and benefits for programs such as WIC, TANF, Medicaid, etc, then I'd suggest you look on your state's website at the criteria needed to fill those positions. Typically it's a bachelor's degree, not a master's, and depending on the state, may be a HS diploma or an AA degree. Historically these people have been called "social workers", but they are usually NOT, and states are now passing title protection legislation which requires them to be referred to as "social service workers" (or similar).

    FWIW, n=1 that I hate so much, I actually did take a MSW elective in Social Work and the Law, which focused on duty to warn, civil commitment, and other big issues. (Forgive me, it was 11 years ago- I don't remember every last thing we covered.)
     
  14. Jon Snow

    Jon Snow Senior Member
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    Yes, but it depends on the question. The quote from the psychologist mentions diagnosis. Well, social workers probably shouldn't be doing assessment/diagnosis. Their training is inadequate for that, except under special circumstances. Social workers have two years of graduate school, one often focused on social justice. Practical experience is generally with other social workers. So, no, we shouldn't expect them to be competent at diagnosis, implementing cognitive-behavioral therapy or dialectical behavioral therapy, or insert *modality* here. I see occasionally websites from social workers where they'll go something like this.

    I specialize in:

    cognitive-behavioral therapy
    interpersonal therapy
    dialectical-behavioral therapy
    psychodynamic therapy
    EMDR
    Thought-field therapy


    The odds this person is competent are pretty close to zero.

    In fact, here's a real example I found in a google search for MSW Therapist
    Can you say quack?


    Social workers do not have the training to properly evaluate what constitutes legitimate practice and what doesn't. They should and often do serve a very important role. Case management, grief counseling, supportive therapy. Problem is, they have an effective political lobby and have managed to get status on par with psychologists in some domains. That doesn't mean they belong there.
     
  15. zird00

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    Jon Snow I think you have over stepped your bounds. I too have an MSW. Many MSWs do assessment/diagnosis after 2 years of graduate school with an additional two years of clinical supervision. Social work values do focus on social justice but our education varies by institution. Some schools specifically focus on the clinical aspects of practice, while others focus on community organization, administration, research, etc. Graduate social workers get very effective training in the modalities you mention below. The roles you suggest for social workers are indeed important but until you attend an MSW program and can speak to our skills at that point, I think it is best you leave the quacking to the ducks.:cool:
     
  16. Jon Snow

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    "Jon Snow I think you have over stepped your bounds. I too have an MSW. Many MSWs do assessment/diagnosis after 2 years of graduate school with an additional two years of clinical supervision."

    Supervision by whom... you know, never mind. I still don't see how that's enough to diagnosis/assess competently, especially, given the educational groundwork. Social work has seen an unprecedented expansion that has everything to do with politics and insurance companies and nothing to do with competence.
    Which is important, no doubt.

    "Some schools specifically focus on the clinical aspects of practice, while others focus on community organization, administration, research, etc. "

    In a limited way, very limited. . . so limited that doing things like assessment/diagnosis and advanced therapy techniques should be considered unethical.


    "The roles you suggest for social workers are indeed important but until you attend an MSW program and can speak to our skills at that point, I think it is best you leave the quacking to the ducks."

    I don't need to attend an MSW program to understand what is necessary to adequately evaluate a new therapy technique (i.e., read and understand clinical research) and what is necessary to assess mental illness. In addition to that, I've worked with many social workers. They're great. . . at case management, supportive therapy, and social advocacy. That's traditionally been the social worker's role, and it's a good one. This expansion stuff is purely financially driven. They, as a group, are not, particularly, science driven. The demographic of social work is different than other mental health fields. Do I want social workers around? Absolutely. Do I want them assessing mental illness? No way. Do I want them performing therapy beyond grief counseling without doctoral level supervision? No way.
     
    #15 Jon Snow, Dec 22, 2008
    Last edited: Dec 22, 2008
  17. Jon Snow

    Jon Snow Senior Member
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    You mean the ones I listed coming from what social workers say they're specialists in?

    Like, thought-field therapy (no empirical support) or EMDR (no empirical support for the mechanism that is sold) or "Shamanic practices and soul retrieval healing" (what the hell is that?), or how about the fact that they list so many specialties? Umm no, you can't be an expert in every treatment modality ever invented, sorry.
     
  18. Jon Snow

    Jon Snow Senior Member
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    http://www.thoughtfieldtherapy.net/

    LOL.

    There are quacks across all levels of practice, be it psychology, psychiatry, social work, or masters level counselors. The problem I have with social workers is they don't have the training to evaluate what is quackery and what isn't. To those psychologists that do these things, I say shame on them.
     
  19. Jon Snow

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    Notice something. The, by far, majority of practitioners are masters level, LCSW, MFT, LPC, MA. There are a few PsyDs, fewer PhDs, and even an MD. None, none are board certified. Welcome to mental health circa 2008. Quack-ville. Of course, you can find PhD, ABPP types out there in quak-ville too. All I can say to that is stupid knows no bounds.

    Check this out. I swear it's like the wild west out there. So disheartening for this scientist/practitioner to see. Seriously, these people suck.
     
  20. zird00

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    I think this discussion is turning to a turf war plain and simple. You can speak with any MSW and I assure you they have had evidenced based practiced POUNDED INTO their head. I will not debate the merits and proper roles of MY profession with you simply because you are threatened by well qualified expansion on our part. Yes social workers do case mgt., grief counseling, etc. but they are capable of more based on EDUCATION. And must I remind you of the litany of psychologists practicing things like

    - Thought Field Therapy
    - Hypnotism
    - Cognitive re-programming

    In any field you will find those who are qualified and those who believe they are.
     
  21. Jon Snow

    Jon Snow Senior Member
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    Threatened by well qualified expansion? No. You aren't taking me at face value and are assigning a motivation that suits your prejudice.

    Annoyed by the introduction of unqualified, incompetent, low cost providers into the market? Yes. For the record, I don't provide therapy services. Thus far, the clinical side of what I do is not threatened by MSWs. Could it be? Sure, with the proper lobbying.

    "And must I remind you of the litany of psychologists practicing things like

    - Thought Field Therapy
    - Hypnotism
    - Cognitive re-programming

    In any field you will find those who are qualified and those who believe they are. "

    I agree. Not sure hypnosis should be in there. My point is that social work education is inadequate to the task with respect to informing practitioners about what is scientific and what isn't. For example, take EMDR. It works. But, why? *insert pseudo neuro-science explanation here*. Do social workers have enough theoretical/bio background to understand the explanation is complete nonsense? Nope. Does exposure therapy work just as well without the pseudoscience thrown in? Yep. Obviously, because there are plenty of psychologists/MDs that do practice things like EMDR and thought field therapy, there are inadequacies even at the doctoral level in education. We don't need to compound the problem by giving barely educated social workers free reign in mental health.

    It's kind of like letting nurses practice primary care or even specialist care just because they have a few years experience. Hell, they at least get to observe a real doctor. Who do social workers get to see?
     
    #20 Jon Snow, Dec 22, 2008
    Last edited: Dec 22, 2008
  22. All4MyDaughter

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    This is the MSW/LCSW forum. It is inappropriate and unprofessional to bash other professions. In addition, on SDN it is a TOS violation:

    Closing this thread.
     
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