Clinical Social Worker Education and Training

[BSWdavid]

I have read several posts that suggest LCSWs don't have the training and education to provide therapy and diagnostic assessments. I am finishing up my MSW program and will say that I do understand some of what has been said. It is very difficult to reach competency in a two year program. However, course work has been evidence based, focused mostly on CBT. The DSM course was presented from a differential diagnosis perspective, and practicum has consisted of two semesters of working with clients while applying CBT techniques and differential diagnostic assessments. Furthermore, our assessments are signed off by an LCSW and again by a psychiatrist. Rarely is something questioned in the assessment.

I think it is unfortunate that social workers are pigeoned holed into the category of "case manager, supportive therapist, etc." when our education does prepare us for much more. However, I desire more depth in my training which is why I will be beginning a 4-year clinical social work PhD program that will allow me to establish the depth of knowledge and strong clinical skill set that I didn't get in the MSW program. I still wonder how I will be looked at even after I have my PhD? Sometimes I think it has more to do with looking down on another profession than anything.

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[stigmata]

Answer this w/o looking it up: What is a confidence interval and how is it used to interpret test scores?

In many states LCSWs can perform testing, but that does not mean they should. Plus you need to be aware that if you decide to do testing and assessment and your case goes to any form of legal proceeding you and your client will likely lose if the other side produces a psychologist to refute your results. It happens all the time, and I have done it.

 

[erg923]

I still wonder how I will be looked at even after I have my PhD? Sometimes I think it has more to do with looking down on another profession than anything.

Perhaps an alternative view would be territoriality, scope of practice, and economics.

I do not like the idea of a ph.d in SW having the same job description as me, not because I think his/her profession sucks, but then, what is the point of mine, right?

Clearly delineated professional roles prevents this thing from occurring in the first place...If you get a ph.d in social work, I think the ph.d should be in social work, not pseudo-clinical psychology

 

[Student4Life0]

Perhaps an alternative view would be territoriality and economics.

I do not like the idea of a ph.d in SW having the same job description as me, not because I think his/her profession sucks, but then, what is the point of mine, right? Clearly delineated professional roles prevent this thing from occurring in the first place...If you get a ph.d in social work, I think the ph.d should be in social work, not pseudo-clinical psychology

Exactly. It is just not the same training/profession. If it were...why would we have PhD programs in clinical psychology, and programs in social work? Why not just blend the two? It is different training (although yes, there are similarities), and therefore, the jobs should be different.

 

[Student4Life0]

In fact, BWS, if what you're actually interested in practicing is clinical psychology, why not switch paths and get your PhD in that instead?

 

[deleted176373]

I still wonder how I will be looked at even after I have my PhD? Sometimes I think it has more to do with looking down on another profession than anything.

If you use your degree as a Ph.D. in clinical social work to gain employment that is really in the realm of clinical psychology, you will be looked at, and rightly so, as someone who took a backdoor route to a career in clinical psychology.

If you want to be a clinical psychologist, get a degree in clinical psychology. If you want to be a clinical social worker, be it at the Master's level or Ph.D. level, then you should get a degree in clinical social work.

They are different degrees for a reason.

See below, the overlap is actually pretty narrow in that Clinical Social Workers use therapy as a tool to achieve Social Work outcomes, and not the treatment of mental illness or to provide assessment of mental abilities. On the other hand, the primary purpose of clinical psychology is NOT social change, social justice, community organizing, or social policy change. It is important to acknowledge that there is overlap, but mostly in that public health policy becomes an area of interest to both disciplines.

The International Federation of Social Workers defines Social Work as: "The social work profession promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being. Utilising theories of human behaviour and social systems, social work intervenes at the points where people interact with their environments. Principles of human rights and social justice are fundamental to social work."

Practice:

"Social work addresses the barriers, inequities and injustices that exist in society. It responds to crises and emergencies as well as to everyday personal and social problems. Social work utilizes a variety of skills, techniques, and activities consistent with its holistic focus on persons and their environments. Social work interventions range from primarily person-focused psychosocial processes to involvement in social policy, planning and development. These include counseling, clinical social work, group work, social pedagogical work, and family treatment and therapy as well as efforts to help people obtain services and resources in the community. Interventions also include agency administration, community organization and engaging in social and political action to impact social policy and economic development. The holistic focus of social work is universal, but the priorities of social work practice will vary from country to country and from time to time depending on cultural, historical, and socio-economic conditions."

On the other hand Clinical Psychologists (according to division 12)

"The field of Clinical Psychology integrates science, theory, and practice to understand, predict, and alleviate maladjustment, disability, and discomfort as well as to promote human adaptation, adjustment, and personal development. Clinical Psychology focuses on the intellectual, emotional, biological, psychological, social, and behavioral aspects of human functioning across the life span, in varying cultures, and at all socioeconomic levels."

Practice:
"The Clinical Psychologist is educated and trained to generate and integrate scientific and professional knowledge and skills so as to further psychological science, the professional practice of psychology, and human welfare. Clinical Psychologists are involved in research, teaching and supervision, program development and evaluation, consultation, public policy, professional practice, and other activities that promote psychological health in individuals, families, groups, and organizations. Their work can range from prevention and early intervention of minor problems of adjustment to dealing with the adjustment and maladjustment of individuals whose disturbance requires then to be institutionalized.

Practitioners of Clinical Psychology work directly with individuals at all developmental levels (infants to older adults), as well as groups (families, patients of similar psychopathology, and organizations), using a wide range of assessment and intervention methods to promote mental health and to alleviate discomfort and maladjustment.

Researchers study the theory and practice of Clinical Psychology, and through their publications, document the empirical base of Clinical Psychology. Consultants, Teachers, and Clinical Supervisors share the Clinical Psychology knowledge base with students, other professionals, and non-professionals. Clinical Psychologists also engage in program development, evaluate Clinical Psychology service delivery systems, and analyze, develop, and implement public policy on all areas relevant to the field of Clinical Psychology. Many Clinical Psychologists combine these activities.

Assessment in Clinical Psychology involves determining the nature, causes, and potential effects of personal distress; of personal, social, and work dysfunctions; and the psychological factors associated with physical, behavioral, emotional, nervous, and mental disorders. Examples of assessment procedures are interviews, behavioral assessments, and the administration and interpretation of tests of intellectual abilities, aptitudes, personal characteristics, and other aspects of human experience and behavior relative to disturbance.

Interventions in Clinical Psychology are directed at preventing, treating, and correcting emotional conflicts, personality disturbances, psychopathology, and the skill deficits underlying human distress or dysfunction. Examples of intervention techniques include psychotherapy, psychoanalysis, behavior therapy, marital and family therapy, group therapy, biofeedback, cognitive retraining and rehabilitation, social learning approaches, and environmental consultation and design. The goal of intervention is to promote satisfaction, adaptation, social order, and health."

 

[BSWdavid]

If you use your degree as a Ph.D. in clinical social work to gain employment that is really in the realm of clinical psychology, you will be looked at, and rightly so, as someone who took a backdoor route to a career in clinical psychology.

If you want to be a clinical psychologist, get a degree in clinical psychology. If you want to be a clinical social worker, be it at the Master's level or Ph.D. level, then you should get a degree in clinical social work.

They are different degrees for a reason.

See below, the overlap is actually pretty narrow in that Clinical Social Workers use therapy as a tool to achieve Social Work outcomes, and not the treatment of mental illness or to provide assessment of mental abilities. On the other hand, the primary purpose of clinical psychology is NOT social change, social justice, community organizing, or social policy change. It is important to acknowledge that there is overlap, but mostly in that public health policy becomes an area of interest to both disciplines.

The International Federation of Social Workers defines Social Work as: "The social work profession promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being. Utilising theories of human behaviour and social systems, social work intervenes at the points where people interact with their environments. Principles of human rights and social justice are fundamental to social work."

Practice:

"Social work addresses the barriers, inequities and injustices that exist in society. It responds to crises and emergencies as well as to everyday personal and social problems. Social work utilizes a variety of skills, techniques, and activities consistent with its holistic focus on persons and their environments. Social work interventions range from primarily person-focused psychosocial processes to involvement in social policy, planning and development. These include counseling, clinical social work, group work, social pedagogical work, and family treatment and therapy as well as efforts to help people obtain services and resources in the community. Interventions also include agency administration, community organization and engaging in social and political action to impact social policy and economic development. The holistic focus of social work is universal, but the priorities of social work practice will vary from country to country and from time to time depending on cultural, historical, and socio-economic conditions."

On the other hand Clinical Psychologists (according to division 12)

"The field of Clinical Psychology integrates science, theory, and practice to understand, predict, and alleviate maladjustment, disability, and discomfort as well as to promote human adaptation, adjustment, and personal development. Clinical Psychology focuses on the intellectual, emotional, biological, psychological, social, and behavioral aspects of human functioning across the life span, in varying cultures, and at all socioeconomic levels."

Practice:
"The Clinical Psychologist is educated and trained to generate and integrate scientific and professional knowledge and skills so as to further psychological science, the professional practice of psychology, and human welfare. Clinical Psychologists are involved in research, teaching and supervision, program development and evaluation, consultation, public policy, professional practice, and other activities that promote psychological health in individuals, families, groups, and organizations. Their work can range from prevention and early intervention of minor problems of adjustment to dealing with the adjustment and maladjustment of individuals whose disturbance requires then to be institutionalized.

Practitioners of Clinical Psychology work directly with individuals at all developmental levels (infants to older adults), as well as groups (families, patients of similar psychopathology, and organizations), using a wide range of assessment and intervention methods to promote mental health and to alleviate discomfort and maladjustment.

Researchers study the theory and practice of Clinical Psychology, and through their publications, document the empirical base of Clinical Psychology. Consultants, Teachers, and Clinical Supervisors share the Clinical Psychology knowledge base with students, other professionals, and non-professionals. Clinical Psychologists also engage in program development, evaluate Clinical Psychology service delivery systems, and analyze, develop, and implement public policy on all areas relevant to the field of Clinical Psychology. Many Clinical Psychologists combine these activities.

Assessment in Clinical Psychology involves determining the nature, causes, and potential effects of personal distress; of personal, social, and work dysfunctions; and the psychological factors associated with physical, behavioral, emotional, nervous, and mental disorders. Examples of assessment procedures are interviews, behavioral assessments, and the administration and interpretation of tests of intellectual abilities, aptitudes, personal characteristics, and other aspects of human experience and behavior relative to disturbance.

Interventions in Clinical Psychology are directed at preventing, treating, and correcting emotional conflicts, personality disturbances, psychopathology, and the skill deficits underlying human distress or dysfunction. Examples of intervention techniques include psychotherapy, psychoanalysis, behavior therapy, marital and family therapy, group therapy, biofeedback, cognitive retraining and rehabilitation, social learning approaches, and environmental consultation and design. The goal of intervention is to promote satisfaction, adaptation, social order, and health."

First off, The International Federation of Social Workers isn't really the best example. Secondly, The NASW defines clinical social work as: Clinical social work has a primary focus on the mental, emotional, and behavioral well-being of individuals, couples, families, and groups. It centers on a holistic approach to psychotherapy and the client's relationship to his or her environment. Clinical social work views the client's relationship with his or her environment as essential to treatment planning.

Clinical social work is the professional application of social work theory and methods to the diagnosis, treatment, and prevention of psychosocial dysfunction, disability, or impairment, including emotional, mental, and behavioral disorders (Barker, 2003).

 

[BSWdavid]

Perhaps an alternative view would be territoriality, scope of practice, and economics.

I do not like the idea of a ph.d in SW having the same job description as me, not because I think his/her profession sucks, but then, what is the point of mine, right?

Clearly delineated professional roles prevents this thing from occurring in the first place...If you get a ph.d in social work, I think the ph.d should be in social work, not pseudo-clinical psychology

How is this any different than when psychology infringed on psychiatry? Now psychologists want prescription rights - the hypocrisy amazes me!

Psychotherapy doesn't belong to psychology.

 

[BSWdavid]

If you use your degree as a Ph.D. in clinical social work to gain employment that is really in the realm of clinical psychology, you will be looked at, and rightly so, as someone who took a backdoor route to a career in clinical psychology.

If you want to be a clinical psychologist, get a degree in clinical psychology. If you want to be a clinical social worker, be it at the Master's level or Ph.D. level, then you should get a degree in clinical social work.

They are different degrees for a reason.

See below, the overlap is actually pretty narrow in that Clinical Social Workers use therapy as a tool to achieve Social Work outcomes, and not the treatment of mental illness or to provide assessment of mental abilities. On the other hand, the primary purpose of clinical psychology is NOT social change, social justice, community organizing, or social policy change. It is important to acknowledge that there is overlap, but mostly in that public health policy becomes an area of interest to both disciplines.

The International Federation of Social Workers defines Social Work as: "The social work profession promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being. Utilising theories of human behaviour and social systems, social work intervenes at the points where people interact with their environments. Principles of human rights and social justice are fundamental to social work."

Practice:

"Social work addresses the barriers, inequities and injustices that exist in society. It responds to crises and emergencies as well as to everyday personal and social problems. Social work utilizes a variety of skills, techniques, and activities consistent with its holistic focus on persons and their environments. Social work interventions range from primarily person-focused psychosocial processes to involvement in social policy, planning and development. These include counseling, clinical social work, group work, social pedagogical work, and family treatment and therapy as well as efforts to help people obtain services and resources in the community. Interventions also include agency administration, community organization and engaging in social and political action to impact social policy and economic development. The holistic focus of social work is universal, but the priorities of social work practice will vary from country to country and from time to time depending on cultural, historical, and socio-economic conditions."

On the other hand Clinical Psychologists (according to division 12)

"The field of Clinical Psychology integrates science, theory, and practice to understand, predict, and alleviate maladjustment, disability, and discomfort as well as to promote human adaptation, adjustment, and personal development. Clinical Psychology focuses on the intellectual, emotional, biological, psychological, social, and behavioral aspects of human functioning across the life span, in varying cultures, and at all socioeconomic levels."

Practice:
"The Clinical Psychologist is educated and trained to generate and integrate scientific and professional knowledge and skills so as to further psychological science, the professional practice of psychology, and human welfare. Clinical Psychologists are involved in research, teaching and supervision, program development and evaluation, consultation, public policy, professional practice, and other activities that promote psychological health in individuals, families, groups, and organizations. Their work can range from prevention and early intervention of minor problems of adjustment to dealing with the adjustment and maladjustment of individuals whose disturbance requires then to be institutionalized.

Practitioners of Clinical Psychology work directly with individuals at all developmental levels (infants to older adults), as well as groups (families, patients of similar psychopathology, and organizations), using a wide range of assessment and intervention methods to promote mental health and to alleviate discomfort and maladjustment.

Researchers study the theory and practice of Clinical Psychology, and through their publications, document the empirical base of Clinical Psychology. Consultants, Teachers, and Clinical Supervisors share the Clinical Psychology knowledge base with students, other professionals, and non-professionals. Clinical Psychologists also engage in program development, evaluate Clinical Psychology service delivery systems, and analyze, develop, and implement public policy on all areas relevant to the field of Clinical Psychology. Many Clinical Psychologists combine these activities.

Assessment in Clinical Psychology involves determining the nature, causes, and potential effects of personal distress; of personal, social, and work dysfunctions; and the psychological factors associated with physical, behavioral, emotional, nervous, and mental disorders. Examples of assessment procedures are interviews, behavioral assessments, and the administration and interpretation of tests of intellectual abilities, aptitudes, personal characteristics, and other aspects of human experience and behavior relative to disturbance.

Interventions in Clinical Psychology are directed at preventing, treating, and correcting emotional conflicts, personality disturbances, psychopathology, and the skill deficits underlying human distress or dysfunction. Examples of intervention techniques include psychotherapy, psychoanalysis, behavior therapy, marital and family therapy, group therapy, biofeedback, cognitive retraining and rehabilitation, social learning approaches, and environmental consultation and design. The goal of intervention is to promote satisfaction, adaptation, social order, and health."

When did psychotherapy, clinical assessment, etc. become the domain of clinical psychology? Psychiatrists were doing this long before psychologists were. Many of the "fathers" of current psychological assessment and technique were not even psychologists (i.e. Sigmund Freud and Aaron Beck). One might ask, why didn't clinical psychologists become psychiatrists if they want to treat mental disorders, prescribe medications, etc?

As a note, I don't agree with clinical social workers performing psychological testing. I agree that this is the domain of psychology and should remain so.

 

[deleted176373]

How is this any different than when psychology infringed on psychiatry? Now psychologists want prescription rights - the hypocrisy amazes me!

Psychotherapy doesn't belong to psychology.

The difference is that psychologists who want prescription rights are willing to undergo training specifically in pharmacology and practice in a VERY limited area. That said, I don't think that prescription privileges in general is good for the clinical psychology community in general. There are limited roles for this certification, such as in the military. In deployed settings the operational limitations of bringing psychiatry to the field in suitable numbers might justify the use of psychologists with additional training with the ability to prescribe.

Just as I believe that if a Ph.D. level social worker or psychologist from outside of clinical psychology participates in a re-specialization program. I see little to no problem with it... but to backdoor your way into psychiatry is no less wrong than backdooring your way into clinical psychology.

Mark

 

[deleted176373]

When did psychotherapy, clinical assessment, etc. become the domain of clinical psychology? Psychiatrists were doing this long before psychologists were. Many of the "fathers" of current psychological assessment and technique were not even psychologists (i.e. Sigmund Freud and Aaron Beck). One might ask, why didn't clinical psychologists become psychiatrists if they want to treat mental disorders, prescribe medications, etc?

As a note, I don't agree with clinical social workers performing psychological testing. I agree that this is the domain of psychology and should remain so.

Wow, really hit a nerve, didn't I.

Why are you so adamant about forcing yourself into the role of clinical psychologist through a degree in clinical social work? Perhaps you should ask yourself that.

Mark

 

[BSWdavid]

The difference is that psychologists who want prescription rights are willing to undergo training specifically in pharmacology and practice in a VERY limited area. That said, I don't think that prescription privileges in general is good for the clinical psychology community in general. There are limited roles for this certification, such as in the military. In deployed settings the operational limitations of bringing psychiatry to the field in suitable numbers might justify the use of psychologists with additional training with the ability to prescribe.

Just as I believe that if a Ph.D. level social worker or psychologist from outside of clinical psychology participates in a re-specialization program. I see little to no problem with it... but to backdoor your way into psychiatry is no less wrong than backdooring your way into clinical psychology.

Mark

I don't see a PhD in clinical social work as a backdoor into clinical psychology. The license is still LCSW and scope of practice doesn't change. What does change is the expertise in a particular psychotherapeutic modality. It seems as though your argument is that psychologists are the only ones properly trained to diagnose and treat mental disorders, and should have exclusive rights to such professional practices, however, I have failed to produce a single research study that supports such a claim.

 

[BSWdavid]

Wow, really hit a nerve, didn't I.

Why are you so adamant about forcing yourself into the role of clinical psychologist through a degree in clinical social work? Perhaps you should ask yourself that.

Mark

No nerve has been hit. I have no desire to be a clinical psychologist.

 

[BSWdavid]

Answer this w/o looking it up: What is a confidence interval and how is it used to interpret test scores?

In many states LCSWs can perform testing, but that does not mean they should. Plus you need to be aware that if you decide to do testing and assessment and your case goes to any form of legal proceeding you and your client will likely lose if the other side produces a psychologist to refute your results. It happens all the time, and I have done it.

You are absolutely right; I have no idea what that is. I also have no interest in psychological testing. I agree that this should be limited to clinical psychologists.

 

[erg923]

Many of the "fathers" of current psychological assessment and technique were not even psychologists (i.e. Sigmund Freud and Aaron Beck). One might ask, why didn't clinical psychologists become psychiatrists if they want to treat mental disorders, prescribe medications, etc?

First, that's pretty inaccurate. I am unaware of what scales Freud developed and Beck put together a self-report depression checklist and a self-report anxiety scale. I would not call that assessment, would you? "Assessment" is the conceptual integration of multiple pieces of data, one of which is statistically sound data from psychometric instruments. Sure, psychiatrists and other disciplines have participated, but assessment via psychometric instruments has really been lead and refined by psychologists since the early 1900's-Thordike, Cattel, Wechsler, Hathaway, Meehl, Kaplan, etc, etc.

Second, and MUCH more importantly, WHO GIVES A ****! How is this at all relevant to modern day practice? Neuropsychpology was largely pioneered by experientalists and behavioral neurologists, BUT these people are no longer qualified to practice clinical neuropsychology for reasons too plentiful to get into here. Should this be a viable reason to change training guidelines for them should they develop sudden interest in practicing again?

 

[BSWdavid]

First, that's pretty inaccurate. I am unaware of what scales Freud developed and Beck put together a self-report depression checklist and a self0report anxiety scale. I would not call that assessment, would you? "Assessment" is the conceptual integration of multiple pieces of data, one of which is statistically sound data from psychometric instruments. Sure, psychiatrists and other disciplines have participated, but assessment via psychometric instruments has really been lead and refined by psychologists since the early 1900's-Thordike, Cattel, Wechsler, Hathaway, Meehl, Kaplan, etc, etc.

Second, and MUCH more importantly, WHO GIVES A ****! How is this at all relevant to modern day practice? Neuropsychpology was largely pioneered by experientalists and behavioral neurologists, BUT these people are no longer qualified to practice clinical neuropsychology for reasons too plentiful to get into here. Should this be a viable reason to change training guidelines for them should they develop sudden interest in practicing again?

The point I am attempting to make is that mental health assessment and treatment is not, and has never been exclusive to clinical psychology. Mental health treatment is a multidisciplinary field. In fact, 60% of therapists are clinical social workers, not psychologists.

 

[Student4Life0]

The point I am attempting to make is that mental health assessment and treatment is not, and has never been exclusive to clinical psychology. Mental health treatment is a multidisciplinary field. In fact, 60% of therapists are clinical social workers, not psychologists.

That's in part due to the current sad state of managed care. You can get away with paying them less. Am I wrong about that?

 

[BSWdavid]

That's in part due to the current sad state of managed care. You can get away with paying them less. Am I wrong about that?

No, that is partially correct. But that is also one of the reasons that psychiatrists were slowly pushed out of psychotherapy.

 

[BSWdavid]

You know, the Beck family is quite inspirational to me. I had a chance to meet with Aaron and Judith Beck at a workshop in Philadelphia and I asked the pair of them, "What is your take on the turf war between the different mental health professions?" I got a strange look from Aaron Beck and he responded by saying "I think we all have a unique perspective to bring to the field. There's a lot of human suffering and we need as many people as we can find to help alleviate problems." - I am paraphrasing of course. What I think is interesting about the Becks is that Aaron Beck is a psychiatrist, Judith Beck a psychologist, and Dan Beck a clinical social worker. I wonder if they fight over who should be assessing and treating mental health.

 

[edieb]

You know, the Beck family is quite inspirational to me. I had a chance to meet with Aaron and Judith Beck at a workshop in Philadelphia and I asked the pair of them, "What is your take on the turf war between the different mental health professions?" I got a strange look from Aaron Beck and he responded by saying "I think we all have a unique perspective to bring to the field. There's a lot of human suffering and we need as many people as we can find to help alleviate problems." - I am paraphrasing of course. What I think is interesting about the Becks is that Aaron Beck is a psychiatrist, Judith Beck a psychologist, and Dan Beck a clinical social worker. I wonder if they fight over who should be assessing and treating mental health.

Their statement said each profession has a unique perspective. In other words, social work = case management, psychiatrist = prescribing, psychologist = testing, prescribing, psychotherapy, assessment, management of other mental health professions, program evaluation, etc

 

[BSWdavid]

Their statement said each profession has a unique perspective. In other words, social work = case management, psychiatrist = prescribing, psychologist = testing, prescribing, psychotherapy, assessment, management of other mental health professions, program evaluation, etc

I am sorry but that is not what they said. They are training clinical social workers to perform cognitive therapy. Social work does not = case management. I think it is interesting that you equate psychiatrists into prescribing, social workers into managing cases, but psychologists into multiple roles. Wow, what an ego!

 

[BSWdavid]

Daniel Beck, an LICSW, is a cognitive therapist in private practice, a founding fellow of the Academy of Cognitive Therapy, senior supervisor at the Beck Institute, and an instructor at Tufts Univ. Medical School

 

[Student4Life0]

I don't understand why anybody is even feeding into this arguement. BSW...if you want to be a psychologist so bad (which on some level, you must, because you are trying to fill the job description of one), then go get your PhD/PsyD in clinical. If not, then no..you are not qualified to fill the same job description. Social worker = social worker. Psychologist = psychologist. What is the confusion?

 

[edieb]

Daniel Beck, an LICSW, is a cognitive therapist in private practice, a founding fellow of the Academy of Cognitive Therapy, senior supervisor at the Beck Institute, and an instructor at Tufts Univ. Medical School

that's good for him

 

[BSWdavid]

It is amazing how so many of the psychologists and psychology students on here have such large egos! No, I don't want to be a psychologist!!! That doesn't mean that I can't assess and treat mental disorders; this is not the exclusive right afforded to psychologists. What part of that don't you understand?

 

[Student4Life0]

It is amazing how so many of the psychologists and psychology students on here have such large egos! No, I don't want to be a psychologist!!! That doesn't mean that I can't assess and treat mental disorders; this is not the exclusive right afforded to psychologists. What part of that don't you understand?

I think that is exactly what it means. Or that at least you cannot do it with the same level of competence that a psychologist who went to school for 5+ years to earn a doctoral degree can. It would be silly to think that you could.

 

[Student4Life0]

It just seems these days that everybody is trying to sneak in the backdoor. And I suppose it is becoming easier and easier. Masters level clinicians and social workers are being given more and more responsibility, and it all comes down to money/insurance. I think it is a really sad state of affairs. Being somebody that is currently at the MA level, I sometimes wonder why I am even bothering to attempt to pursue a doctoral degree. Is there really a point these days? Who knows. I have decided that yes, for me there is a point, because I want the high level of training/competency, as well as the research experience in evidence based practice.

I don't know. This still seems like a silly argument to me...comparing apples and oranges.

 

[edieb]

Yes, it is sad. However, many ppl know the difference. Where I work I always have patients tell me the want to see a PhD not a social worker. Thus, there will always be a segment of the population who knows the difference in training, stringency of admission requirements, et cetera

It just seems these days that everybody is trying to sneak in the backdoor. And I suppose it is becoming easier and easier. Masters level clinicians and social workers are being given more and more responsibility, and it all comes down to money/insurance. I think it is a really sad state of affairs. Being somebody that is currently at the MA level, I sometimes wonder why I am even bothering to attempt to pursue a doctoral degree. Is there really a point these days? Who knows. I have decided that yes, for me there is a point, because I want the high level of training/competency, as well as the research experience in evidence based practice.

I don't know. This still seems like a silly argument to me...comparing apples and oranges.

 

[edieb]

It is amazing how so many of the psychologists and psychology students on here have such large egos! No, I don't want to be a psychologist!!! That doesn't mean that I can't assess and treat mental disorders; this is not the exclusive right afforded to psychologists. What part of that don't you understand?

BTW, why is your status listed as "Psychology Student"? I thought you didn't want to be a psychologist

 

[BSWdavid]

As I continue to respond to these posts, I wonder, is it even possible to get any of you to understand my point? I hear time and again that social workers and masters level clinicians cannot perform as well as psychologists, but I have yet to have been presented with evidence to support this claim. For a profession as dedicated to empirical evidence as has been noted, it seems counter-intuitive that so much of what has been posted on this forum has been emotionally driven vs. empirically supported.

Some of the best clinicians that I have known have been the ones who have ignored professional boundaries and have set their personal interests aside. Does anyone here make the claim that Aaron Beck is an inferior clinician because he is a psychiatrist and not a psychologist? I read a quote recently that Nancy McWilliams, a well-respected psychoanalytic author, clinician, and professor, was trained and mentored by a psychoanalyst-clinical social worker. I have met many inferior clinicians; some clinical social workers, some psychiatrists, and some psychologists. In the end, does it matter so much which profession we belong to? I think the really good therapists tend to transcend their respective professions. I doubt Freud's training was all that impressive compared to today's standards, yet we don't dismiss the contributions he has made to the professions.

 

[Student4Life0]

Yes, it is sad. However, many ppl know the difference. Where I work I always have patients tell me the want to see a PhD not a social worker. Thus, there will always be a segment of the population who knows the difference in training, stringency of admission requirements, et cetera

Very true. To be honest, at the end of the day, I know the difference. And that is enough to make me want to continue on with my education. Plus...I'm a bit of a nerd and I enjoy being in school

 

[BSWdavid]

BTW, why is your status listed as "Psychology Student"? I thought you didn't want to be a psychologist

I don't want to be a psychologist. I was a psych MA student when I created this profile but switched to the MSW program after realizing that at the masters level, an MSW was preferred over an MA in psych. i also wanted more clinical experience than the MA program afforded.

 

[edieb]

I don't want to be a psychologist. I was a psych MA student when I created this profile but switched to the MSW program after realizing that at the masters level, an MSW was preferred over an MA in psych. i also wanted more clinical experience than the MA program afforded.

that's good for you

 

[Student4Life0]

I don't want to be a psychologist. I was a psych MA student when I created this profile but switched to the MSW program after realizing that at the masters level, an MSW was preferred over an MA in psych. i also wanted more clinical experience than the MA program afforded.

It's funny because I went through the same struggle not too long ago, when I had to choose between an MSW program and my current MA clinical program. I gained admission into both, and was told time and time again (even by professors) that an MSW is preferred over an MA in clinical. That I would have more job offers, opportunities, etc. It seemed to make more sense to just go to the MSW program, but after an open house, I was very turned off. The concentration was actually called "case management" and the program had relatively very little clinical therapy/assessment training. What is even scarier is that most of the clinicians employed at the local (well respected) psychiatric hospital got their MSWs from that very same program. In the end, I opted to take the more difficult path, and ended up in my MA program.

That being said, I imagine that your program is more clinical in nature, as I know that some MSW programs are. However, I think my experience is part of why I have a stigma against the MSW degree.

 

[BSWdavid]

It's funny because I went through the same struggle not too long ago, when I had to choose between an MSW program and my current MA clinical program. I gained admission into both, and was told time and time again (even by professors) that an MSW is preferred over an MA in clinical. That I would have more job offers, opportunities, etc. It seemed to make more sense to just go to the MSW program, but after an open house, I was very turned off. The concentration was actually called "case management" and the program had relatively very little clinical therapy/assessment training. What is even scarier is that most of the clinicians employed at the local (well respected) psychiatric hospital got their MSWs from that very same program. In the end, I opted to take the more difficult path, and ended up in my MA program.

That being said, I imagine that your program is more clinical in nature, as I know that some MSW programs are. However, I think my experience is part of what helped me form my stigma against the MSW degree.

Your experience is understandable. Unfortunately, programs tend to very in their clinical exposure. State licensure laws very greatly in social work, so some programs get away with offering less clinical rigor. There have been a couple of courses that weren't offered in my swk program which I took through the psych dept. Our program has its weaknesses, but we have some great faculty members with a broad range of experience and expertise.

 

[psich]

Psychotherapy doesn't belong to psychology.

Then what does belong to psychology? Is it just testing?

No nerve has been hit. I have no desire to be a clinical psychologist.

Then what, in your eyes, is the difference between what you want to do and what a psychologist does? Testing? Honestly, apart from that there seems to be so much overlap based on what you've shared that there is no room for any distinction between the fields. Many psychologists do not do assessments but perform psychotherapy.

It is amazing how so many of the psychologists and psychology students on here have such large egos! No, I don't want to be a psychologist!!! That doesn't mean that I can't assess and treat mental disorders; this is not the exclusive right afforded to psychologists. What part of that don't you understand?

Are you sure we didn't hit a nerve?

 

[BSWdavid]

Then what does belong to psychology? Is it just testing?

Then what, in your eyes, is the difference between what you want to do and what a psychologist does? Testing? Honestly, apart from that there seems to be so much overlap based on what you've shared that there is no room for any distinction between the fields. Many psychologists do not do assessments but perform psychotherapy.

Are you sure we didn't hit a nerve?

No nerve, but a bit tired of trying to make my point clear when it has become apparent none are interested in my point. I am saddened that it has come down to this. Our professions are at each others' throats and I wish it could be different, but I realize now that some don't want it to be different. I guess the good news is that I can move forward with my career despite what some on here believe.

 

[loveoforganic]

The double standard here is kind of silly. I think we can all agree that ability in a particular area is training dependent, degree independent. With adequate training, a psychologist is going to be able to safely and efficaciously prescribe psychotropics. Is adequate training the full brunt of medical school and psychiatry residency or can it be trimmed down? With adequate training, a Doctor of SW is going to be able to safely and efficaciously administer psychotherapy, or even psychometrics. Is adequate training the full brunt of a PhD/PsyD or can it be trimmed down to allow them to work in one of these areas?

The issue is who's going to determine what's enough? Social workers certainly aren't going to let themselves fall under psychology licensing boards if those boards aren't going to perceive their training as adequate, similar to how CRNA's aren't going to be volunteering to go under the board of medicine and take the steps and anesthesiology boards. People always look out for number one.

Edit: edie's outline of the roles of the various providers is particularly amusing.

 

[BSWdavid]

The double standard here is kind of silly. I think we can all agree that ability in a particular area is training dependent, degree independent. With adequate training, a psychologist is going to be able to safely and efficaciously prescribe psychotropics. Is adequate training the full brunt of medical school and psychiatry residency or can it be trimmed down? With adequate training, a Doctor of SW is going to be able to safely and efficaciously administer psychotherapy, or even psychometrics. Is adequate training the full brunt of a PhD/PsyD or can it be trimmed down to allow them to work in one of these areas?

The issue is who's going to determine what's enough? Social workers certainly aren't going to let themselves fall under psychology licensing boards if those boards aren't going to perceive their training as adequate, similar to how CRNA's aren't going to be volunteering to go under the board of medicine and take the steps and anesthesiology boards. People always look out for number one.

Edit: edie's outline of the roles of the various providers is particularly amusing.

Finally, someone with a fresh perspective!

 

[stigmata]

So how would a non-psychologist gain competence in assessment? CME/CEUs? I have attended over 100 neurology CMEs: can I not put in a spinal cord stimulator device?

 

[Therapist4Chnge]

So how would a non-psychologist gain competence in assessment? CME/CEUs? I have attended over 100 neurology CMEs: can I not put in a spinal cord stimulator device?

Exactly.

I attend weekly brain cuttings, neurology rounds, review dozens of MRIs, CT scans, etc....does that qualify me to be a neurologist, absolutely not.

 

[cara susanna]

You know, the Beck family is quite inspirational to me. I had a chance to meet with Aaron and Judith Beck at a workshop in Philadelphia and I asked the pair of them, "What is your take on the turf war between the different mental health professions?" I got a strange look from Aaron Beck and he responded by saying "I think we all have a unique perspective to bring to the field. There's a lot of human suffering and we need as many people as we can find to help alleviate problems." - I am paraphrasing of course. What I think is interesting about the Becks is that Aaron Beck is a psychiatrist, Judith Beck a psychologist, and Dan Beck a clinical social worker. I wonder if they fight over who should be assessing and treating mental health.

You know why I think he said that? He's employed. It's nice to think about this ideal world where everyone has their piece of the work and we all do it together, but the reality is that psychologists are being pushed out of their jobs by people who have less training. And whether you think it's a good idea or not, you can't really expect us to be happy about the fact that we spend 5+ years in school and have less job prospects than someone with a 2-3 year Masters.

 

[Student4Life0]

You know why I think he said that? He's employed. It's nice to think about this ideal world where everyone has their piece of the work and we all do it together, but the reality is that psychologists are being pushed out of their jobs by people who have less training. And whether you think it's a good idea or not, you can't really expect us to be happy about the fact that we spend 5+ years in school and have less job prospects than someone with a 2-3 year Masters.

That is really the part that bothers me about this whole thing. I am finishing up my masters right now, and planning to hopefully continue on with my doctorate next fall. Will I have less job prospects than my classmates? The majority of them are stopping at the masters, and looking to get the LPC. And they will push us all out of jobs one day..

 

[loveoforganic]

So how would a non-psychologist gain competence in assessment? CME/CEUs? I have attended over 100 neurology CMEs: can I not put in a spinal cord stimulator device?

You're jumping into specifics while I remained vague. If you're trying to provide a surgical technique as an example and really want some sort of counter point, look at dpm's and their scope of practice/regulation relative to ortho's. With an intense neuropsychological/anatomy background, hey, maybe you CAN become qualified to do that procedure with additional training different and maybe even less than 4 years of medical school and 4 years of residency.

The only thing that's going to stop you from trying to learn and perform that procedure (assuming the practice of which is lucrative and seen as equally enjoyable to other treatments to perform) is inability to be reimbursed for your work and a fear of being successfully sued.

 

[erg923]

Speaking of McWilliams, your incessant need to put everyone on an equal playing field and obliterate the strengths and skill sets that are unique to each profession would be an interesting psychobabble hour for you.

You have started threads like this before, and I do not understand why? You are simply rehashing things that we already know and that we simply have fundamental disagreements about. To sum up: Yes, yes, all the aforementioned professions have role in the mental healthcare. Yes, SW can indeed be good therapists. This is obvious and no one disputes this. Some disciplines are more extensively trained in certain areas or techniques (ie., multilevel cognitive assessment). Not everyone is equal in their breadth and depth of training at the present time. This is the way its is. Deal.

 

[stigmata]

You're jumping into specifics while I remained vague. If you're trying to provide a surgical technique as an example and really want some sort of counter point, look at dpm's and their scope of practice/regulation relative to ortho's. With an intense neuropsychological/anatomy background, hey, maybe you CAN become qualified to do that procedure with additional training different and maybe even less than 4 years of medical school and 4 years of residency.

The only thing that's going to stop you from trying to learn and perform that procedure (assuming the practice of which is lucrative and seen as equally enjoyable to other treatments to perform) is inability to be reimbursed for your work and a fear of being successfully sued.

Yep, same for LCSWs doing assessment.

 

[futureapppsy2]

As someone who received a BSW myself and knew many MSW students through my undergrad internship, I have a healthy respect for social work, and I think there are many talented social worker clinicians out there. However, social work training isn't nearly as comprehensive or as focused as doctoral training in clinical, counseling, or school psych. For example, most MSW students I knew took maybe 3 or 4, at most, classes in psychopathology, assessment/interviewing, and treatment and had at most 900 hours of clinical practica (if they did both of their practica at clinical sites--many had or chose to do one practicum placement that wasn't traditionally clinical). Contrast that to my school psych PhD program, where we take three psychopathology or therapy courses and three assessment classes in the first year alone and get more then twice as many hours of that on just internship, not including the 3+ years of pre-internship practica we're required to have. Additionally, I really do think psychologists are much better trained in reading and understanding research and psychometrics than MSWs are--most MSW programs require a class (or maybe two) in research methods, whereas we're required to take, at minimum, three classes in stats and two in psychometrics/research methods. Anecdotally, I don't think most social workers, particularly MSWs, are trained to go to or really understand the literature when looking at interventions, and I think that's a weakness in the training as well.

Of course, there are exceptions to all of these things--I work with a Social Work PhD who is in a 100% research position and who I have the utmost respect for-- and there are some LCSWs who are probably better therapists than some psychologists. In general, I think the Social Work training is fundamentally different from psychology training (more training in social justice and social systems, less training in clinical skills) and that doctoral training is fundamentally different from masters-level training in depth and breadth. Also, I've known many BSW and MSW students who had no real interest in therapy but passion for other aspects of social work.

 

[loveoforganic]

Yep, same for LCSWs doing assessment.

I don't think you understand the point I was making? Or maybe I'm not seeing what point you're trying to make with my post?

 

[stigmata]

"The only thing that's going to stop you from trying to learn and perform that procedure (assuming the practice of which is lucrative and seen as equally enjoyable to other treatments to perform) is inability to be reimbursed for your work and a fear of being successfully sued"

 

[loveoforganic]

Ah, gotcha. Well we're in agreement there. I'll apply that statement to anything similar.