Closed thread (link to new discussion)

[Jon Snow]

This is the MSW/LCSW forum. It is inappropriate and unprofessional to bash other professions. In addition, on SDN it is a TOS violationlease note that this also includes the posting of taunts on a forum solely for the purpose of deriding that forum's topic and/or members.

This is a psychology forum on the Student Doctor Network. The discussion was not an unreasonable bash. Nor is it in anyway unprofessional. Putting blinders on, plugging your ears, and screaming "Nah, nah, nah" is not professional behavior. You think these issues aren't discussed professionally? Seriously? The purpose had nothing to do with taunting nor anything to do with deriding a topic or membership. Reasonable discourse should not be discouraged. I understand the moderator who closed this is a pharmacy student and probably has very little understanding of the issues currently face mental health. Among them are incompetence, use of unsupported treatment modalities, insurance reimbursement, mental health parity (recently passed bill), and so on. A major shift in the last decade has been the extensive lobbying efforts of social work to expand their scopes of practice. Given the expansion is into domains that have in the past been doctoral level, I think it's reasonable to discuss the hazards of that. The topic posed was an innocent question. My response is what I believe, I think it is logical, and it is not a bash.



I am saddened that someone felt the need to complain rather than offer up empirical evidence or a reasonable debate to what was on the table.

to the pharmacist mod: Would you be irritated if pharmacy technicians or random folks with bachelors degrees were allowed to act as pharmacists?

 

[biogirl215]

Though I *really* don't agree with JS' position on some of the issues in the thread, I do agree that many of topics brought up are worse at least discussing, civilly. For example, I disagree with the assertion that social workers aren't trained or encouraged to use evidenced-based treatment--this was something that was brought up even in my university's 100-level social work class, and something that has been brought up again in my social work practice classes and will almost certainly be brought up yet again in the required social policy and research classes (and ALL accredited BSW and MSW programs are required to have mandatory research classes).

I'd also like to disagree with the statement that non-EBM treatment (i.e., EMDR) is only practiced by non-doctoral practictioners. I've seen faculty at university-based, fully funded, fairly research-heavy programs openly express an interest in EMDR. In fact, I was speaking to one of my psych professors (who is, imo, very well-trained, and who, based on numerous discussions with him as well as taking his class, is very much "into" proper research--he's one of the most prolific faculty in our program) this semester, and the topic of grief therapy came up. I pointed out that there is little--if any-- empirical support for grief therapy. His answer? "I'm not a strict empiricist. I believe that there are benefits to psychotherapy that empirical research can't capture."

 

[Jon Snow]

For example, I disagree with the assertion that social workers aren't trained or encouraged to use evidenced-based treatment--this was something that was brought up even in my university's 100-level social work class, and something that has been brought up again in my social work practice classes and will almost certainly be brought up yet again in the required social policy and research classes (and ALL accredited BSW and MSW programs are required to have mandatory research classes).

I don't doubt that social workers are encouraged to use evidence-based treatment. What I question is the education with respect to evaluating evidence. I also question this, incidentally, for another recently proliferating group (professional schools of psychology). What constitutes a reasonable degree of evidence before application of a methodology? Further, one can't discount as necessary, breadth of knowledge with respect to diagnosis and treatment. Is one year of school enough? I say one year, because many social work programs focus on social justice for one year. Important for social advocacy, but not for understanding mental illness. My contention is that one year, plus a couple of years of clinical supervision, are not enough to properly evaluate empirical evidence from a theoretical or practical level. The breadth of knowledge is simply not there. I can't imagine cramming everything I needed to know from a theoretical vantage-point into one year. It's barely adequate at 5 (the length of my doctoral program) + a year internship + two years fellowship.


This is also an issue with respect to assessment. For example, what constitutes an empirically supported assessment scale? What are psychometrics? What is a normative sample? For specific scales, how were they normed, what are the ceilings and floors, how are they most commonly used in clinical practice, what are the strengths and weaknesses of the scale? What medical conditions might cause mental health symptoms? Etc. . .

I'd also like to disagree with the statement that non-EBM treatment (i.e., EMDR) is only practiced by non-doctoral practictioners.

I already agreed with this statement, so there's nothing to disagree with

I'm not a strict empiricist. I believe that there are benefits to psychotherapy that empirical research can't capture.

This, as a defense to using EMDR? No, that's unsatisfactory. Too big of a loophole to do whatever you want. As I said, it isn't a clear demarcation. You will find odd viewpoints from a scientific/critical thinking vantage point at all levels. It's an issue of ratio and tools to perform.

 

[Therapist4Chnge]

While JS can be a bit rough around the edges, I do think it is important to be able to discuss these rather controversial issues. I do agree that the scope creep that is happening is a very real area for discussion/debate. I cringe when I see a laundry list of "specialty" areas, that are rarely related.

It is always a bit of a tightrope walk when discussing these issues, but I usually err on the side of leaving a thread open as long as people can keep it professional (looks at JS ).

So back on topic.....

What is being done to support SW's expansion into primary areas of therapy/diagnosis/assessment? Curriculum changes, increased req. clinical hours, increased supervision hours? My interactions with SW are similar to Jon's (social advocacy, case management, supportive work), though I don't see where the training gets to the clinician. In the previous mentioned areas they are a great asset, and they have made my life a heck of a lot easier.

The LCSW is a bit closer to "additional training", but I still think it isn't quite there. Considering what gets crammed into Doctoral training, I can't see how they can adequately get the training to do therapy/assessment/diagnosing AND the administrative/advocacy training. I know some programs offer more of a slant to one or another, but how can that all be done in 2 years, ethically?

In cases of expansion, the group wanting to expand should PROVE that there is competency, and it shouldn't be up to the current system to PROVE they are not. Unfortunately the MA/MS level lobbies are much more active than the doctoral level, and we are losing on sheer numbers and influence.

I'd like to have a discussion (Using emperically supported data and related information if at all possible) to talk about these issues.

 

[Jon Snow]

"When you get a BS you think you know everything. When you get your MS you realize you know nothing. When you get your PhD you still realize you know nothing but it is ok because now you know no one else does either"

Maybe it goes. . .

"When you get a BA you think you know everything. When you get your MS, you think you know everything. When you get your PhD you still think you know everything."

 

[Therapist4Chnge]

Please go HERE for a more focused and professional discussion.....