LCSW--Psych Testing

[aequitasveritas]

Actually, the bolded is incorrect.

BSW or BSSW = Bachelors (of Science) of Social Work = generalist practice = no psychotherapy

What the hell is "generalist practice"?

MSW = Masters of Social Work = depending on the track/coursework, MAY be eligible for a clinical license, which when obtained may permit independent practice, including but not limited to psychotherapy. Some psychotherapy services MAY be provided under direct supervision of a licensed provider, usually a LCSW. That's rare.

...I did not specify private practice or independent practice

LCSW = LICENSED (not a degree) Clinical Social Worker = requirement of completion of accredited MSW program. Generally suggests the highest level of social work licensure and permits independent practice, including psychotherapy. Title of highest level varies dependent on state- in mine, it's LCSW, one state away it's LICSW, and 3 states the other way it's LISW

Of course but thank you

Many states have now created other tiers of licensure that are for non-clinical MSWs, for those social workers who engage in community or administrative practice. This prohibits them from engaging in independent clinical practice.

What separates an LCSW from an MSW besides passing the licensure exam and internship? I am asking in sincerity


Pingouin, BSSW, MSW, LCSW[/QUOTE]

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[spctle342]

What separates an LCSW from an MSW besides passing the licensure exam and internship? I am asking in sincerity

An MSW isn't eligible for licensure until he/she has accumulated a significant number of supervised hours and passed the exam. Apparently, you know that. Beyond that, not all those who earn their MSW choose to pursue licensure. Licensure implies clinical practice, which is only one of the many capacities in which social workers may choose to work. Others may serve as community organizers, researchers, policy analysts, or any of a million other things. In my opinion, (and I'm sure most would agree) a licensed social worker isn't any further up on the hierarchy than one without a license...just different. To say that there isn't a difference between an MSW and a LCSW is akin to saying that there isn't any difference between a clinical psychologist and a professor of psychology, etc.

 

[aequitasveritas]

An MSW isn't eligible for licensure until he/she has accumulated a significant number of supervised hours and passed the exam. Apparently, you know that. Beyond that, not all those who earn their MSW choose to pursue licensure. Licensure implies clinical practice, which is only one of the many capacities in which social workers may choose to work. Others may serve as community organizers, researchers, policy analysts, or any of a million other things. In my opinion, (and I'm sure most would agree) a licensed social worker isn't any further up on the hierarchy than one without a license...just different. To say that there isn't a difference between an MSW and a LCSW is akin to saying that there isn't any difference between a clinical psychologist and a professor of psychology, etc.

I don't mean to pick a bone with you, but some supervision hours and studying for a minimum competency exam(ours are also thus) does not make someone ready for private practice or psychotherapy in general.

This is one of the reasons there is a love loss between psychologists and LCSWs in the community. The amount of training we go through and the level of sacrifice is utterly different and more intense/elongated, which makes us balk when someone portends to practice what we practice...and then a chorus says "why can't we do psych testing?"

If I may be a tad glib, I would't want a (mainly) professor of psychology(noted above) just doing a simple re-specialization and then providing therapy.

 

[spctle342]

I don't mean to pick a bone with you, but some supervision hours and studying for a minimum competency exam(ours are also thus) does not make someone ready for private practice or psychotherapy in general.

This is one of the reasons there is a love loss between psychologists and LCSWs in the community. The amount of training we go through and the level of sacrifice is utterly different and more intense/elongated, which makes us balk when someone portends to practice what we practice...and then a chorus says "why can't we do psych testing?"

If I may be a tad glib, I would't want a (mainly) professor of psychology(noted above) just doing a simple re-specialization and then providing therapy.

You're preaching to the choir. As someone with no interest in clinical work, I'm not offended in the least by the suggestion that LCSWs are poorly equipped for the task. I think many licensed social workers would agree with this assessment, but I'm sure that others would take objection. I know there are programs that do focus almost exclusively on psychotherapy, and I don't doubt that graduates of such programs are capable of provisional and subsequent independent clinical practice. Unfortunately, I don't think I could confidently say that any MSW with a clinical concentration is ready for the task.

The reality is that no one really cares. MSWs are consistently the preferred providers of clinical services for low-income populations (Medicaid) and it's purely a matter of money. In my state, if I were to pursue licensure, I would invariably wind up rubber stamping treatment recommendations for the system(s) I despise and practicing CBT, not because it's effective; but because it's ridiculously cheap, fast, and arguably can be administered with no regard for the individual needs of any particular client. If I had an advanced degree in psychology, I'd probably be a little resentful as well. These are several of the thousands of reasons why the clinical persuasion does not appeal to me at all as a future social work student.

 

[aequitasveritas]

Well stated...I agree

 

[slinger]

Interesting discussion, repetitive discussion, but interesting. You just admitted that your test is a minimum competency exam for licensure as a psychologist as well as the LCSW exam. I guess I am somewhat confused, you honestly think that college work at any level is what makes someone a great psychotherapist? I would hope that if a student learned anything in college, they learned that it is merely a foundation that they obtain and it is the PRACTICE that makes someone into the practitioner that they will be. NOT a school program.

Aequitas, some supervision hours on an LCSW? It takes a MINIMUM of 2 years to get the hours needed, a lot of people do it in 3 years. I am not sure where you are getting your information from. Psychologists have there years of clinical supervision as well. I just don't understand why some Psychologists believe that due to an extra year or 2 of this or that, and some more coursework makes them inherently MUCH better psychotherapists. We all have something to put into the field, and you would do better not to focus on why we are so much different, and put your energy into how each profession can help each other. From the sound of it, you aren't going to be doing your future clients any justice with this attitude.

Generalist practice is the practice of social work as most people understand the profession. The brokering, linking, referrals, phone calls, case management, community outreach. This is all generalist practice. Clinical practice, well you should know what this is. A good clinical programs trains in all forms of psychotherapy and should provide adequate training in psychopharmacology.

"What separates an LCSW from an MSW besides passing the licensure exam and internship? I am asking in sincerity"

It isn't an internship, it is a minimum of 2 years of clinically supervised hours, and an exam. Also, the MSW program that the individual went through had to have clinical focus. All state behavioral science boards REQUIRE this. The ASWB requires this.

 

[Therapist4Chnge]

I just don't understand why some Psychologists believe that due to an extra year or 2 of this or that, and some more coursework makes them inherently MUCH better psychotherapists.

This sounds like the, "well it is just more classes and some research" argument that gets tossed around. It isn't just about the time, it is also about the depth of the content and approach to the material. I've lectured at all different levels (Bachelors, Masters, Specialist, and Doctoral), and these areas are completely different.

My expectations for a Bachelors student is as hair above rote memorization. I'd love for there to be more depth, but outside of a seminar class...it just isn't going to be there. At the Masters level there is more depth, but the focus of the class is still very much on learning the material. It is about learning technique and application. At the Doctoral level, knowing the material is a given. The way in which the material is understood, synthesized, and implemented is the biggest differentiation.

You don't need to understand different regression models to be a good psychotherapist, but how a doctorally-trained clinician approaches a case and utilizes other aspects of their training is different than how a non-doctorally trained individual will approach a case and use their training. It is more than "an extra year or two".

 

[aequitasveritas]

Aequitas, some supervision hours on an LCSW? It takes a MINIMUM of 2 years to get the hours needed, a lot of people do it in 3 years. I am not sure where you are getting your information from. Psychologists have there years of clinical supervision as well. I just don't understand why some Psychologists believe that due to an extra year or 2 of this or that, and some more coursework makes them inherently MUCH better psychotherapists. We all have something to put into the field, and you would do better not to focus on why we are so much different, and put your energy into how each profession can help each other. From the sound of it, you aren't going to be doing your future clients any justice with this attitude.


It isn't an internship, it is a minimum of 2 years of clinically supervised hours, and an exam. Also, the MSW program that the individual went through had to have clinical focus. All state behavioral science boards REQUIRE this. The ASWB requires this.

Apples =/= Apples here.

At my last internship I did comprehensive neuropsych assessment...I made mistakes, was corrected, revised, made more mistakes, etc.

Doctoral internships include psych assessment to elaborate on the basic training in didactics. MSW internships do not and cannot.

Just for example, it takes an incredibly trained mind to simply administer a Rorschach through the Comprehensive System or the Rorschach Performance Assessment System. The nuances you need to know, the skill in coding it, the knowledge of how to run RPS or Riap (not a ton), and that's just to generate the Structural Summary! What to do with the results is another thing...how to know where and how to integrate it with other test materials is another-another thing!

It takes ALOT of skill to write an assessment organized around the mind (for a psych assessment) and around the brain functions (for a neuro assessment). The know-how of how to find the pieces of the various tests and then integrate them into the appropriate sections of a report...and then to use the integration to answer referral questions....this is something that needs specialization at the doctoral level.

So I'm making a case for drawing a line in the sand between the professions..this is why I'm not just trying to "help our professions grow" etc.

Btw....why r u commenting on how I will serve my patients based on my commentary on an online thread? Comon that's utterly ridiculous.
I could argue that ur idea that LCSWs can do testing is deleterious to mental health...and THAT would be a good argument.

 

[slinger]

I'm not going to engage in the argument again, as it has been hashed over and over on here, and it digresses from the original post topic. You don't need to draw a line in the sand between professions. Social Workers do Social Work + Psychotherapy. Psychologists do formal assessment, testing, and psychotherapy. The line has been drawn.

What I meant, is that within the realm of psychotherapy, psychologists and social workers bring different philosophies to the practice. I just get tired of psychologists coming onto an M.A/MSW forum and trying to state misinformation about how limited social workers are within psychotherapy and how much lesser our training is than psychology, and they aren't even social workers.

The Psychologists I work with and I am friends with are GREAT people, and highly intelligent. They do not discredit the field of social work, and it's application of psychotherapy. A line does not need to be drawn to differentiate between two professions at the expense of one profession's integrity.

Apples =/= Apples here.

At my last internship I did comprehensive neuropsych assessment...I made mistakes, was corrected, revised, made more mistakes, etc.

Doctoral internships include psych assessment to elaborate on the basic training in didactics. MSW internships do not and cannot.

Just for example, it takes an incredibly trained mind to simply administer a Rorschach through the Comprehensive System or the Rorschach Performance Assessment System. The nuances you need to know, the skill in coding it, the knowledge of how to run RPS or Riap (not a ton), and that's just to generate the Structural Summary! What to do with the results is another thing...how to know where and how to integrate it with other test materials is another-another thing!

It takes ALOT of skill to write an assessment organized around the mind (for a psych assessment) and around the brain functions (for a neuro assessment). The know-how of how to find the pieces of the various tests and then integrate them into the appropriate sections of a report...and then to use the integration to answer referral questions....this is something that needs specialization at the doctoral level.

So I'm making a case for drawing a line in the sand between the professions..this is why I'm not just trying to "help our professions grow" etc.

Btw....why r u commenting on how I will serve my patients based on my commentary on an online thread? Comon that's utterly ridiculous.
I could argue that ur idea that LCSWs can do testing is deleterious to mental health...and THAT would be a good argument.

 

[aequitasveritas]

I'm not going to engage in the argument again, as it has been hashed over and over on here, and it digresses from the original post topic. You don't need to draw a line in the sand between professions. Social Workers do Social Work + Psychotherapy. Psychologists do formal assessment, testing, and psychotherapy. The line has been drawn.

OIC..."psychotherapy"....that simple little totally monolithic thing

I am arguing that social workers should not be practicing psychotherapy in private practice. In community mental health clinics they can do supportive treatment with psychotic and borderline organized people, which is fine by me. But, when it comes to the general public I think it's a different ball game and it's way outside of a masters degree and a few internships.

What I meant, is that within the realm of psychotherapy, psychologists and social workers bring different philosophies to the practice. I just get tired of psychologists coming onto an M.A/MSW forum and trying to state misinformation about how limited social workers are within psychotherapy and how much lesser our training is than psychology, and they aren't even social workers.

I wouldn't dare comment on the quality or depth of social work as I am not a social worker. I only wish MSWs would stick to social work or mental health clinics and stay out of private practice in the community. I feel the same way about most MFTs.

The Psychologists I work with and I am friends with are GREAT people, and highly intelligent. They do not discredit the field of social work, and it's application of psychotherapy. A line does not need to be drawn to differentiate between two professions at the expense of one profession's integrity.

There is no need to discredit anyone. Social work is great...and it should stay in it's rightful place...rather than drift into psychotherapy.

AI am also curious why you refer to yourself as a "resident" yet you say you're also a social worker....?

 

[Therapist4Chnge]

What I meant, is that within the realm of psychotherapy, psychologists and social workers bring different philosophies to the practice. I just get tired of psychologists coming onto an M.A/MSW forum and trying to state misinformation about how limited social workers are within psychotherapy and how much lesser our training is than psychology, and they aren't even social workers.

In relation to actual training in theory, modalities, etc...yes, I'd argue that social work training programs spend less time training in these areas when compared to other mental health positions that allow for independant private practice.

The Psychologists I work with and I am friends with are GREAT people, and highly intelligent. They do not discredit the field of social work, and it's application of psychotherapy. A line does not need to be drawn to differentiate between two professions at the expense of one profession's integrity.

I don't believe it is meant to discredit any field, but it is important to outline differences in training, scope, and application of the training. Social Work as a field of study is rooted in advocacy, social justice, and related areas...with only a fraction of the training dedicated to actual psychotherapy. Supportive therapy is one thing, but hanging a shingle and providing a range of psychotherapy related services is a completely different animal.

When scope is discussed in relation to other mental health positions, social work tends to highlight both sides of their training (traditional SW areas AND psychotherapy), but there is no acknowledgement that the breadth and depth of training and overall number of training hours directly related to psychotherapy are less. There is still a strong push to offer private practice, and a fight to allow the same services as other mental health positions, even though the overall number of training hours directly related to psychotherapy are less.

This isn't a knock on SW as a profession, but rather an attempt to highlight that "the same but different" argument is not valid. A 60 credit hour MS program, whether it is an Mental Health Counseling, Marriage and Family Therapy, or Social Work...is still a 60 credit hour MS program. The pie isn't any bigger, so the amount of time spent on other areas of study impacts how much time can be set aside for directly related psychotherapy training. A line needs to be drawn because "the same but different" argument is not valid. For the record, I have the same objection to MHC and MFT training, as I don't believe there is sufficient training to support independant private practice.

Here is the description of the practice areas of social work, pulled directly from NASW's website:

Social work practice consists of the professional application of social work values, principles, and techniques to one or more of the following ends: helping people obtain tangible services; counseling and psychotherapy with individuals, families, and groups; helping communities or groups provide or improve social and health services; and participating in legislative processes. The practice of social work requires knowledge of human development and behavior; of social and economic, and cultural institutions; and of the interaction of all these factors.

I can't begin to pretend to have proficiency in core areas like helping people obtain tangible services or intervening to help improve social and health serves, but I do take issue in how social work claims proficiency in core areas of psychology training such as psychotherapy training and human development and behavior, without having nearly the same basis of training. It isn't a knock on social work training, it is a knock on how psychotherapy training is being presented by social work.

I have a great deal of respect for the social workers I work with on a daily basis, as they truly excel at connecting my patients with social services, advocating for them on a daily basis, and helping them re-integrate into their communities. I can't do that, as navigating the system would make my head explode. They are a wealth of information as it relates to the patient's social history, genogram layout, and impact of social factors on their situation. They provide supportive therapy in crisis, and they page me to come do an assessment and provide intervention as needed. However, they do not formally assess psychological status, make a formal diagnosis, or provide traditional psychotherapy, which are all aspects of private practice psychotherapy.

 

[PsyDLICSW]

. MSWs are consistently the preferred providers of clinical services for low-income populations (Medicaid) and it's purely a matter of money.
Actually, this is not the case at least in my state. LICSWs are independent and practice independently without supervision in my state and they work for two years under supervision to get that independence. Medicaid requires clinical social workers to get a psychiatrist's signature on their case notes to get paid and work under a psychiatrist's supervision. As a result of the supervision requirement, the LICSWs in my state do not accept Medicaid because they don't have to work under supervision. Private insurance accepts LICSWs as independent therapists and does not require supervision. It's ridiculous that social workers do not really treat the populations they advocate for, but this is the way it is in my state. In my state, Medicaid is the #1 insurance provider (we are rural and poor) and they typically see psychologists. Social workers are seeing the middle and working class with private insurance, not Medicaid.

 

[Neuropsych2be]

This sounds like the, "well it is just more classes and some research" argument that gets tossed around. It isn't just about the time, it is also about the depth of the content and approach to the material. I've lectured at all different levels (Bachelors, Masters, Specialist, and Doctoral), and these areas are completely different.... snip ...You don't need to understand different regression models to be a good psychotherapist, but how a doctorally-trained clinician approaches a case and utilizes other aspects of their training is different than how a non-doctorally trained individual will approach a case and use their training. It is more than "an extra year or two".

I worked for years and years as a master's level therapist and clinician. I used to be of the mindset that a Ph.D. was only a research project and a couple years of classes different than me. Now that I am nearing the end of a doctoral program, I am acutely aware that my previous beliefs were quite wrong. Doctoral training gives one a greater ability to evaluate and synthesize a particular problem. I find that my ability to engage in case conceptualization from multiple perspectives or to gather and integrate finding form multiple sources is vastly improved. I also have learned to apply a more complete set of skills, including psych testing where appropriate, to a clinical conundrum. Ph.D.'s in clinical psychology actually take from 6-8 years from the beginning of grad school to licensure for independent practice if one includes the year of post-doc supervision. That is vastly beyond anything an LCSW receives.

That being said, there is little empirical evidence to support the idea that Ph.D.s have greatly superior outcomes in therapy than LCSW's. And there is no evidence that well trained clinical social workers (LCSW's) or LPC's are not able to do effective private practice (sorry T4C but I don't agree with you on that one). In fact I think LPC's have better clinical training than LCSW's but that's another debate. However the vast differences in training gives a Ph.D. a much larger clinical skill set. Its not just more training but also training at a higher conceptual level than anything an LCSW would get in a master's program. For this reason I advocate doctoral level training for all *clinical* social workers and LPC's.

 

[Ecomaster]

I worked for years and years as a master's level therapist and clinician. I used to be of the mindset that a Ph.D. was only a research project and a couple years of classes different than me. Now that I am nearing the end of a doctoral program, I am acutely aware that my previous beliefs were quite wrong. Doctoral training gives one a greater ability to evaluate and synthesize a particular problem. I find that my ability to engage in case conceptualization from multiple perspectives or to gather and integrate finding form multiple sources is vastly improved. I also have learned to apply a more complete set of skills, including psych testing where appropriate, to a clinical conundrum. Ph.D.'s in clinical psychology actually take from 6-8 years from the beginning of grad school to licensure for independent practice if one includes the year of post-doc supervision. That is vastly beyond anything an LCSW receives.

That being said, there is little empirical evidence to support the idea that Ph.D.s have greatly superior outcomes in therapy than LCSW's. And there is no evidence that well trained clinical social workers (LCSW's) or LPC's are not able to do effective private practice (sorry T4C but I don't agree with you on that one). In fact I think LPC's have better clinical training than LCSW's but that's another debate. However the vast differences in training gives a Ph.D. a much larger clinical skill set. Its not just more training but also training at a higher conceptual level than anything an LCSW would get in a master's program. For this reason I advocate doctoral level training for all *clinical* social workers and LPC's.

I think we're making some progress now. The key is indeed what is the outcome in therapy? If one would ask this question, then the outcome is what counts for the many seeking it? And to many individuals the outcome is less profound than many may think either coming from an LCSW/MFT or PHD/PSYD. The key is that I do believe that case conceptualization may be coming from an increased depth from the school aspect (for the sake of masters vs doctoral level), but professional experience, personality, also factor into the therapeutic outcome. Anyone heard of engagement? If clients arn't engaged, it wouldn't matter what you say, how you say it, and what you know, because they are not listening nor are they likely to see you again after your first "appointment."

I believe that are many gifts offered by Doctoral trained clinicians. You're doctors for goodness sake, and have the gift of increased research capacity and knowledge. Know the human psychological condition on a depth that in which knowledge can be created. Direct practice (therapy, case management) is only one aspect, an aspect to me seems almost less important than being granted the power of knowledge. Master's level workers are advanced practitioners so they can be good at being what they do: direct practice. Doctoral level? Go create knowledge!

Eco

 

[BSWdavid]

Social workers have been providing psychotherapy services since WWII, around the same time that psychologists began offering clinical services. So please, enough with the "encroachment" issues, as this began long before most of us were even born. LCSWs provide more psychotherapy services than psychologists, psychiatrists, and counselors combined. We aren't going anywhere.

 

[PsyDLICSW]

Social workers have been providing psychotherapy services since WWII, around the same time that psychologists began offering clinical services. So please, enough with the "encroachment" issues, as this began long before most of us were even born. LCSWs provide more psychotherapy services than psychologists, psychiatrists, and counselors combined. We aren't going anywhere.

I or any one else on this thread never insinuated that social workers are going anywhere or shouldn't be doing therapy. They provide the most psychotherapy. I think others are concerned about social workers doing testing and this is the issue. Social workers are not trained to do testing. States don'e even let people with masters degrees in psychology interpret tests. I think social workers are entitled to do therapy if they are properly trained to do so. My social work program did not adequately train therapists, but people coming out of my program are doing therapy with this less than adequate training. There are some people who graduated from my program who have to take grad level counseling courses because they did not recieve the adequate training in the MSW program. Like I said before, social workers have every right to do therapy as long as they are properly trained to do so and that their program has more of a clinical emphasis (as opposed to policy or more general "direct practice"). This thread was started to address concerns about social workers doing testing. Social workers should not be doing testing. Period!

 

[BlackSkirtTetra]

I am relatively new to the field, just embarking on my MSW program, and I'm three months late to this discussion, but I have read this entire thread and thought I'd point out something that a lot of folks probably know but seem to have overlooked: a lot of what any given person is capable of doing in a professional context depends upon the individual person just as well as her training.

Formal education, training, and licensure are very important and cannot be underestimated (especially when it comes to our differences), but so are the aptitude, interests, non-formal education, and competence of the individual practitioner. I know I might be stating the all-too-obvious, but between any two LCSWs or between any two PhDs, these things can vary quite a lot, so you can imagine how much they might potentially vary between a LCSW and a PhD.

 

[BlackSkirtTetra]

I have been searching different states since reading this thread, and I have found that the laws of at least one state (West Virginia) say a LCSW can do this:

§30-30-11. Scope of practice for a Licensed Certified Social Worker.

A licensed certified social worker may:

1. Perform all duties within the scope of practice of a licensed graduate social worker and licensed social worker;
2. Apply social work theory and methods to the diagnosis, treatment and prevention of psychological dysfunction, disability or impairment, including emotional and mental disorders and developmental disabilities; and
3. Determine behavioral health diagnosis, using diagnostic taxonomies commonly accepted across disciplines among behavioral health professionals.

(Emphasis added.)

This apparently applies to both the LCSW and the LICSW in WV.

Is anybody familiar with West Virginia's laws? Is "determining behavioral health diagnosis" different from actually "making a diagnosis?"

From the WVSWB: http://www.wvsocialworkboard.org/licensinginfo/regular/lcswlicense.htm

 

[stigmata]

"Determine behavioral health diagnosis, using diagnostic taxonomies commonly accepted across disciplines among behavioral health professionals"

This is not referring to testing, but to diagnostic taxonomies like the DSM-IV and ICD.

 

[BlackSkirtTetra]

Oh. That makes more sense. Thank you very much. I appreciate your help.

 

[PsyDLICSW]

I have been searching different states since reading this thread, and I have found that the laws of at least one state (West Virginia) say a LCSW can do this:



(Emphasis added.)

This apparently applies to both the LCSW and the LICSW in WV.

Is anybody familiar with West Virginia's laws? Is "determining behavioral health diagnosis" different from actually "making a diagnosis?"

From the WVSWB: http://www.wvsocialworkboard.org/licensinginfo/regular/lcswlicense.htm

I am. I got my MSW in WV. When they say "determine behavioral health dx" that refers to making diagnoses from the DSM-IV to bill insurance companies. I think the LCSW has to be supervised and LCSWs usually work in a community mental health center and function much like an LPC (who are not independent in my state). LICSWs are independent and can work independently like a psychologist in terms of therapy without supervision. LICSWs are the therapists in my state. LICSWs have more of a therapy/counseling role than LCSWs. LCSWs are supervised in therapy and LICSWs are not.

"Clinical social work services consist of assessment, diagnosis, treatment, including psychotherapy and counseling, client-centered advocacy, consultation and evaluation. The process of clinical social work is undertaken within the objectives of the social work profession and the principles and values of its code of ethics."
-From the WV licensing Board for licensure of the LICSW.

Hope this helps


Assessment in social work refers to psychosocial assessment and not a psych eval.

 

[PsyDLICSW]

More on WV law

Level A: LSW, Bachelors of SW required, pass a test

Level B: Licensed Graduate SW, MSW required, generalist practice, pass a test

Level C: Licensed Certified SW, MSW required, pass another kind of test, you can do clinical work but under someone else's licence


Level D: Licensed Independent Clinical Social Worker: MSW + 2years supervision, pass a test

 

[BlackSkirtTetra]

That is really interesting! Thank you for the great explanation!

Did you go through all the levels (A, B, C, and D) of licensure in WV?

 

[PsyDLICSW]

That is really interesting! Thank you for the great explanation!

Did you go through all the levels (A, B, C, and D) of licensure in WV?

I am working on level D, but I am in a PsyD program so my supervised hours do not count because my supervisor is a licensed psychologist. I have to wait until I graduate and get an LICSW to supervise me

 

[BlackSkirtTetra]

So after you earn your PsyD, you still plan to work as an LICSW? That's interesting to me because I wouldn't immediately think that way.

 

[slinger]

This is such an interesting discussion. Like someone repeated earlier, it is repetitive, but interesting to say the least.

The 2 major distinctions that need to be noted are Licensed Master's Level Social Workers, commonly referred to as LMSW's. These former students are products of a CSWE approved graduate education. You can practice within ANY agency, and do psychotherapy under direct supervision from a Psychologist, or an LICSW/LISW/LSCSW.

This is a nationally tested, but state licensed profession, much like all. Unfortunately, there are no distinctions to limit the scope of practice of an LMSW to just generalist/administrative work, if that was the scope of their graduate education. I think this is a fault that will hopefully be corrected. I do not think that someone with a generalist education should be practicing psychotherapy without at least receiving EXTRA formal clinical education.

Anyone with the title of Licensed Clinical Social Worker/Licensed Independent Social Worker/Licensed Specialty Clinical Social Worker, these are ALL the same thing and require the same effort, nationally mandated, and state implemented. To be able to qualify to take the independent licensing exam, you must have a minimum of 2 years of LMSW Clinical experience, under direct clinical supervision. As of current, there are a couple states that actually require a 3rd year (which I think is great).

For all the Psychology "clan" members out there who tend to chime in on this, please understand that a real clinical social work graduate program teaches us all the methods developed by PSYCHOLOGISTS and a few SOCIAL WORKERS (cheap profession plug) for the purposes of practicing Psychotherapy, and they recognize this and endorse this on a national level. So you all, as individual Psychologists need to realize, that while our training, ethics, and scope of learning/practice is inherently different, the Psychotherapy is most definitely overlapped. The form and methodology of different applied psychotherapies cannot and does not always need to be quantified to a level of systematic psychological testing. Also, Psychotherapy being performed by qualified clinical social workers is not a "less than version" of psychotherapy than provided by a Psychologist.

Please remember this, just because clinical/treatment success is achieved through a fully quantifiable beginning diagnostic assessment, does not mean that individual and environmentally induced psych/biological disorders cannot reach treatment success until they are able to be quantified. Accurate data is ALWAYS good practice, but the ability to gather and interpret data as a social scientist does not always increase efficacy in the psychotherapy performed, and it does NOT mean a more constant and accurate diagnosis.

 

[stigmata]

" but the ability to gather and interpret data as a social scientist does not always increase efficacy in the psychotherapy performed, and it does NOT mean a more constant and accurate diagnosis. "

A) Psychologists are not social scientists.
B) Assessment data is not research, it is mathematical variation from the mean and the very basis of diagnosis.
C) How can you treat someone if you don't understand what is wrong with them?

 

[Therapist4Chnge]

For all the Psychology "clan" members out there who tend to chime in on this, please understand that a real clinical social work graduate program teaches us all the methods developed by PSYCHOLOGISTS and a few SOCIAL WORKERS (cheap profession plug) for the purposes of practicing Psychotherapy, and they recognize this and endorse this on a national level. So you all, as individual Psychologists need to realize, that while our training, ethics, and scope of learning/practice is inherently different, the Psychotherapy is most definitely overlapped.

Given that the vast majority of training and research has come from psychology, I think we'd be in the best position to judge what is needed to adequately assess, diagnose, and treatment a pt. Assessment is crucial in ensuring that the diagnosis and treatment is correct, though it is often the 1st thing glossed over in practice.

The form and methodology of different applied psychotherapies cannot and does not always need to be quantified to a level of systematic psychological testing.

Why not? It provides additional data to help inform the diagnosis and treatment.

Manualized treatments like CPT, PE, and related all have some sort of metric to assist in providing additional data to inform applicability of the Tx as well as the progress during the Tx. CBT uses a range of different metrics to inform Tx, some more formalized than others. Assessment is an integral part of treatment. The reason that it is not included in all treatment is not based on clinical applicability, but outside factors like money, time, and scope of practice.

Please remember this, just because clinical/treatment success is achieved through a fully quantifiable beginning diagnostic assessment, does not mean that individual and environmentally induced psych/biological disorders cannot reach treatment success until they are able to be quantified. Accurate data is ALWAYS good practice, but the ability to gather and interpret data as a social scientist does not always increase efficacy in the psychotherapy performed, and it does NOT mean a more constant and accurate diagnosis.

Meehl & Dawes both did an extensive amount of work showing that clinical judgment is not as accurate as statistically supported judgments...the kind of data you get from standarized psychometrics. There are a host of biases that come into play with clinical judgment, which is why objective data from psychometrically sound assessments are needed.

 

[slinger]

Given that the vast majority of training and research has come from psychology, I think we'd be in the best position to judge what is needed to adequately assess, diagnose, and treatment a pt. Assessment is crucial in ensuring that the diagnosis and treatment is correct, though it is often the 1st thing glossed over in practice.



Why not? It provides additional data to help inform the diagnosis and treatment.

Manualized treatments like CPT, PE, and related all have some sort of metric to assist in providing additional data to inform applicability of the Tx as well as the progress during the Tx. CBT uses a range of different metrics to inform Tx, some more formalized than others. Assessment is an integral part of treatment. The reason that it is not included in all treatment is not based on clinical applicability, but outside factors like money, time, and scope of practice.



Meehl & Dawes both did an extensive amount of work showing that clinical judgment is not as accurate as statistically supported judgments...the kind of data you get from standarized psychometrics. There are a host of biases that come into play with clinical judgment, which is why objective data from psychometrically sound assessments are needed.

I understand where you are coming from, and much of the research from Meehl and Dawes. When you say clinical judgment, are you speaking of judgment of diagnosis, or psychotherapy practice? The main problem I have with this idea of being rigid in our "statistics vs. clinical judgment" thinking is that; a statistically based diagnosis is still intervened on a "clinical judgment" and humanistic level. We are not robots after all.

So if we have 100 patients with the same diagnosis, and we implement the same treatment from all Psychologists, I can pretty much guarantee that all implementations of psychotherapy will show small to large variances in their methods of practice, therefore ending in different treatment outcomes. I know I am preaching to the choir Therapist4Change, you are a smart cat, you understand where I am coming from don't you?

 

[beba221]

You sure can't. You have not been trained to administer and score those tests. Did your LCSW program have a common sense class that you forgot to attend?

 

[Therapist4Chnge]

I understand where you are coming from, and much of the research from Meehl and Dawes. When you say clinical judgment, are you speaking of judgment of diagnosis, or psychotherapy practice? The main problem I have with this idea of being rigid in our "statistics vs. clinical judgment" thinking is that; a statistically based diagnosis is still intervened on a "clinical judgment" and humanistic level. We are not robots after all.

So if we have 100 patients with the same diagnosis, and we implement the same treatment from all Psychologists, I can pretty much guarantee that all implementations of psychotherapy will show small to large variances in their methods of practice, therefore ending in different treatment outcomes. I know I am preaching to the choir Therapist4Chnge, you are a smart cat, you understand where I am coming from don't you?

It appears that your are arguing that the gathering and interpretation of additional data by the clinican will not:
1. Always increase the efficacy of treatment.
2. Provide a more constant and accurate diagnosis.

My position is that having additional objective data, like the data from psychological assessment, will almost without exception provide the clinician with a better understanding of the case and allow them to make a more accurate diagnosis. Being able to have an accurate diagnosis definitely impacts treatment efficacy.

Variance in the treatment outcome is a function of having the correct diagnosis, providing the intervention in the correct manner, and not having one of many moderating and mediating factors derail the treatment. Obviously you cannot account for all variables, but my argument is that securing the correct diagnosis will have the greatest impact on treatment outcome.

At the end of the day, masters and doctorally-trained clinicians will provide clinical services. However, I am trying to differentiate between the variety of training models out there, as I get frustrated when people lump all of them together. There are large differences between "assessment", as are there large differences between "psychotherapy".

I am trying to better deliniate these differences, as I often hear, "we all do assessment and we all do psychotherapy, you just do it from a psychological framework, and we do it from a [social work, counseling, FMT, nursing, etc]. It is pretty much the same." My argument is that it is quite different.