MSW - is there a stigma?

[ITALA]

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As I mentioned in the previous topic, I am choosing between the three Master level options (MFT, MHC, MSW), which would allow me to go into the private practice.

A random survey of my friends revealed that if they were faced with some problems and had to choose a therapist the LAST person they would choose would be a Social Worker. Public perception of a social worker seems to be of someone helping out the less economically advanced populations in jails, hospitals and welfare offices, and NOT someone who sits in the office and helps people sort through depression, anxiety and marriage difficulties. Yet, from my research the MSW degree seems to be the most recommended and more widely accepted in most states.

I am very anxious to make the right decision in choosing a program, and would be grateful to hear your thoughts about the public perception of LCSW and whether or not this might hinder my chances of acquiring clients when I begin practice (which I assume to be not an easy thing to do).

Thank you in advance for your help.

 

[NeuroPhD]

I am very anxious to make the right decision in choosing a program, and would be grateful to hear your thoughts about the public perception of LCSW and whether or not this might hinder my chances of acquiring clients when I begin practice (which I assume to be not an easy thing to do).

Thank you in advance for your help.

I routinely refer patients I evaluate out to psychotherapists. I've never come across a stigma towards social workers relative to the other degrees you mention. Most of the therapists I refer to are either psychologists or social workers.

 

[pingouin]

A random survey of my friends revealed that if they were faced with some problems and had to choose a therapist the LAST person they would choose would be a Social Worker. Public perception of a social worker seems to be of someone helping out the less economically advanced populations in jails, hospitals and welfare offices, and NOT someone who sits in the office and helps people sort through depression, anxiety and marriage difficulties.

If this is indeed your friends' perspective of what social workers do, then they have a very narrow and limited view of the profession. Of course there are social workers who work in those jobs, but not all do. Specifically mentioning hospitals, those are certainly a diverse patient population, not just economically disadvantaged people. If home health care needs to be arranged, the social worker will be doing it, whether you have Medicaid or are paying 100% out of pocket just because you can.

If you want to find out what social workers do, talk with social workers. I submitted several links in the stickied thread at the top of the forum for people to have quick access to NASW, etc.

For the record, in my career I've heard that I'll be "picking drunks up off the street and putting them back on the paddy wagon" (courtesy of a long-time family friend), "going to peoples' homes and taking their kids away" (can't count the number of times) and will "never make enough money to live on". I'm happy to say that none of these things are remotely close to true.

 

[toby jones]

That was my initial perception of social workers, too. I was corrected on that when it came to my internet travels, however. Some social workers train to be psychoanalysts, and they clearly function as therapists. I've also encountered some websites online where the people looked pretty good and MSW was their primary qualification.

I've never heard of MFT or MHC so for me MSW wins!

More seriously, though... What is the difference in the programs? What kinds of courses do you do? What kind of experience do you get? IMHO you should do the program that is the most appealling to your interests and really... Care less about the title ;-)

 

[WannaBeDrMe]

Some social workers train to be psychoanalysts, and they clearly function as therapists.

I adore that you wrote " clearly function as therapists."

I have an MSW. According to something one of my profs made me read, the majority of practicing psychotherapists ARE MSW's... (be careful of your wording, psychoanalyst is NOT same as psychotherapist)

To the original poster, where I'm from, there is far more stigma associated with professional counselors and marriage and family therapists than with social workers.

I am speaking for some and not all programs... but a lot of the counseling programs are very superficial in what they teach and their program/internship hours are far fewer than for MSW programs.

The MFT's I know have trouble billing and finding work b/c they are such a specialized nook and an agency would rather hire someone w/a set in stone reimbursable rate.

All of that being said, I no longer want to be a social worker. I am looking to enroll in a doctoral psychology program. Therapizing is not for me... I absolutely enjoy testing/assessment/diagnostics.

I don't regret earning my MSW and several aspects of it fit me very well. However, I need more to be fulfilled.

Out of the 3 programs, I'd definitely go with the MSW. There is a far more broad range of skill/interests/career plans with individuals receiving that degree.

 

[PsyKardinal]

I rarely run into a stigma between the three choices of LPC, LCSW, or LMFT. Most people in the public want a therapist that will do a good job. Each of the three licenses require a masters, internship and lots of supervision before independent practice. If anything the folks with an LMFT have a more restricted time in working for agencies or hospitals only because they specialize in working with in the Family dynamic.

jeff

 

[ITALA]

Thank you everybody for your replies.

 

[ITALA]

If this is indeed your friends' perspective of what social workers do, then they have a very narrow and limited view of the profession.

I thought about this and wondered if this could be due to the fact that my friends are all from other countries and might think social worker equals immigration/welfare, so I asked some Americans in my class today and heard the same reply "Social Workers? Aren't they the ones working in hospitals with underprivileged populations and victims of abuse, etc.?"

It is just a bit discomforting that people might feel this way because if I am interested in building a private practice, I, of course, would want to have a degree and license which will attract people, not make them scratch their heads and wonder why I am providing MH counseling while I should be out helping poor people, etc.

Having said that, after talking to some people at my University, and all the advise I found here and elsewhere on the internet I am leaning towards MSW simply because it is much easier to find a job with it (at least for the mandatory 2,000 hrs, or if private practice does not work out) and it is acceptable in all states (in case I ever want to move) as opposed to MHC and LPC, which are not recognized by all states.

I am so confused about all this that I am starting to look back at PhD options...

 

[toby jones]

How do most clinicians build up a patient base?

I guess I'm just not too sure what the difference in qualification is going to make.

One way of building up a client base is to work with an agency. The people who are hiring will know what your qualification means and that won't make a damn to your patients.

Another way of building up a client base is reputational. People who work with you come to know the sorts of clients you work best with and they might refer on. Patients who are happy with the service you provide will reccomend you to their friends.

Who looks at the bit of paper on the wall anyway? I would if I was finding the person WITHOUT a referral but really how many clients are attracted in this latter way???

 

[ITALA]

How do most clinicians build up a patient base?

I guess I'm just not too sure what the difference in qualification is going to make.

One way of building up a client base is to work with an agency. The people who are hiring will know what your qualification means and that won't make a damn to your patients.

Another way of building up a client base is reputational. People who work with you come to know the sorts of clients you work best with and they might refer on. Patients who are happy with the service you provide will reccomend you to their friends.

Who looks at the bit of paper on the wall anyway? I would if I was finding the person WITHOUT a referral but really how many clients are attracted in this latter way???

Well, I am not sure about that. Yes, of course you generally build a business by referrals. But in this line of work... if I personally needed a psychotherapist, I would not go asking my friends and colleagues for a referral because I would feel uncomfortable letting them know that I am in need of mental health help, nor would I want to imply that they might be in need of such help by asking them for such a referral. I am afraid there is still quite a lot of stigma attached to mental health field and thus personal referrals are more rare... Having said that I do agree that in the end it is up to you how successfully you build your practice and at the end of the day the letters in your license will not matter. However, it takes years to build a successful business and my concern is how well I am going to do during this years and what degree would be most helpful. That's all. 🙂

 

[pingouin]

Actually, toby's pretty on-base regarding garnering referrals.

When I worked at a community mental health center as a therapist, our clients were assigned by who had the earliest open intake appointment. Not much picking and choosing of clients or problems going on there. There was some ability to staff and transfer to someone who might be a better fit, but with everyone's schedules quite full that was a rarity.

In private practice, my referral base has been more varied. My very first client was a teenager referred to me by someone I used to work with who had assessed her at the ER, knew she needed a therapist, and knew I needed clients. A few were from their insurance companies or EAPs, based on geographic proximity to the client's home. Then I got hooked in with a couple of psychiatrists who other people in my practice knew. That was a goldmine of their own referrals, as well as referring other psychiatrists to use me. About a year in was when I started getting the "my friend saw you and said I should call you..." phone calls. I have to tell you- those are the most flattering of any referral. And just a couple of months ago, I finally finally FINALLY connected with a PCP who has been giving my name out left and right, and I had to tell her I'm leaving in July. Boo.

Certainly there is still some stigma surrounding therapy, but I think you'd be surprised at how much it's decreased in the last decade. People are becoming much more open about seeing therapists, psychiatrists, and being on medications. Everybody and their brother knows someone who's seeing someone, on something, or "bipolar", and they're more than happy to talk about it.


As far as what's on the wall.. I can't think of any client who has ever asked what the difference is between myself and a LPC. On very rare occasion (like maybe twice in the last 3 years) I've been asked about LCSW vs PhD. My diplomas are on my wall, as is my license, and if people comment, it's more likely about me having moved back from the East Coast to the Midwest rather than noting the school or the degree. Only one person was hung up on the name of the school, and that was more of an reflection of her unstable sense of self (it's a good school so that made me "better" and "smarter" than her) rather than her actually caring about where I went.