Social workers supervising Psychologists administratively

[BuckeyeLove]

Anyone have any experience with this? How can someone who doesn't even know the difference between validity and reliability (or in some cases not even independently be licensed), be administratively supervising doctoral level providers? I recently ran into someone who works in a forensic setting, and whose supervisor (an LSW), is allowing all mental health providers (not just psychologists), to administer psychological tests. I told this individual to file a grievance and report it to their respective boards. I've also had experiences with LSW's supervising my department administratively recently at one of my places of employment, and I'm not going to lie, I'm having a hard time checking my ego at the door (e.g., I'm about to be a board certified forensic psychologist, will be starting law school, done more work privately on my pinky finger than this particular social worker supervisor, etc, etc, etc,). Mainly I'm just having a hard time not blowing up via email on this individual giving me illogical and non-evidenced based directives who doesn't have near the clinical background that I do, and does not back up any of their directives with rational reason (and who also appears to get defensive when challenged).


...ok. end rant. Mainly just looking for some consensual validation. I'm still early career, and I know that I will not always have bosses that I like and/or agree.

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[WisNeuro]

Anyone have any experience with this? How can someone who doesn't even know the difference between validity and reliability (or in some cases not even independently be licensed), be administratively supervising doctoral level providers? I recently ran into someone who works in a forensic setting, and who's supervisor (an LSW), is allowing all mental health providers (not just psychologists), to administer psychological tests. I told this individual to file a grievance and report it to their respective boards. I've also had experiences with LSW's supervising my department administratively recently at one of my places of employment, and I'm not going to lie, I'm having a hard time checking my ego at the door (e.g., I'm about to be a board certified forensic psychologist, will be starting law school, done more work privately on my pinky finger than this particular social worker supervisor, etc, etc, etc,). Mainly I'm just having a hard time not blowing up via email on this individual giving me illogical and non-evidenced based directives who doesn't have near the clinical background that I do, and does not back up any of their directives with rational reason (and who also appears to get defensive when challenged).


...ok. end rant. Mainly just looking for some consensual validation. I'm still early career, and I know that I will not always have bosses that I like and/or agree.

Our healthcare system uses some SWs as mid level admins. I don't think the pay is great, but they are f*cking clueless. In a recent meting, one talked about spending all day trying to fix a billing issue with some neuropsychologists at our sister hospital, and not knowing what to do. I informed them that all they had to do was add a specific modifier to the billing. It was something any actual neuropsychologist/psychologist should have known how to fix in about 10 seconds. I honestly don't care as long as they stay out of my way, and let me run my clinic however I see fit, which has been the case so far. But, I don't hold back when throwing them under the bus when they do something incompetent. As in, we recently had a meeting with an upper level admin and I pointed out several ways we were losing great deals of revenue due to how things have been managed thus far.

 

[AcronymAllergy]

I've heard psychiatrists say the same thing about having a psychologist in a supervisory position over them. I generally don't have a problem with it if the supervision is limited to administrative aspects (e.g., time and leave, payroll, implementation and monitoring of clinic/hospital policies, etc.). If it ventures into clinical activities, then my take is that just as with any discipline, the supervisor should generally defer to the practitioner (and/or incorporate input from other, similarly-qualified practitioners) if it's outside that supervisor's scope of training and practice. A social worker authorizing all MH providers to administer psychological tests, in my opinion, is outside scope of practice (although you'd be surprised what some licensing laws say). Just as a psychologist supervisor probably shouldn't be opining about medical practice.

Ideally, if the supervisor is over multiple disciplines, each discipline would have its own lead to help them in addressing clinical and other discipline-specific issues.

 

[Fan_of_Meehl]

Anyone have any experience with this? How can someone who doesn't even know the difference between validity and reliability (or in some cases not even independently be licensed), be administratively supervising doctoral level providers? I recently ran into someone who works in a forensic setting, and whose supervisor (an LSW), is allowing all mental health providers (not just psychologists), to administer psychological tests. I told this individual to file a grievance and report it to their respective boards. I've also had experiences with LSW's supervising my department administratively recently at one of my places of employment, and I'm not going to lie, I'm having a hard time checking my ego at the door (e.g., I'm about to be a board certified forensic psychologist, will be starting law school, done more work privately on my pinky finger than this particular social worker supervisor, etc, etc, etc,). Mainly I'm just having a hard time not blowing up via email on this individual giving me illogical and non-evidenced based directives who doesn't have near the clinical background that I do, and does not back up any of their directives with rational reason (and who also appears to get defensive when challenged).


...ok. end rant. Mainly just looking for some consensual validation. I'm still early career, and I know that I will not always have bosses that I like and/or agree.

All I can say to your post is 'amen' and 'ditto.' However, I will add that my ire for the clueless, control-freak, ignorant/arrogant, 'expertologist,' goose-stepping and power-crazed bureaucratic social work admin types is outstripped only by my absolute revulsion toward the PhD/PsyD psychology 'chiefs' who lack the spine of an earthworm and who sell out the profession (as well as us as individual colleagues) at every opportunity and who don't appear to exert an OUNCE of resistance to the steamroller of clinically inappropriate mandates from above.

There's a scene from that 90s movie Tombstone that comes to mind where the villian is speaking in Latin and the Doc Holliday character quips something like, "That's Latin, dahlin'... apparently Mr. Ringo is an educated man...now I REALLY hate him."

 

[PsyDr]

Pro tip: On cross, it’s a decent idea to respond to hostility with the most technical, jargon filled verbiage.

When confronted with individuals who assume they have the same education, I’ve found it best to treat them as such and ask them for advice using the most technical questions possible.

 

[psych.meout]

I've heard psychiatrists say the same thing about having a psychologist in a supervisory position over them. I generally don't have a problem with it if the supervision is limited to administrative aspects (e.g., time and leave, payroll, implementation and monitoring of clinic/hospital policies, etc.). If it ventures into clinical activities, then my take is that just as with any discipline, the supervisor should generally defer to the practitioner (and/or incorporate input from other, similarly-qualified practitioners) if it's outside that supervisor's scope of training and practice. A social worker authorizing all MH providers to administer psychological tests, in my opinion, is outside scope of practice (although you'd be surprised what some licensing laws say). Just as a psychologist supervisor probably shouldn't be opining about medical practice.

Ideally, if the supervisor is over multiple disciplines, each discipline would have its own lead to help them in addressing clinical and other discipline-specific issues.

This makes the most sense, though I think there are multiple separate issues involved. One issue is that of being supervised by someone from outside your discipline or specialty supervising you when they don't necessarily fully grasp the nuances, demands, scope, etc. of your position. This is where limiting their supervision to administrative and leadership roles and having someone within your discipline/specialty as a direct supervisor can really help.

The second issue is one of scope of practice. This is related to the first issue, as a supervisor may not really understand the scope of practice issues of other types of providers. Alternatively, they may even have personal beliefs and biases that lead to scope of practice creep or even having providers practice widely outside their scopes. I can't count the number of times that master's-level providers have asserted that they are qualified to do assessment and use any psychometric measures they want, because they feel they were trained enough and the law doesn't explicitly prohibit them from doing so (I guess "is vs. ought," ethics, scope of practice, and other concepts are lost on them). Other times, there is downward pressure being exerted from above them to increase billing, improve access to care, and reduce waiting lists or scheduling issues. They may allow scopes of practice to gradually increase to alleviate these pressures, even if they are very well-informed and aware of the issues and consequences of doing so.

A third issue is one of any supervisor not supporting evidence-based practices or even issuing orders or guidelines in direct conflict with EBPs. Again, this is related to the other issues, but even providers within the same discipline or specialty can promote policies which contradict the best EBPs. It's often discussed here, but there just is so much heterogeneity in training standards that some pretty wacky stuff gets done by actual, licensed psychologists and other providers who should ostensibly know better.

 

[Ollie123]

In general, I feel like AMCs (and likely many other locations) have spiraled out of control with these things. I actually encounter far fewer problems with this in my clinical world than my research world, where I am routinely dependent on a dozen or more administrators who take 2 months to do anything, typically do that thing wrong, and then expect me to bear the consequences of them having screwed up.

In the clinic if we are talking about something limited to management of office space, scheduling etc. I have zero issue with it as long as they are reasonable and responsive.

A big part of me is wondering why we aren't seeing faculty outright revolt. I've been sorely tempted to organize one here. I think if we got a couple hundred faculty to agree that they would not see patients, write grants or publish papers until the university cleaned up their act, I imagine we could light a fire under some folks....