pschmom1 said:
I am interested in everyone's opinion of social workers, mainly MSWs or LCSWs.
They're wonderful! But I might be a little biased since I'm both.
Currently I have a private practice, and I also work PRN at a local children's hospital on the med floors. And I'm doing prereqs to prep for the MCAT.
For those who are in practice now, or have their own practice (or have knowlege on this matter), do you have social workers that work w/you to provide therapy to your patients when you can not?
My own practice has 5 clinicians, 3 LCSWs and 2 LPCs (acronyms may vary depending on your state). We have several psychiatrists who refer to us frequently for therapy, and in exchange will usually see our clients who need a medication evaluation. Of the three I'm thinking of, one has a cash-only practice and sees his patients for 1/2 to a full hour per session, one combines cash and insurance clients and tries to spend 20-30 minutes, and the third has told us "you went to school to do therapy, I went to school to do medication" and usually only does 15 minute med checks. She's the only one who has a therapist within her group's practice, but said she hasn't gotten good feedback, therefore refers most clients elsewhere.
How about psychiatric social workers? I know that in the final year of graduate school for social work you choose your specialty and one of the specialties is psychiatric social work. Do you refer your patients to specific therapists or psychologists for therapy when you don't provide the therapy?
I'm going to say that most specialization actually occurs after graduation, mostly because since MSW programs are only two years (if you go full time), it's just not enough time to truly "specialize". My school's only offering was "clinical" social work, by which they meant psychodynamic theory and self-psychology. Had I been older and wiser and done more investigative work, I probably would have chosen another school which fit my personality and style better. My school mandated a class which was basically psychopathology, but not all of my friends who were at other programs had something so intense; our textbook was Kaplan and Sadock's
Synopsis of Psychiatry. There is also a mandatory two-semester practicum which can be done in a variety of settings (I was at an EAP- quite the dichotomy from the psychodynamic classroom stuff) with various levels and types of therapy experience over the minimum 900 hours. It's been in the jobs I've had since graduation that I've been able to "specialize", along with 3000 hours of supervised clinical experience in order to get my license, the continuing ed seminars, the consultation with colleagues, the consultation with psychiatrists.... and on and on.
Of what benifit do you think social workers that specialize in psychiatric care provide, as opposed to one that specializes in family or short term crisis counseling? I know these are a lot of questions all at once, but I am very interested because my friend plans on getting her MSW and she is also very interested in psychiatric disorders and such, and would rather be associated with that type of therapy as opposed to couple counseling ect.
I'm a bit confused by your statements, as short-term crisis counseling usually does have a psychiatric component to it (often acute anxiety), as does family counseling (a behavioral disorder? a personality disorder creating family conflict? many others..). And couples counseling........ was it OPD who once said something like "I'd rather claw my eyes out"? Whoever it was, I echo that sentiment.
Her mom whom is an MSW specialized in substance abuse receintly told her that psychiatric social workers have limited resources and that b/c the patients have psychiatric disorders or conditions and are so "messed up" that the therapy would be unsuccessful and she would get "nowhere" with her clients.
I'm a little surprised a substance abuse social worker feels comfortable commenting on mental health consumers being "messed up" and going "nowhere", given the spotty track record of most substance abusers' roads to sobriety and the comorbidity of substance abuse and psychiatric disorders. It's all about perspective. For a substance abuse client, perhaps the goal is permanent sobriety. For my clients? Well, I saw two women yesterday diagnosed with borderline PD. One hasn't had an extreme emotional outburst in almost two months, and the other, for the first time in the 6 months I've been seeing her weekly or twice weekly, reported that she had NO thoughts of self-harm, suicide, or wishes for death. To me, that's huge progress.
Could you please clarify the "limited resources" comment? Social workers are usually known as the resource kings/queens. I will grant that resources are becoming a bit more scarce due to government budget cutbacks, etc., which is scary.
I personally have read several books, mainly on schizophrenia and dissociative personality disorder in which a social worker (masters level) works side by side with the psychiatrist and provides most of the therapy. Sorry so long, I appreciate your professional (or non professional) opinion on this. Thanks
Coordination of care is crucial in for the patient, IMHO. Psychiatrist and therapist need to be on the same page, sending the same messages, or else the patient may get very confused and get worse. Coordination of care also helps prevent manipulation and triangulation.
All that having been said, I'd also like it on the record that I believe many MSW programs have become degree factories. Caveat emptor, and do your homework before referring.