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Social workers are required to have a Master's degree in social
work and a license from the state in which they practice. Is this
fair, or even necessary? What about people who have a natural
talent for helping others, but who lack opportunity to fulfill
the educational requirements? Are the counselling professions
losing some of the best potential workers because of educational
and licensing requirements?
Let's divide today's
topic into two discussion areas: (1) educational requirements, and
(2) licensing requirements. To the best of my knowledge, there are
still some states where you can practice counselling without
meeting any requirements whatsoever. You might not be able to call
yourself a psychotherapist, but you can market your craft as
some sort of counselling service. Of course, you are not eligible
for insurance reimbursement and must rely on a cash-paying
clientele.
Regarding career
preparation, my conviction is that social workers should be held to
high educational standards. Natural talent cannot suffice. There
are too many complexities in human behavior, too many theories and
therapeutic approaches, such that natural talent alone cannot
navigate the profession. Anyone practicing any form of counselling
also needs to be educated in ethics, confidentiality, interpersonal
boundaries, and self-disclosure. Another advantage of formal
education is the opportunity to do fieldwork under the supervision
of a qualified professional. Having a good fieldwork experience is
invaluable preparation for the real world, and it can supplement
any weaknesses within the university's course offerings.
State licensure,
however, does not guarantee social work effectiveness. Getting
your state license is generally a matter of completing graduate
school, taking the licensing exam, perhaps getting letters of
recommendation, and having a certain number of years of work
experience--depending on the type of license you are seeking. Now,
anyone who has gone through college and graduate school can get a
minimal passing score on the licensing exam. But, passing an
exam does not mean you are a good person.
The advantage of
licensure seems to be in the area of consumer protection. It
enables patients to inquire about the status of or to file
complaints against any social worker. It enables the state
licensing board to track social workers and to take action
against malpractitioners and lawbreakers.
Unfortunately, there
are social workers who are incompetent (despite their formal
education), who violate interpersonal boundaries (despite their
fieldwork training), or who commit crimes such as welfare and
insurance fraud. My guess is that it is easier for state boards to
intervene in cases of criminal conduct than in cases of therapy
malpractice. The former is obvious, while the latter can sometimes
be difficult to prove. Nevertheless, patients need an arena in
which they can bring forth questions and complaints.
Licensure, however,
can be costly and complicated. Perhaps you live in a state that
requires license renewal every two years. There are forms to fill
out. There is a renewal fee of, let's say, $300.00. There may be
a requirement to provide documentation of a certain number of
continuing education units. There may be requirements to get your
completed forms notarized and to submit a fingerprint clearance
card. Then, the only useful result of all this effort is that the
state can track you. The social worker receives absolutely no
benefit from licensure other than eligibility to work.
In other words, you
must pay the state in order to make a living. What does the state
do with all that money? How much money does the state need to
protect consumers? Why should law-abiding, ethical, competent
social workers have to pay a right-to-work (a right which some
argue is already guaranteed by the U.S. Constitution--the First
Amendment right to assembly--and by the Taft-Hartley Act) fee which
is apparently used by board members to review license applications
and to investigate complaints? If a social worker is non-compliant
with laws, rules, and regulations, then why is that individual not
totally responsible for restitution? Why do you and I and the
majority of social workers have to pay for the misconduct of the
few?
There must be a
better way for the state to protect consumers. Licensure is
really unnecessary. A simple registration system would be
adequate. Social workers, and all other types of counsellors,
should be asked to voluntarily register with the state. It should
be a simple matter of keeping the state updated with your name
and address, educational accomplishments, and place of current
employment. This information should be posted as public record.
Registration should not cost more than $25.00 for processing. This
should be a one-time fee. If you need to update your information,
it should not cost more than $5.00 to $10.00 for processing.
Consumers could then
decide for themselves whether to hire your services. If you did
not voluntarily register with the state, that might indicate to
the patient that you have something to hide, or that you just
object to any government control over your profession. If you are
registered, the patient could check your qualifications and legal
status. Registered or not, the patient (or employer) would make an
informed decision about you and would have a way to file a public
complaint if necessary.
The state would not
have the right to determine the requirements for practicing any
form of counselling. This means that those with limited or no
college education could proclaim themselves as therapists. If
registered with the state, however, the non-degree workers could be
tracked. The disadvantage is that incompetent non-degree workers
could give all professionals a bad name, but probably no worse than
incompetent licensed workers. The advantage is that consumers,
rather than the state, have the ultimate decision-making power.
Consumers are regarded as having enough intelligence to make the
best choice for themselves.
If all registration
information were kept updated and posted on the internet or
published annually in a booklet, then consumers and employers
could check on anyone practicing any variation of counselling.
The state would also be responsible for listing any crimes or
malpractice committed by any practitioner. Crimes (such as welfare
or insurance fraud) would be defined by law. Malpractice would be
defined by the employer in agency situations. Private
practitioners would be responsible for creating and posting their
own mission statement and code of ethics in their offices (or
perhaps adopt the N.A.S.W. code). Patients would be given copies
of these statements and codes to read and sign before accepting
treatment.
Some might argue
that state licensure gives the profession of social work more
respect and political clout. This would be difficult to prove. If
true, however, then the profession has paid a high price to place
itself in the ranks of doctors and attorneys: it has abdicated
its authority to state government boards. Public respect for the
profession has always been a hindrance, but this is due to the
stigma of mental health problems and not to a lack of government
approval. As for political clout, the N.A.S.W. is politically
active--and seems to be aligned with the liberal left.
My strong belief
is that anyone practicing psychotherapy should have a diploma in
psychology or social work. It is education and experience, not
licensure, that qualifies social workers to help others. But, I
think there should be an option, such as an apprenticeship, for
those who would incur severe hardships from the educational
requirements.
There could be an
employment category of social worker assistant. These
workers would be required to have an Associates Degree. Any
motivated person can complete a total of two years of education at
a local community college. Then, these workers could obtain jobs
assisting formally-trained professionals. Their job duties would
be similar to the fieldwork assignments which all social work
grad-students are required to do, except that they would continue
for an extended period of time. Let's say that after 12 years of
steady employment as social worker assistant, these workers would
be eligible to get jobs as professional social workers, equal in
status to the current category of M.S.W.
An alternate
route to professionalism, apprenticeship in contrast to formal
education, could enrich the profession by inclusion of workers
from different economic and cultural backgrounds. Workplaces
would become like the 'teaching hospitals' in which training
and education is a part of the job and on the job. People with
natural talent would be given focus and supervision, while
professionals would necessarily have to keep their knowledge base
updated in order to be useful to both patients and social worker
assistants.
When I began my
career in counselling in the 1980's, in the State of New York,
licensure (or certification as it was called in those days) was an
option. Moreover, there was no distinction between licensed social
workers and licensed clinical social workers. Many social
workers voluntarily took the licensing exam and got their state
license. My opinion is that the license was more of a status
symbol, since you could work for any agency as well as open your
own practice with only your M.S.W. Also, I believe many social
workers internalized the license as a personal goal--never
imagining that someday it would become an instrument of government
control and revenue, and a bureaucratic nuisance.
(Written 07/24/06 - Revised 08/16/10)
[NOTE: For other
essays on similar topics, see Social Workers in Loan Debt
(written 05/12/08), C.E.U.'s and M.S.W.'s
(written 05/22/06), Ye Olde Social Worker
(written 08/19/02).]
Until we meet
again....... .......stay sane.
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