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U.S. regulation of social work began in the 1940s. By the mid-1990s, all jurisdictions within the United States regulated the profession through licensure. One purpose of licensure is to protect the public and the profession; however, legislation defining social work varies vastly among jurisdictions. The variation exists not only between jurisdictions, but also within licensure categories. The disparity within clinical social work continues without resolve. This qualitative study explored the barriers encountered and solutions used in three states as they secured laws allowing licensed clinical social workers to independently provide mental health services. Grounded theory research, based on information from 12 historians, is used to develop a theory to aid advocates in jurisdictions not yet achieving fully independent practice of clinical social work. The emerging theory offers a complex-systems approach to using a strategic framework to overcome barriers when attempting policy change. The primary purpose of the research is to develop strategies that aid in securing changes in clinical social work regulation. The emerging theory may serve a broader purpose by supporting the Association of Social Work Board's (ASWB) goal of practice mobility and license portability. As advocates in various jurisdictions attempt to align regulations with the Model Social Work Practice Act from ASWB, they may experience barriers. This emerging theory could guide efforts to change clinical social work regulation.

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The current study examined the relationship between pre-licensure supervised experience requirements and license violations in order to ascertain whether jurisdictions requiring higher numbers of hours of supervised experience to obtain clinical social worker (CSW) licensure had fewer violations. The purpose of the study was to explore if there is a measure of “enough” supervised experience without compromising protection of the public. Three data files were used to complete the study: National Practitioner Data Bank (NPDB), Association of Social Work Boards (ASWB)’s Supervision Requirements per Jurisdiction Data, and ASWB’s U.S. Social Work Licensee Data. Results indicated that jurisdictions requiring less than 4,000 hours of supervised experience reported fewer violations than would be expected, whereas jurisdictions requiring 4,000+ hours of supervised experience reported more violations than would be expected given the number of CSWs within the respective groups. Results question the practice of requiring higher amounts of supervised experience as a regulatory standard. Implications for social work regulation include support for nationally standardizing the required amounts of supervised experience outlined by Groshong (2011) and the ASWB (2018) Model Social Work Practice Act.