An Emerging Theory to Guide Clinical Social Workers Seeking Change in Regulation of Clinical Social Work

Abstract

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.

Defining Clinical Social Work and its Implications for Practice

“…The current study's findings are different from Cooper-Bolinskey (2019) where clinical social workers felt limited in their ability to provide psychotherapy to clients; some jurisdictions restrict the definition of clinical social work to psychotherapy. Boards of Social Work that limit clinical social work to psychotherapy may create challenging situations for practitioners seeking clinical licensure.…”

“…Social work's foundations in the early 1900s grounded practice in the case work model which assessed how the individual's environment was a source of or relief from stress (2015). Through the 1970s, social work continued to place emphasis on the social component of the work, looking to person-in-environment as components of change (Cooper-Bolinskey, 2019; 2015). From the 1940s to 1970s, social work focused on the process of licensure and regulation with the goal of protecting practitioners and consumers (Johnson, 1970); this appears to coincide with a shift in clinical practice from person-in-environment to intrapsychic processes (Thyer, 2017).…”

“…From the 1940s to 1970s, social work focused on the process of licensure and regulation with the goal of protecting practitioners and consumers (Johnson, 1970); this appears to coincide with a shift in clinical practice from person-in-environment to intrapsychic processes (Thyer, 2017). While the delineation and definition of clinical social work in licensing emerged from efforts to professionalize practice and protect clients, it has caused a rift in the discipline's identity (Cooper-Bolinskey, 2019; Plitt Donaldson et al, 2014; Weiss-Gal & Welbourne, 2008). Within direct practice work there now appears to be a designation between clinical and nonclinical work (Cooper-Bolinskey, 2019; Groshong, 2009).…”

“…While the delineation and definition of clinical social work in licensing emerged from efforts to professionalize practice and protect clients, it has caused a rift in the discipline's identity (Cooper-Bolinskey, 2019; Plitt Donaldson et al, 2014; Weiss-Gal & Welbourne, 2008). Within direct practice work there now appears to be a designation between clinical and nonclinical work (Cooper-Bolinskey, 2019; Groshong, 2009). Research on social work's definitions of clinical practice in licensure and the potential impact of these regulations on the profession is emergent (Cooper-Bolinskey, 2019, 2016; Groshong, 2009) yet has considerable implications for those in the field.…”

“…Within direct practice work there now appears to be a designation between clinical and nonclinical work (Cooper-Bolinskey, 2019; Groshong, 2009). Research on social work's definitions of clinical practice in licensure and the potential impact of these regulations on the profession is emergent (Cooper-Bolinskey, 2019, 2016; Groshong, 2009) yet has considerable implications for those in the field.…”