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Frequent questions

We have prepared this section for people who have some questions regarding Clinical Social Work. The questions we have selected are based on those that we are frequently asked about this specialty of the profession. We also want to express that this is not an absolute truth regarding the  topic, nor does it want to give legal elements regarding it, being simply our vision as an institution regarding the state of the art of the discipline.  We hope that they will be of help to your concerns and that you can quickly respond to some of the key elements that every Social Work professional should know.

1. What is Clinical Social Work? 
2. Since when does Clinical Social Work exist?
 
3. What is the difference between a social worker and a clinical social worker?
 
4. Where can a clinical social worker be trained?
 
5. Where can a clinical social worker be accredited or certified?
 
6. Where can a clinical social worker practice?
 

7. Which  are the goals of a clinical social worker?
8. What are the roles of a Clinical Social Worker?

9. What are the main functions, activities, or services performed by a clinical social worker?
10. Does a clinical social worker need clinical supervision?
11. In which countries does clinical social work exist?

12. What organizations recognize Clinical Social Work at the international level?

13. Why is training / updating important  constant in Clinical Social Work?

1. What is Clinical Social Work?  

There are multiple definitions of what Clinical Social Work is, such as those of Pinkus et al (1977), Lieberman (1980); Meyer (1983), Dorfman (1988; 1996), Barker (2003), Quintero (2004), National Association of Social Workers (1987; 2005), Center for Clinical Social Work (2007), Groshong (2009), Ituarte (1992 ; 2017), Regalado (2018) and Reyes (2019). Therefore, the Chilean Institute of Clinical Social Work (2020) provides its own definition, which includes the wealth of the previous ones:

 

"Clinical Social Work is a specialized practice of the profession, which is exercised through a due postgraduate training process and clinically supervised. The approaches and methodologies include the integration of Social Work methods with a therapeutic purpose, from a broad theoretical framework and epistemological. The main functions and services of clinical social workers are oriented to carry out comprehensive evaluations, as well as to systematize, supervise, investigate and advise clinically. One of the main forms of professional practice is the application of different therapeutic practices, including their individual, family, group and collective modalities Other clinical practices within the TSC are counseling, family therapy, liberating social pedagogy in mental health, crisis intervention, case defense, mediation, home visits for therapeutic purposes and community development, among other as related ".

 


2. Since when does Clinical Social Work exist?  

 

The point of origin of Clinical Social Work must be considered from the very beginning of the profession in the United States. Obviously, due to contextual factors, this practice at the beginning of the 20th century did not have that name, nor was it being conceptualized in that way. However, since the emergence of the Societies of Organization of Charity (COS), and from the work carried out by Jane Addams and Mary Richmond, the need arises to understand that social problems not only depend on individual factors (intrapsychic), but that problems such as poverty are due to contextual determinants and subjective factors in mutual relation, establishing early our main ontological characteristic as a profession, which is the “person in their environment” perspective. There are those who argue that the concept of Clinical Social Work emerged in the 30s from the hand of Edith Abbott, but added to this, and thanks to the contribution of the caseworkers (caseworkers) who deepened the subjective dimension of the practice, mainly from the application of psychoanalytic ideas, both Freudian and non-Freudian; Figures such as Gordon Hamilton, Jessie Taft, Virginia Robinson, Helen Harris Perlman and Florence Hollis, granted and relieved the therapeutic dimension in the practice of Social Case Work, calling the latter a "psychosocial therapy". In the mid-1960s and due to social movements, the case method was questioned, and a controversy arose within Social Work. However, social workers who were committed to direct intervention (casework, family treatment and group work) began to defend and recognize the existence of Clinical Social Work as the spiritual successor to Case Social Work, but this time, His practice and training should have higher standards, therefore he required postgraduate training. It is at the end of the 60s and during the 70s that Clinical Social Work Societies begin to appear in different states, the first journal "Clinical Social Work Journal " in 1973 and the first formal definition will emerge in 1978 by the National Association of Social Workers. (NASW). It was since then that many social workers would define themselves as "clinics" and a large part of them will be strongly linked to the development of family therapy. In the 1980s, the concept of Clinical Social Work became widespread and a defense project began to regulate its practice, mainly to defend the professional practice of therapy and mental health services, since other professions had intentions to monopolize this area. At the end of the 90s, the first clinical licenses granted by each state with specific requirements (LCSW) were created, which will allow reimbursements for medical insurance in private practice. It will be until 2003 that the practice of Clinical Social Work will be regularized at the legislative level in 50 states in the United States. Today, clinical social workers are the largest mental health group in the United States, surpassing psychologists, psychiatrists and psychiatric nurses together, becoming one of the top 5 mental health professions by federal law, with approximately 200,000 active professionals in the system. Therefore, being a clinical social worker in the United States in the vast majority of states requires at least a master's degree (MSW), clinical supervision of at least two to three years of supervised post-master clinical work and / or pass a knowledge test from the American Board of Examiners in Clinical Social Work. (Groshong, 2009)


3. What is the difference between a social worker and a clinical social worker?  

Since Clinical Social Work is a specialty, which operates mainly in English-speaking countries, in these countries the training of Social Work is stratified, there is what is called generalist practice, which is practiced mainly by people with a Bachelor's Degree in Social Work (BSW ) and who would ultimately be the social worker without specialization (equivalent to the person who has the professional title and the bachelor's degree here in Chile). However, to carry out clinical or therapeutic work, which requires more training, due to an ethical issue towards people, since one does not acquire specialized skills with undergraduate studies, one has to undertake specialized studies, mainly Master's in Social Work (MSW) or PhD (DSW or PhD). In Latin America the situation is quite different, since in many countries there is no regulatory system for advanced training in the profession, which implies that qualified clinical practice and proper training in the therapeutic exercise of the profession are not ensured. In our view, a clinical social worker in this context is a Social Work professional, who desirably must have a degree in Social Work and the respective professional title, as well as a postgraduate degree in the clinical area, but desirably in Clinical Social Work. (postgraduate, specialized diploma or master's degree). There are exceptions where such training can be equivalent to a complementary curriculum (for example, having a Master's degree in Clinical Psychology or Family Therapy), however, this is not enough, it is expected that you also have professional experience in workplaces where has directly cared for individuals, families or groups, under a therapeutic orientation in their practice and with experiences of clinical supervision in their professional work.


4. Where can a clinical social worker be trained?  
 

Currently, in Chile there is only one specific and exclusive program in this area, which is:  "International Diploma in Clinical Social Work: For a contemporary therapeutic practice with individuals, families and groups" . Which is carried out by us as an Institute, the call for its III Version 2022 will be at the end of this 2021. In an alternative line, with fewer training hours and focused on skills, there is the "Diploma in Skills for Clinical Social Work" of the Pontifical Catholic University of Chile.

5. Where can a clinical social worker be accredited or certified?  
 

In Chile there is no juridical-legal system that accredits clinical specialties in Social Sciences professions, as well as in Social Work. Internationally, accreditations have to do with certain clinical licenses (for example, LCSW or LICSW in the United States), accreditation (ACSW in Australia) and / or registrations (RCSW / RSW in Canada and South Africa, or the CQSW in the United Kingdom ) that will depend on the respective country and its internal regulatory systems. The only certification as a clinical social worker is to have a postgraduate degree (advanced diploma, postgraduate or master's degree) in Clinical Social Work, as long as this program has a teaching staff for the specialty and a minimum number of theoretical hours of 360- internships that must be given in a training cycle of 1 year. Therefore, we make an ethical and responsible call to colleagues so that they can support an adequate clinical practice and with due training, this is to achieve position the profession in a place of expertise and social credibility.

6. Where can I obtain scientific information on Clinical Social Work?  

In international terms, the specific scientific journals on Clinical Social Work worldwide are: the Clinical Social Work Journal of the United States (paid), the Clinical Social Work and Health Intervention of Austria (free access) and the Latin American Journal of Clinical Social Work of the Chilean Institute of Clinical Social Work (free and public access), the latter being the first journal in Spanish worldwide, as well as the first in Latin America and Ibero-America, and the first in the history of Chile.

7. Where can a clinical social worker practice?  
 

For us as an institute and according to the international and national reality (Chile):

  1. The practice of Clinical Social Work can be carried out in both public and private contexts, or in the free exercise of the profession, and the population to which its practice is directed can have different ages, socioeconomic status, race, life cycle, ethnicity. or gender.

  2. The most frequent areas of exercise may be - not limited to these - the areas of health and mental health, reparation (restitution) of human rights and work with the population victim of domestic violence, abuse or sexual exploitation, in its multiple fields of expression; people who have conflicts with the law, and who require social reintegration, school psychosocial settings, as well as in drug use rehabilitation contexts, in addition to institutions linked to overcoming poverty or social exclusion, or other emerging contexts that require direct services.

  3. Therefore, Clinical Social Work can be applied to any field that requires a direct practice of professional services related to treatment (therapeutic and / or reparative intervention), evaluation, promotion, restoration, rehabilitation or other integrated activities that seek to improve quality. life of people and enhance human well-being.

8. What are the objectives of Clinical Social Work?

Its main objectives according to our institutional vision are oriented towards:

  1. Establish a practice of empowerment and emancipation with the most vulnerable groups in society, but also with other social classes and people who require it

  2. Maintain a cross-cutting perspective by implementing a strengths-based approach, informed by trauma and a collaborative ethic that seeks to reduce oppression and help people to be able to generate changes in their own lives and in their relational or contextual contexts.

  3. Provide a broad therapeutic practice that includes the activation of networks and resources, evaluating in an integrated way, recognizing community strengths, the cultural rescue of human systems and all the actions necessary to alleviate the relational and emotional discomfort of individuals, families and groups .

  4. Contribute with a critical, anti-oppressive and gender perspective to the interior or exterior of social institutions.

9. What are the roles of a clinical social worker?  

The clinical social worker performs multiple roles in their clinical practice, perhaps the best known being the role of therapist. However, reducing Clinical Social Work to that role alone is certainly something that only simplifies this exercise. Other roles are: social and community media linker, advocate, educator, facilitator, case advisor, clinical supervisor, counselor, mediator, private consultant, researcher, or program evaluator.

  10 . What are the main functions, activities, or services performed by a Clinical Social Worker?

The clinical social worker performs multiple functions, activities or services, the important thing is that they must have training in any of these so that they can exercise them in a responsible and ethical way, for example there are clinical social workers more focused on individual or family aspects or others in more collective aspects in their clinical practices. Therefore, the best known are: counseling, therapy, community and network management for therapeutic purposes, resource agent, defense of people's rights, mental health education, psychosocial support, personal or group care strategies, administration of therapeutic programs, multidisciplinary team coordinator, mediation, specialized consulting, clinical supervision, therapeutic practice with groups, empowerment-based community work, interdisciplinary collaboration for therapeutic purposes, crisis intervention, home visit for therapeutic purposes. among others.

 


11. Does a clinical social worker need clinical supervision?

Yes, of course. Every clinical intervention process involves one or more stages of supervision, both for the social worker and for other professions involved in therapeutic services. At the international level, for example in the United States and Canada, clinical supervision is a constant and mandatory process for professional practice because people's clinical situations change or because the intervention process itself needs to be revitalized to help deliver services. according to people's needs. This is why supervision is a space for reflection to analyze clinical cases and is a place to receive guidance and guidance from a supervisor (who generally has more experience and training) who will facilitate theoretical and practical integration processes. Due to the fact that clinical work generates or is highly loaded with stress, this produces an emotional exhaustion in professionals, therefore, supervision is also a reflective space of the clinical social worker's own person, which favors their own personal care of the professional.

 


12. In which countries does clinical social work exist?

The clinical social worker degree or license or accreditation (LCSW or LICSW) exists primarily in the United States in its 50 states regulated by federal law. In Canada in the provinces of Alberta and British Columbia there is a registry of clinical social worker (RCSW) and in Australia in recent years there is accreditation as a clinical social worker (ACSW) or accreditation as a mental health social worker (AMHSWs) . Regarding the case of Canada, in a large part of the other provinces of the country, what is required to exercise a therapeutic practice is the Master of Social Work and the union accreditation (RSW). In South Africa Clinical Social Work has existed since the 1980s and there is a formal registry (RCSW). A noteworthy feature is that Social Work in almost the majority of English-speaking countries (England, Ireland, New Zealand, etc.) is considered a clinical profession (In the countries that make up the United Kingdom, the Certification of Professional Qualification in Social Work [CQSW ]). Therefore, in these countries a specific license or title of Clinical Social Work is not required,  Instead, it is required to be a social worker (BSW) with a master's degree (MSW) and with the specific records in the Social Work colleges, which accredit you to practice as a therapist with the aforementioned training. Other countries where Clinical Social Work exists or where social workers fulfill therapeutic functions are: Norway, Germany, Switzerland, Finland, Saudi Arabia, Sweden and Israel. Within the Spanish-speaking countries, only Puerto Rico has the characteristics described above and there are master's degrees in Clinical Social Work up to a Doctorate degree, this is mainly due to the American influence at the political-legal level. In these last two years, Chile and Spain have begun a vindication of Clinical Social Work, counting on the foundation of the Chilean Institute of Clinical Social Work (March 20, 2019) and the Spanish Institute of Clinical Social Work that was born on October 22, 2019. 2019. Both institutions collaborate, both independently and strategically in the socialization of Clinical Social Work in Spanish-speaking countries and Latin America, delivering advanced training from their own centers and on some occasions in collaboration with other professional, academic or social institutions in general.

13. What organizations recognize Clinical Social Work at the international level?

Among the most common organizations that recognize Clinical Social Work at the international level are: American Psychology Association (APA), National Association of Social Workers , American Clinical Social Work Association ,  Alberta College of Social Workers , British Columbia College of Social Workers , Australian Association of Social Workers ,  European Center for Clinical Social Work. and  Official College of Social Work of Santa Cruz de Tenerife in Spain . Other important organizations that recognize the therapeutic exercise of Social Work are the Canadian Association of Social Workers  in its regulatory disciplinary statutes, and finally, the International Federation of Social Workers in conjunction with the International Association of Schools of Social Work, which in 2014 approved the new world definition of Social Work, which explicitly states that: " Social work practice encompasses a variety of activities including various forms of therapy and counseling, group work and community work; policy formulation and analysis; and advocacy and policy interventions. From an emancipatory perspective, this definition supports social work strategies that aim to increase people's hope, self-esteem and creative potential to confront and challenge the dynamics of oppressive power and the structural sources of injustice, thus incorporating the micro-macro and the personal into a coherent whole ".  

14. Why is training / updating important  constant in Clinical Social Work?

At the international level, and by way of example, in countries such as the United States and Canada, the professional clinical license or registration may be suspended or not renewed, and in some cases it may be eliminated due to unethical situations. In order to maintain the respective credential, it is required to accredit or certify annual hours of training or improvement regarding the work areas or areas of interest related to the practice carried out by the professional. In our contexts, and specifically in Chile, although it is not a legal obligation to maintain continuous training / updating, it does constitute a desirable action on the part of any employer or by the same professional who wants to improve their disciplinary skills. Our vision as an Institute is that Social Work professionals, and specifically those dedicated to clinical practice, are constantly being trained or trained, since the training update will allow them to qualify their practice and improve the therapeutic services they deliver to people. We believe that an ethical issue should appeal to develop a qualified clinical practice, which allows justice to the real needs of individuals, families and groups in our society, while on the other hand, this will enable the professional to maintain an avant-garde regarding to the constant challenges that the profession presents. This is why our Institute annually offers refresher courses to strengthen different topics of interest regarding clinical / therapeutic work in Social Work.

REFERENCES

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  3. American Psychological Association (2017). What is the difference between Psychologists, Psychiatrists and Social Workers? Available at: https://www.apa.org/ptsd-guideline/patients-and-families/psychotherapy-professionals.pdf

  4. Australian Association of Social Workers. Accredited Clinical Social Worker (ACSW).  Available at: https://www.aasw.asn.au/membership-information/accredited-clinical-social-worker-acsw

  5. Barker, RL (2003). The social work dictionary . (4th ed.). Washington, DC: NASW Press.

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  7. Canadian National Association of Social Workers (2008). Social Work Scope of Practice . Retrieved from https://www.casw-acts.ca/sites/default/files/attachements/scope_of_practice_august_08_e_final_17.pdf

  8. Center For Clinical Social Work (2007). Clinical Social Work Described . Available in:  http://acswa.org/wp-content/uploads/CtrCSWDescribedFeb071.pdf

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