Rule Making on Definition of Clinical Social Work (HB 1339)

At the Sep 4th, 2009 DORA Board of Social Work Examiners meeting the Board voted to ammend Rule 17.  This is the rule that was also discussed at the July 10th rule making hearing, at which NASWCO representatives testified.  To date, there is no official posting from DORA regarding the ammended rule as it is being reviewed the the Attoney General's office.  NASWCO leaders attended the September 4th meeting and report that the proposed NASW language for ammending Rule 17-C (made in testimony) was NOT ADOPTED by the DORA Board.  The Board did appear to consider NASWCO testimony and included some wording from the testimony in it's changes to Rule 17-C (specifically the term "biopsychosocial"). 

Following is the change to Rule 17-c-4-C-1 that the Board approved which is most concerning to NASWCO (see Background on Issue below). 

(C) The post degree hours required under 17(c)(4)(B) above must meet the following requirements;

(1) Clinical social work practice for LCSW licensure (as noted in 12-43-409):

a) At minimum, half of the work experience hours (1,680) must include a professional relationship that involves treatment, diagnosis, testing, assessment, or counseling.  One or more may occur during any of the following activities:

§  Assisting individuals or groups to alleviate mental disorders;

§  understanding unconscious or conscious motivation;

§  resolving emotional, relationship, or attitudinal conflicts; or

§  modifying behaviors that interfere with effective emotional, biopsychosocial or intellectual functioning.

 At the July 10th, 2009 DORA rule making hearing for HB 1339, the Social Work Board postponed voting on any rule changes until the September board meeting in order to take into consideration testimony.  NASWCO and Clinical Society were represented by Practice Standards Committee Co-Chairs Ron Langer and Sandra Holman provided testimony on behalf of NASW-CO.  Please check this website for furthe updates before the September meeting.

Click here to view Ron Langer's Testimony

Click here to view Sandra Holman's Testimony

Background on the Issue

The mental health statute had a definition of clinical social work practice that placed a greater emphasis on psychotherapy than national standards of practice for the social work profession. Based on this, the Board of Social Work Examiners passed rules and policies that required significant psychotherapy hours from those seeking their LCSW. There are clinical social workers in a variety of settings who do not necessarily perform psychotherapy but who do perform clinical social work functions. The statutory definition of clinical social work practice was updated through House Bill 1339 by amending Section 12-43-401(4) to “Clinical social work practice shall have the same meaning as social work practice as defined in 12-43-403.” It passed the legislature and was signed by the governor in June 2009.

The Rule Making session with the Board of Social Work Examiners is scheduled for July 10th at DORA at 9am. DORA staff has met with NASWCO to discuss suggestions for rule making. In agreement with NASWCO, DORA has suggested changes to the rules that delete any reference to the word “psychotherapy” and replace with appropriate language. In Rule 17(c)(4), they are proposing to add language that says that half of the work experience hours (1680 of 3360) must include particular activities. NASWCO has no issue with the percentage of hours DORA wants to require. Our issue is with the language that defines those activities - it is taken verbatim from the definition of psychotherapy in a different part of the statute (12-43-201-9). We believe the language should be taken from the definition of social work practice (12-43-403).

To be fair, the definition of psychotherapy in the statute may be broader than what many social workers would expect – but there have been misunderstandings and problem interpretations in the past. In addition, we do not want to confuse or meld the terms of psychotherapy and clinical again. We must avoid setting a precedent that suggests that clinical social work is predominantly psychotherapy. If the language used in the rule is taken directly from the definition of psychotherapy, than the groundwork is set for such a precedent.

Proposed NASWCO language for Rule 17 (C)(1)(a):

At a minimum, half of the work experience hours (1,680) must include direct intervention and problem solviing with clients and/or thier systems based on a biopsychosocial assessment, and will inlcude one or more of the activities listed in 12-43-403(2) (a)-(m)(q)(t): assessment, diagnosis, treatment planning and evaluation, measurement of psychosocial functioning, crisis intervention, therapeutic, individual, marital, and family interventions, client education, case management, mediation, advocacy, discharge, referral and continuity of care planning and implementation, consultation, supervision, social groups work, psychotherapy.
 

In addition we propose the following changes:

That 17(c)(4)(C)(1) rely upon the statue changes in 12-43-401 and read "Clinical soical work practice for LCSW licensure as noted in 12-43-401(4) and in 12-43-403".

Rule 17(c)(4)(C)(2) appears to exclude the LSW as a prerequisite for post-degree work experience and needs to be added.