Virginia Society for Clinical Social Work

1. (i) is necessary for the protection of public health, safety, and welfare or for the economical performance of important governmental functions;

2. (ii) minimizes the economic impact on small businesses in a manner consistent with the stated objectives of applicable law; and

3. (iii) is clearly written and easily understandable.

CURRENT VBSW REGULATIONS

VSCSW COMMENT

18VAC140-20-50 A. “supervised experience”

Not explicitly defined in regulations

The terms “Supervised Experience”, “Post-master’s degree experience”, “Work Experience” and “Experience” appear to be used interchangeably and none of the terms are defined in the regulations and are not clearly written and easily understood.

18VAC140-20-50 A. 1. “…post-master's degree experience…”

Not explicitly defined in regulations

18VAC140-20-50 A. 2. b “…average no less than 15 hours per week…”

It appears that “per week” and “per 40 hours” are used interchangeably but this is not explicitly defined in the regulations. 

18VAC140-20-50 A. 2. “…per 40 hours of work experience…”

It appears that “per week” and “per 40 hours” are used interchangeably but this is not explicitly defined in the regulations.

18VAC140-20-50 A. 2. a. “…Experience…”

Not explicitly defined in regulations

18VAC140-20-50, A. 2 The applicant shall have completed a minimum of 3,000 hours of supervised post-master's degree experience in the delivery of clinical social work services

From the wording it appears that all 3000 hours are to be “in the delivery of clinical social work services.”  However 18VAC140-20-50, A. 2. b. suggest that the 3000 hours spent in the delivery of clinical social work services are divided between 1380 hours with “face-to-face” meetings with clients and “the remaining” 1670 hours in “ancillary duties and activities supporting the delivery of clinical services” This regulation is not clearly written and easily understood (see below also).

18VAC140-20-50, A. 2. b. “…minimum of 1,380 hours. The remaining hours may be spent in ancillary duties and activities supporting the delivery of clinical services...”

     In the regulations “clinical social work services” are defined, however there is nothing in that definition to clarify if it includes both “face-to-face client contact” and “ancillary duties and activities” referred to in 18VAC140-20-50, A. 2. b. The wording “remaining hours” suggest that “clinical social work services” includes both “face-to-face client contact” and “ancillary duties and activities.”  Neither “ancillary duties” nor “activities supporting the delivery of clinical services” are defined in the regulations.  The regulation is not clearly written nor easily understood.

     The wording “…supporting the delivery of clinical services...” adds some confusion in that “clinical services” appears to be a more generic term than “clinical social work services..”  The term “clinical services” is not defined in the regulations and it is not clear if this term has the same meaning as “clinical social work services” or is being used as a more generic term.  This regulation is not clearly written and not easily understood.  

     Along with the terms “ancillary duties and activities supporting the delivery of clinical services:” another term should be included called “Clinical Case Management.”  A definition is:

Clinical Case Management:

Definition: Clinical Case Management is a modality of mental health practice that, in coordination with the traditional psychiatric focus on biological and psychological functioning, addresses the overall maintenance of the mentally ill person’s physical and social environment with the goals of facilitating his or her physical survival, personal growth, community participation, and recovery from or adaptation to mental illness.

    (Clinical Case Management: Definitions, Principles, Components, By Joel Kanter, MSW,  in Hospital and Community Psychiatry, April 1989, Vol. 40, No. 4, p361)

18VAC140-20-10. Definitions. B.

clinical social work services

“include the application of social work principles and methods in performing assessments and diagnoses based on a recognized manual of mental and emotional disorders or recognized system of problem definition, preventive and early intervention services and treatment services, including but not limited to psychotherapy and counseling for mental disorders, substance abuse, marriage and family dysfunction, and problems caused by social and psychological stress or health impairment”

  It appears that the intention of the regulations are that both “face-to-face client contact” and “ancillary duties and activities” should be included in the definition of “clinical social work services,” but the definition does not indicate that intention in a clear and explicit manner.

     VSCSW has had feedback from MSW’s who have applied for licensure that their social work experience does not meet the current definition. This includes experience in crisis intervention, hospice, and other social work settings that previously met the requirements of the regulations.  It can appear that the board is applying some standard in the review of credentials that is not in the definitions or regulations.  If an MSW has documented that they are providing Assessment, Diagnosis and Treatment of clients then it seems they have met the definition in the regulations. Some applicants have been told that they did not see clients for a long enough period of time. There is nothing in the regulations that specifies a length of time that the client must be seen. Again it appears that a standard that is not in the definitions or regulations is being applied to applicants.   This definition is not “clearly written and easily understood.”

  This regulation is having a negative economic impact in that the determination that an applicant’s experience does not meet the requirement causes the applicant to replace those hours of experience with new hours that do meet the requirement when the applicant’s original hours of work experience should have been counted.  This delays the opportunity for licensure which delays the ability of the applicant to engage in autonomous practice and earn income.

18VAC140-20-10. Definitions.

"Face-to-face supervision" means the physical presence of the individuals involved in the supervisory relationship during either individual or group supervision.

To require all supervision to be “face-to-face” places an economic burden on the small business social work practitioners. With Skype, the Internet and World Wide Web there is the possibility of acquiring supervision from experts located long distances from the suprevisee.  This regulation should be rewritten to have less negative economic impact on practitioners and should allow for a portion of the supervision to be by means that are not “face-to-face.”

18VAC140-20-10. Definitions

Clinical course of study" means graduate course work which includes specialized advanced courses in human behavior and social environment, social policy, research, clinical practice with individuals, families, groups and a clinical practicum which focuses on diagnostic, prevention and treatment services.

This definition appears to be sufficient upon first reading. However there are MSW’s who have graduated with an MSW, with a clinical concentration, from a CSWE accredited graduate social work program and are being told their coursework does not meet the standard.  This definition therefore is not clearly written and easily understood.

18VAC140-20-49. Educational requirements for a licensed clinical social worker.

A. The applicant shall be a graduate of a Master or Doctor of Social Work Program in a clinical course of study. An applicant with a nonclinical concentration shall complete additional graduate level academic course work and field placement/practicum to meet all requirements for a clinical course of study.

B. The minimum course requirements for a clinical course of study shall include graduate level courses consisting of:

1. Twelve credit hours of explanatory theory;

2. Twelve credit hours of practice theory;

3. Three credit hours of psychopathology including assessment, diagnosis, and treatment;

4. Three credit hours of social work practice research; and

5. Coursework in diversity issues, social justice, culture, and at-risk populations.

C. The requirement for a supervised field placement/practicum in clinical social work services shall be a minimum of 600 hours, which shall be integrated with clinical course of study coursework and supervised by a person who is a licensed clinical social worker or who holds a master's or doctor's degree in social work and has a minimum of three years of experience in clinical social work services after earning the graduate degree. An applicant who has otherwise met the requirements for a clinical course of study but who did not have a minimum of 600 hours in a supervised field placement/practicum in clinical social work services may meet the requirement by obtaining an equivalent number of hours of supervised practice in clinical social work services in addition to the experience required in 18VAC140-20-50.

D. Graduates of a bachelor of social work program who earn advanced standing in the master’s program shall meet all minimum course requirements for a clinical course of study, except advanced standing students may count up to six hours of explanatory theory and up to six hours of practice theory completed during the bachelor degree program towards meeting the requirements.

E. A master of social work program shall (i) include foundation course work common for all social work students, (ii) include advanced course work for student specialization, and (iii) be accredited by the Council on Social Work Education. A doctor of social work program shall at a minimum: (i) meet all requirements for the advanced course requirements for a clinical course of study, and (ii) be accredited by the appropriate regional academic accrediting body (e.g., Southern Association of Colleges and Schools).

Below is an example of how the basic course requirements for VCU, MSW in a clinical concentration, from a CSWE accredited MSW program would leave the graduate 6 credit hours short of meeting the VBSW requirements for Clinical Course of Study.  The MSW applicant would have to return to graduate school to acquire these extra 6 credits even though they had an MSW degree that meets the standards of the CSWE.  This regulation causes an undue economic burden and impact on the applicant.

VBSW: The minimum course requirements for a clinical course of study include graduate level courses consisting of:

Virginia Commonwealth

University MSW course #s. These are the course required by VCU to acquire an MSW

Number

of credits earned

Number of credit hours short of VBSW requirement shown in RED

12 credit hours Explanatory Theory (How we understand Human Behavior through a BioPsychoSocial perspective, i.e., psychodynamic, ego psychology, self psychology, relational, systems, cognitive behavioral, socio/cultural, behavioral, etc.)

601

610

6

6

12 credit hours Practice Theory (Models of Direct Practice, Clinical Practice or Psychotherapy, i.e., individual, family, child and adolescent, or group psychotherapy, cognitive behavioral, client centered, short-term, etc. from conventional theoretical models of social work practice).

604

605

704

705

12

0

3 credit hours Psychopathology including assessment, diagnosis and treatment.

703

3

0

3 credit hours Social Work Practice Research

609

706

707

9

+6

Course work in Diversity Issues, Social Justice, Culture, and At-Risk Populations (i.e., abused children)

603

3

0

Supervised Field Placement/Practicum in clinical social work services* should be a minimum of 600 hours, which are integrated with the Clinical Course of Study course work.  Supervision of the student shall be provided by a supervisor who holds Master’s or Doctor’s degree in Social Work and has a minimum of 3 years of experience in clinical social work services* after earning the graduate degree or who is a Licensed Clinical Social Worker.  An applicant who has otherwise met the requirements for a clinical course of study but who did not have a minimum of 600 hours in a supervised field placement/practicum in clinical social work services may meet the requirement by obtaining an equivalent number of hours of supervised practice in clinical social work services in addition to the experience required in 18VAC140-20-50 of Regulations Governing the Practice of Social Work.

693

694

793

794

12

0