The primary mission of the Society is:
We are Clinical Social Work Psychotherapists
Marsha Wineburgh, DSW, President
The practice of social work is more than 100 years old and highly diversified, across many settings, across several levels of education, and many areas of interests. One- eighth of all the social workers in the United States live here in New York State. We, the members of the NYSSCSW, are a self-selected group of clinical social workers within this very large profession. We are not defined by the setting we work in; rather we are defined by our interest in and/or our expertise in mental health and the treatment of mental illness with all its derivatives and nuances. Our knowledge base draws from distant as well as allied professions, from psychiatry and sociology to spirituality and the creative arts. We are the clinical social work psychotherapists, whether we have a special interest in psychoanalysis, grief counseling, EMDR, or marriage and family therapy. There are nearly 26,000 LCSWs in New York State, all potential members, whose interests we advance and protect.
Ironically, after the passage of the licensing law for clinical social work (2002), wherein the function of LCSWs was explicitly described, confusion grew about what clinical social workers actually do and, consequently, whose interests the Clinical Society should represent. Many social workers believe that any direct contact with a client/patient is a clinical intervention. If one subscribes to this belief, then the mission of our organization could expand to include this wider base of direct practice professionals and might include medical social work, child welfare, or case management. One of the problems with this expansion is that there would be no professional social work organization representing the particular interests of social work psychotherapists. And there would be internal conflicts of interest within the organization about financial and legislative priorities stemming from the legitimate tensions between these different practice groups.
KEEP IT SIMPLE: We are the only social work organization specifically representing social work psychotherapists in this state. There is no other professional organization that is able to represent and advocate for our particular needs without encountering conflicts of interests with other social work specialty groups. The history of our organization validates the effectiveness of our narrowly focused agenda.
Let’s review this history: In 1968, the New York State legislature legally recognized social work as a profession by passing a title certification law which created the “certified social worker (CSW).” It was a weak form of regulation because compliance was voluntary. There was no legal requirement for an MSW to obtain a CSW and many as one-third of MSWs statewide chose not to get it. In addition, the description of the practice functions of social workers was so vague it made it difficult to prosecute ethical and criminal violations. Despite these limitations, however, this law did begin to legally define social work as a profession in New York State.
The Clinical Society (NYSSCSW) was founded in 1968, in part as a result of national NASW’s embracing the BSW as the entry level into social work. Concurrently, the leadership of the New York’s psychology associations had introduced hostile legislation to require social workers providing psychotherapy services to be supervised by psychologists (the Biondo bill). Founders of the Clinical Society were social work psychotherapists, graduates of advanced training institutes, who opposed national NASW’s decision to lower professional entry standards and also actively disputed this psychology bill. From the beginning, the mission of the Clinical Society was to establish clinical social work as one of the traditional, autonomous mental health disciplines – along with clinical psychology, psychiatry and psychiatric nursing on both the state and federal levels of government.
The New York State legislature, in the 1970’s, was not amenable to licensing additional professions, so passing legislation for a clinical social work license was not possible. Instead, the Clinical Society prepared a bill to amend the Insurance Statute that would allow employers the option to cover mental health services rendered by certified social workers (the “P” law). Employees could request this coverage from their employers if it was not already available in their health insurance contract. The services of CSWs who had three years (20 hours/week full time) of supervised psychotherapy experience would be eligible to register for insurance reimbursement. This legislation was finally passed in 1978.
Optional coverage was a beginning; mandatory coverage for our mental health services within the state was our goal. Using the cost experience of covering state employees’ mental health services by P- CSWs, we went back to the legislature to change the Insurance statute to require reimbursement for CSW-Rs in any group policy that already covered psychologists and psychiatrists (the “R”). Both peer review for mental health services and managed care’s acceptance of social work psychotherapists on their panels were helpful in supporting our arguments for mandatory insurance reimbursement. The “R” statute, which requires three additional years of supervised psychotherapy experience, was passed in 1985, and still identifies the most experienced LCSWs. (Note that both legislative efforts were initially drafted by Clinical Society and initially opposed by the other social work professional groups.)
Finally, the opportunity arose to introduce a scope of practice license that fully described the functions of the clinical social worker providing mental health services. In the early 1990s, the State Education Department indicated they would consider a social work licensing bill. The Clinical Society promptly drafted and introduced LCSW legislation. NASW was invited to add an LMSW level. Fifteen years later, after hundreds of hours of meeting with the BSWs, both chapters of NASW, the deans of the social work schools, and other social work groups, we agreed to the final version of the bill: two licenses for the social work profession, LMSW and LCSW.
Licensing LCSWs meant that the practice of psychotherapy would be limited to psychology, psychiatry and clinical social workers. Basically, all other practitioners would be unable to legally provide mental health services. Consequently, the State Education Department and the Higher Education Committees of the Senate and Assembly decided to license all of the recognized providers of psychotherapy services in New York State. Psychoanalysts without mental health backgrounds, MFTs, mental health counselors and creative arts therapists had been lobbying for decades for legal recognition. The state ultimately recognized these four groups under a new Board of Mental Health Practitioners.
When the smoke cleared in 2004, there were six newly licensed groups providing psychotherapy services, i.e., diagnosis or diagnostic assessments, treatment and treatment planning. The only psychotherapists who could practice autonomously, without physician consultation, referral or supervision excluding psychiatrists, were LCSWs and clinical psychologists. These two licenses were subsequently found by the Supreme Court of New York to be equivalent which finally established the LCSW as one of the four traditional mental health professions.
The Clinical Society has succeeded in establishing a legal identity for clinical social work psychotherapists. We have parity with the other mental health groups, a more comprehensive license than exists in most states, and insurance reimbursement for our services. Attempts to erode these gains are continuous from forces both within and outside of our profession. Our mission is to protect and advocate for our continued right to assess, diagnose and provide psychotherapy services autonomously.