Engaging in Clinical Private Practice Without the LCSW
What LMSWs and Supervisors Need to Know
Clinical practitioners are a highly valued and significant part of NASW-NYC’s membership. The Chapter recognizes and support their contributions and remains committed to maintaining standards of effective practice. With this support in mind, it has been brought to NASW-NYC’s attention that some LMSW social workers have been engaging in clinical private practice prior to obtaining the LCSW. The Chapter believes that entering into clinical practice outside of an agency setting prior to obtaining the LCSW—even when obtaining private supervision—is a violation of existing professional standards.
Obtaining significant, agency-based, supervised clinical experience for several years following the acquisition of a master’s degree in social work is a well-documented standard in the social work profession.
Four Citations Reflect Standards For Clinical Private Practice
• “The NASW Standards for Clinical Social Work in Social Work Practice” states: “In most instances, clinical social workers are required to have the following credentials... a minimum of two years or 3,000 hours of post-masters degree experience in a supervised clinical setting [and] a clinical license in the state of practice.”
• “Clinical Social Workers in Private Practice: A Reference Guide,” the NASW private practice guidelines, states: “the appropriate minimum credentials required for independent practice… [include] two years of full-time (or equivalent part-time) clinical social work experience supervised by a clinical social worker…”
• The NASW Private Practice Specialty Practice Section recommends five years of clinical supervision and experience prior to entering independent practice.
• The NASW Code of Ethics section on “Social Workers’ Ethical Responsibilities to the Social Work Profession (5.01)” states: “Social workers should work toward the maintenance and promotion of high standards of practice.” In addition, the Code of Ethics (1.04) also states: “Social workers should provide services and represent themselves as competent only within the boundaries of their education, training, license, certification, consultation received, supervised experience, or other relevant professional experience.”
The Reason for NASW-NYC’s Concern
• Accountability is of primary concern in professional practice. Upon graduation from a master’s degree of social work program and acquisition of the LMSW credential, one has achieved a certain degree of education and preparation for a range of social work practice, but it is nevertheless a minimum amount of experience. Given the complexity of clinical work, limiting one’s practice to agency-based work in the first three years of post-master’s degree work assures that there will be accountability through the administrative and clinical oversight typically available in such a facility.
• LMSW social workers who engage in private practice while purchasing private supervision to meet the requirements for the LCSW are, in actuality, functioning as the employer of the supervisor. Given that such LMSWs are free to replace their supervisor at anytime, they are virtually without accountability. This is a problematic position for anyone with limited post-masters experience.
• The overriding priority of consumer protection is significantly diminished by engaging in private practice outside of a facility prior to obtaining the LCSW.
• LMSW social workers and their supervisors should be aware of the special and additional liability risks posed by LMSWs conducting a clinical private practice, including the issue of the vicarious liability of the supervisor of such a LMSW. The Clinical Social Work Practice Update (Volume 3, Number 2) states that: “supervisors...share the responsibility for services provided to the patient and can be held liable for negligent or inadequate supervision related to negligent conduct by the supervisee... Direct liability... can be charged when a supervisor assigns a task to a supervisee who is inadequately prepared to perform it.” (pages 3-4). (Further information can be obtained by reading “Supervisor Beware: Reducing Your Exposure to Vicarious Liability” at http://www.naswinsurancetrust.org/understanding_risk_management/practice_pointers.asp).
NASW-NYC urges that LMSWs should, at a minimum, obtain their LCSW prior to engaging in clinical practice in a private practice setting. LCSWs should carefully consider the legal and ethical problems associated with providing supervision to LMSWs who are engaged in clinical private practice.