Friday, April 11, 2014

What exactly is a social worker, are they like psychologists, or counsellors?

        Think of a therapist (a psychotherapist, clinical social worker, psychologist, whoever you associate with the term). Just notice what comes up for you. For some people, images of the classic psychoanalysis situation arises: one person laying on a couch with another sitting upright in an armchair with clipboard in hand, scribbling/jotting away... what are they writing anyway!?

Betty Draper on the couch giving a look to her therapist.

Go ahead and google differences between social workers and psychologists, you'll find a lot of comparisons and a surprisingly large amount of misinformation (it doesn't help that there are different types of social workers and psychologists). Calling oneself a social worker or psychologist is a special thing, only certain people with specific credentials are allowed to do so as these professions (and titles) are regulated.

In my search around the web, I found a surprisingly good website by Ontario's Ministry of Health and Long-Term Care that explains the "types of mental health services in Ontario." However, even this site does not clearly spell out who is who when it comes to psychologist, social worker, and counsellor.

So, let's pick it apart: to put it simply, social workers are not psychologists but it can be confusing because often times it looks like they do the same thing. Social workers like myself may consider themselves "clinical social workers" and practice the act of psychotherapy (I am of course talking about master's degree level social workers — sometimes referred to LCSW's/Licensed Clinical Social Workers in the United States). This clinical social work role could mean meeting with individuals, couples, families, or groups to offer therapy. The types of therapy offered by social workers are largely psychotherapeutic, psychoeducation, and skills training. These therapies could cover a variety of issues from anger, infidelity, family issues, grief, illness, life changing events, to serious mental health issues. Furthermore, many of these therapies are based on psychological theories (yep, confusing... social workers use psychological theories but more about that later). These many roles and responsibilities of social workers stands in stark contrast to many "comparison" websites claiming that social workers only offer case management, social services, and referrals to psychologists for mental health related issues. In fact, social workers provide more mental health services than all of the helping professions combined.

Social workers in many places around the world (in Canada too) diagnose based on the DSM 5 (one of the widely recognized diagnostic criteria/classification of mental health disorder manuals). This again demonstrates the place of social work in the assessment and treatment of serious or persistent mental health problems. In Ontario, social workers do not diagnose based on syndromal symptoms or disorders. Instead, we use assessment and diagnostic tools to create formulations and treatment plans for our clients. We create a non-pathologizing 'social work diagnoses.'

So if social workers are practically everywhere, doing most of the work with the public, why don't we hear more about them!? Well, social workers use psychological, sociological, and criminological theories to inform their practice but social work as a discipline has few of it's own theories (a strengths based approach is the only product of social work I can think of!?). Psychology has a large research (experimental) base, whereas social work is largely an applied discipline. This distinction could be important in explaining social works lack of publicity. For psychologists there are many universities with grant funding and experimental research programs, not so much for social workers. Instead, we find graduate level (master's degree) social work education for the most part minimally focusing on research methods and data analysis and instead schools of social work offer many practical skills to get social work students out in the field, helping people. This is not entirely unlike the discipline of clinical or counselling psychology who also focus on more practical psychotherapeutic skills and may de-emphasize research skills. Rightfully so, right? Well, more on that in another post.

Ah yes, clients — not patients. Historically (and still today), social work has led helping professions in advocating for the importance of empathic, warm, collaborative, and supportive working relationships. We do not view clients in a pathologizing way. We accept the client's description of their pain/problems. In a social worker's relationship with the clients we serve, social workers seek to share power and build upon client strengths. We do this thing called anti-oppressive practice, where social workers promote a power balance by speaking in non-pathologizing terms, insuring clients not only understand but are involved in making treatment decisions, and to develop/promote the clients own ideas about their involvement in treatment.

Clearly, there is something unique and special about social work. Why else would I bet my career on it?