LICSW and LP? Both Licensed

¶ … LICSW and LP?

Both Licensed Psychologist and Licensed Clinical Social Worker deal with the field of the study of human mind and behavior. There are laws in every state that regulate the definitions and the terms for the practice of psychology, by a licensed psychologist (LP), respectively that of Clinical Social Work by a Licensed Clinical Social Worker (LCSW). The similarities in both fields of work are obvious because both professionals use as a basis for their work the theories developed by the sciences that study human behavior.

The laws regulating the practice of these professionals in every state are basically enumerating many similar principles, conditions and legal frame a LCSW and respectively a LP are allowed to get their licenses and practice these professions with one major difference regarding the conditions to get a license that refers to the level of school diploma and a median difference that refers to the part of work these professionals focus on. For the purpose of naming the common features and the specific difference in the two analyzed field of work, the two laws regulating the obtaining of a license and practicing the two professions in the State of New York have been taken into account, as an example.

According to Art 153, the practice of psychology is defined as follows:

The practice of psychology is the observation, description, evaluation, interpretation, and modification of behavior for the purpose of preventing or eliminating symptomatic, maladaptive or undesired behavior; enhancing interpersonal relationships, personal, group or organizational effectiveness and work and/or life adjustment; and improving behavioral health and/or mental health. The practice includes, but is not limited to psychological (including neuropsychological) testing and counseling; psychoanalysis; psychotherapy; the diagnosis and treatment of mental, nervous, emotional, cognitive or behavioral disorders, disabilities, ailments or illnesses, alcoholism, substance abuse, disorders of habit or conduct, the psychological aspects of physical illness, accident, injury or disability, psychological aspects of learning (including learning disorders); and the use of accepted classification systems. (New York State, Education Law, Art. 153).

The definition for a psychologist places the weight on the research, the study, thus on the development of research design, methods and tests and then their application for the purpose of diagnosing and treating.

According to Art. 154, §7701, in the State of New York, the definition of the practice of clinical social work is based on the practice of licensed master social work plus diagnosis of mental, emotional, behavioral, addictive and developmental disorders and disabilities and of the psychosocial aspects of illness, injury, disability and impairment undertaken within a psychosocial framework; administration and interpretation of tests and measures of psychosocial functioning; development and implementation of appropriate assessment-based treatment plans; and the provision of crisis oriented psychotherapy and brief, short-term and long-term psychotherapy and psychotherapeutic treatment to individuals, couples, families and groups, habilitation, psychoanalysis and behavior therapy; all undertaken for the purpose of preventing, assessing, treating, ameliorating and resolving psychosocial dysfunction with the goal of maintaining and enhancing the mental, emotional, behavioral, and social functioning and well-being of individuals, couples, families, small groups, organizations, communities and society. (New York State Education Law, Art. 154, 2004).

Although this definition involves the part for diagnosis and treatment, it is based on the theories of social work, and it clearly shifts the focus from research to practice and toward integration.

The LCSW and the LP have many similarities in the filed of practice, but they also have two major differences. First, the requirements to qualify for being examined for a license for a LCSW include "a master's or equivalent degree of social work"( New York State Education Law, Art 154, Social Work, §7704, 2) and have two to three years (depending on the state) of post-graduate clinical work experience in the field under the supervision of a professional in the filed of social work or psychology, whereas the requirements for becoming a licensed psychologist require a PhD or a PsyD in Psychology and engagement in psychology related activities under the supervision of a professional, in most states. Furthermore, "PhD psychology programs begin with several years of academic study before moving students into clinical internship" (New York State Education Law, Art 154, Social Work, §7704, 2).

Social work requires the LCSW to work with the psychosocial aspects that affect the client, considering the "environmental systems that impact clients, and on issues of social justice" (New York State Education Law, Art 154, Social Work, §7704, 2). Rachelle a. Dorfman pins the essence of this type of profession to the chore by underlining the central perspective of the practice: that of "person-in-situation"(Dorfman, 1996, p. 2, Goldstein, 2001, p.3).

According to the United States Department of Labor, in the field of social work, "about 5 out of 10 jobs were in health care and social assistance industries and 3 in 10 work for State and local government agencies" (United States Department of Labor. Bureau of Labor Statistics), while in the field of psychology, "about 34% of psychologists are self-employed, compared with only 8% of all workers" (United States Department of Labor. Bureau of Labor Statistics).The U.S. Department of Labor classify Psychologists under the filed of "Social scientists and related occupations," whereas the same organism places the social workers under the field of "Community and social services occupations" (United States Department of Labor. Bureau of Labor Statistics).

Since the filed of social work is more focused on the macro level, that is an individuals' environment, the society that'd (he) will fit in, as opposed to psychology, where the LP is focused on applying tests and the treatment of the individual, the LCSW is more likely to work in "health care and social assistance industries and local government agencies" (McKay. About.com).

The role of the LCSW has gained in importance during the last decades in the U.S. because of various reasons. Jeffrey a Cohen writes an article about the growing importance of the LCSW under the circumstances of the growing filed of managed care that is credited with more attention during the last years. First, Cohen uses Shapiro's definition of "managed care" in order to set the environment a LCSW is usually working in: "any kind of health care services which are paid for, all or in part, by a third party, including any government entity, and for which the locus of any part of clinical decision-making is other than between the practitioner and the client or patient'" ( Shapiro (1995), p. 441, cited by Cohen, J.A). One of the reasons that encouraged the employment of more LCSW in the managed care field during the last decade in the U.S. is based on financial considerations. LCSW cost less than psychiatrists and LP partly because they are more short/medium term therapy oriented professionals.

A modern capitalist state needs a health care system that includes social workers who are involved in providing low-cost and third-party funded social assistance. "Since the 1960s, social work services have become incorporated in and integral to inpatient medical and psychiatric services, hospital-based primary care and specialty care, community health and mental health clinics, alcohol and substance abuse treatment programs, school health clinics, home care agencies, nursing homes and hospice (Garner, 1995; Richman, 1995)" ( NASW, p148).

Health and mental health care facilities, patients' families and their communities are special environments for the patients and their special needs in coping with their disease and the response they get from those they interact with are considered a social problem and as such, their care has come to include a LCSW. The complex web that usually forms a patient's environment is set into motion towards dealing with him or her the best way possible. "Mobilizing the resources of family and friends as well as economic and community support prevents deterioration, making it possible for patients or family to achieve the best level of health" (Garner, 1995; Richman, 1995)" ( NASW, p 149).

Although a Licensed Psychologist and a Licensed Clinical Social Worker are different in their practice goals, they are both concerned with setting a diagnosis, "of mental, emotional, behavioral, addictive and developmental disorders and disabilities and of the psychosocial aspects of illness, injury, disability and impairment undertaken within a psychosocial framework; administration and interpretation of tests and measures of psychosocial functioning; development and implementation of appropriate assessment-based treatment plans"( OP New York State Education Department. Education Law. Art. 154). The LP and the LCSW's practice goals overlap in terms of assessment and treatment methods, but they generally differ in their focus. The ethics and regulations are also overlapping in the two professions. While psychologists are more inclined to use research and test results to reach a conclusion in the benefit of their patients, the sociologists are more prone to asses, diagnose and choose a treatment that is also concerned with "the effects of social change on their practice" ( Rebach, Bruhn, 2001, p. 2).

At a first glance, some could argue that psychology tends to be more scientifically accurate since it is based on research, testing and test interpretation, while clinical sociology, although working with the same general notions, tends to be based more on practice and have a larger view of the subject in question. It is true that a LP is required to have a doctoral degree in order to meet one of the requirements for getting a license to practice psychology, while a LCSW only needs to have a MSC, but this is not a criterion to distinguish a LP from LCSW as the former being more academically suited for a job in a health care setting than the other. "A psychology whose primary rationale is to promote social justice need not throw away its scientific aspirations. Indeed, the things it studies will be more rigorously arrived at. Hence its methods of solution will e more scientific than ever" (Bradley, 2005, p.3).

The globalization world is requiring disciplines to cooperate and help people in the twenty-first century cope with technological advances, scientific breakthroughs and new challenges that changed the pace of our society's development from one century to another. Walls between nations are falling, while transportation and communication means enable people to travel from one point on the globe to another and to exchange goods and information in a matter of hours or seconds. Societies are shaken and put to new tests and the field of behavioral sciences must keep up with the changes. Sociology and, in our case, Clinical Social Work, although deeply rooted in the field of psychology and using a whole range of methods and notions specific to psychology, became a filed that is required to support the whole health care system to work in the best interest of the population.

Bradley emphasizes that "psychology is both science and profession. As science it aims to accumulate knowledge through research. As profession it aims to sell services for the betterment of others and thereby advance the common good"(Bradley, 2005, p.19 ). The Clinical Social Work is "the professional application of social Work theory and methods to the diagnosis, treatment and prevention of psychosocial dysfunction, disability or impairment, including emotional, mental and behavioral disorders (Barker, 2003)" (NASW, 2005, p.9). Both fields interact in their practice in so far they are seeking to work in the benefit of their clients who in turn will return to society that will benefit from their improvement as a whole. Research stands at the basis of both professions, but sociology is generally supposed to work with short-term therapies, as shown before and therefore, it is more adequate in the certain conditions in health care institutions, depending on third party funds and destined to serve a community.

There is a further distinction that is necessary to be made between a LCSW and the field of Social Work in general. Rebach and Bruhn have defined the clinical sociology as "the use and application of sociological theory, methods and findings to bring about social change at the individual, small group, organizational, community, institutional, or social system level (Bruhn & Rebach 1996; Kallen, 1995; Rebach & Bruhn 1991)" (Rebach, Bruhn, 2001, p.3). Rebach and Bruhn quote Straus (1995-9) to conclude that clinical sociology means "using theory to make sense out of life" (Straus,1995-9, quoted by Rebach&Bruhn, 2001, p. 396).

Both future LCSW and LP are supposed to have a certain number of years of clinical experience under the expertise of a master, depending on the state laws, in order to get their license to practice. The former is required to have beside the clinical course "at least three years full-time supervised post-graduate clinical social work experience in diagnosis, psychotherapy, and assessment-based treatment plans, or its part-time equivalent" ( OP New York State Education Department. Education Law. Art 154. Social Work. §7704. 2.c.). The latter is also required to have full time supervised experience in the field. The experience through apprenticeship that is inherited for earlier years in the field of clinical expertise is applied both to the LCSW and the LP.

First, both aforementioned workers are supposed to apply the information gathered during their academic studies and their clinical work to effective intervention. Psychologists as well as Licensed Clinical Social Workers are expected to act like a scientist that is using scientific methodologies specific to psychology, respectively Social Work, quantitative and/or qualitative methods of research in order to advance diagnosis hypothesis, choose between them and decide the appropriate treatment. While the psychologists usually address the specific problems of one patient or group of patients, the LCSW is dealing with "involvement in and the interaction with members of a specific social system" (Rebach, Bruhn, 2001, 15).

The clients of a LCSW could be individuals or groups, depending on the identified problem and the person, group, or institution who is asking for the assistance of such a professional. LCSW may address problems related to a specific individual, but they can also participate in developing and implementing programs, according to the identified problem, at a macro level. The different kinds of intervention, depending on the client and the settings in the work of a clinical social worker are providing diversity in this field (Rebach, Bruhn, 2001, 15). The context, according to Swann and Straus is crucial in the intervention of a clinical social worker because the same problem may require different theoretical approaches in order to be solved (Straus, 1984, p.2). The LCSW is a "change agent" that observes the environment the system in question is working in. He studies and analyses these systems in order to asses and then guide those who are involved in that system and affected by the studied environment. The aforementioned worker has to be able to assume the role of a director who makes decisions destined to alter relations, in order to create the premises for better interrelationship. According to Rebach and Bruhn, the professional in the field of clinical sociology must be able to adapt to each case and find solutions addressing each problem as a unique problem. He is also expected to guide the client toward addressing and resolving future similar problems alone. The LCSW is also supposed to work toward minimizing the chances for regression, preparing his or her client for a continual adaptation to social change (Rebach, Bruhn, 2001, p.34).

The same changes in science and technology and at a macro and micro level that occurred during the last years and made a LCSW be ready to assume several different activities during the day, affected the way a LP practices his profession. Diversity is required in both professions and the fields of practice have extended from being a "manager, a clinical supervisor, an educator, a therapist and a consultant" (Hersen, Gross, 2003, p.110) in the same work day." They are required to deal with various problems and subjects in different settings. Psychology has its roots in philosophy and it swept through art and science, leaning toward one or another along the way. The contemporary field of psychology, although it has its principles based on science, and it is a rigorous matter, it is also based on humanity. It deals with human beings in a social environment and although human behavior and human mind are considered objects of study with scientific methods and research, they also have a spiritual side that escapes scientific rigor.

The interrelationship between clients and LCSW or psychologists and their clients is a special field where both professionals have to be well aware of the ethics of their profession, the rules and regulations as well as learn the art of communication. First, they have to know themselves, in order to be able to get to know others and furthermore, help them solve their problems at a micro or macro level of their environment. Bradley emphasizes that the basis that helps a LCSW or a LP develop his skills and become successful in his or her field of work is common for disciplines like psychology, social work, occupational therapy and psychiatric nursing.

As all practitioners and academics emphasize, the field of work for both LP and LCSW requires excellent communication skills. Since "the structuring formula common to all clinical sociologists -- and to all the helping professions -- is that a client comes to them seeking help" (Rebach, Bruhn, 2001, p.37), they must be prepared to form "positive relationships with clients" (Rebach, Bruhn, 2001, p.37).

According to NCSPP, in 2002, the list of the competencies for a psychologist included the following: "relationship, diversity, assessment, intervention, research and evaluation, consultation, education, management, supervision." All these are available today for a LCSW, too. Moreover, a LCSW is required to be able to strategize, develop and implement programs at a macro-level, depending on the type of client. Cultural and ethnic issues are two elements brought by diversity in unity that are bringing new aspects that have to be especially addressed in both professions. The two practitioners have the goal to reintegrate their clients into the frame of their environment and the social aspect of the human existence is equally affecting their practices.

The contemporary social problems require theories in the field of psychology as well as that of sociology that are continually adapted to their specificity. Am LP cannot conduct his or her studies and find solutions without being aware of these problems, just as an LCSW must be up-to-date in this field. Again, the roles an LP as well as a LCSW assume today in their fields are multiple and are often the same for both of them: besides the traditional roles they had, they must be now: 'broker, mediator, change agent, expert witness, therapist and planner" (Rebach, Bruhn, 2001, p. 291).