Why Does It Matter if My Therapist is a Social Worker?

If you pay attention, you will notice that different counselors and therapists have different letters that come after their name. MSW, MA, MS, LMHC, LMFT, LPC, CDAC, PsyD, etc. No we don’t list these initials just because we can. They actually do mean something important, something that makes a difference for you the client. This article focuses on the social workers, the ones with MSW, LSW and LCSW after their name. Next week, we will have a post about LMHCs. It’s important to us that our clients are educated about the field and sophisticated in choosing the right therapist for them. Understanding professional backgrounds can be useful in meeting this goal. Why Social Workers? March, the month of social work awareness, just ended. During the month of March, our profession gets together to promote the visibility of social workers and celebrate the work that we do. In our professional roles, social workers are a diverse bunch. Many are in private practice, many work in public agencies of various kinds, and many are administators of non-profits or policy makers in different governmental bodies. Social workers are a unique part of the helping professions because we do not trace our professional roots back to Freud. The field of social work comes from two distinct places in the past. One professional ancestor is the Christian women’s movement of the early 20th Century. These women organized and visited the homes of those living in poverty to try and help them improve their lives. Another historical root of social work is the settlement house movement, which also sought to address poverty. The most famous...

Therapeutic Humor

While therapy is serious business and hard work, humor transforms the experience. Frequently my sessions with clients include gigantic peels of laughter. Humor Is Medicine Laughter is common in our office, and I believe it speaks to our ability as therapists. Self-deprecating humor builds the relationship with a new client and helps him feel comfortable. By laughing at myself right away, I show clients I am human, and therapy isn’t scary. Using humor in therapy requires some skill however. Shandi-lee Cox via Compfight As the work and the relationship progress, teasing and laughter become milestones for progress. As I get to know my client, I learn when teasing can gently lead to insight or when it risks causing pain. I know my clients have made amazing progress when they start to laugh at their own stumbles. I have two clients who are very similar in many ways. Both struggle with “mind-reading” what others are thinking or seeing catastorphy around every corner. They are both aware of their tendencies, and they both slip into them again and again. Since this pattern shows up in nearly every session, I gently tease my client each time.  Their responses give me a sense of how far they have come. I believe that becoming emotionally healthy is about learning to accept our weaknesses, love ourselves anyway, and learn to live effectively despite them. Some of my clients remain fully determined to eliminate any flaw and make themselves miserable in the process. Some learn to tolerate and acknowledge their flaws. And some learn to view themselves with compassion and honor the “flaws” that make them who they...

Credentials, a.k.a Alphabet Soup

While I’m on the topic of professionalism and ethics, I thought it would be useful to shed some light on the various credentials and educational degrees of different helping professionals. The list of job titles, acronyms after names, and level of education are confusing to the lay person and important things to consider when looking for someone to help you improve your conscious control over your happiness and well-being. We’ll start with the actual job titles. First off, most helping professionals are called counselors, therapists, coaches or mentors. Counselor and therapist are pretty much synonyms and mean the person has some kind of relevant advanced degree. Coach and mentor, on the other hand, are pretty much unregulated and could be used by someone with nothing more than a high school diploma and a good heart. A psychologist is typically someone with a PhD in psychology, so they will know mental health in great detail. A psychiatrist is someone with a medical degree who specialized in mental health. Only a psychiatrist or another medical doctor can prescribe medications. So that’s the basic breakdown of job titles and the corresponding level of education. If you’re still reading this, now we’ll tackle the alphabet soup that comes after the helping professionals’ name. Social Workers: The title “Social Worker” means the professional has a degree in social work, either a Bachelor’s (BSW) or a Master’s (MSW). A Licensed Clinical Social Worker (LCSW) has a Master’s in Social Work (MSW), two years of on-the-job experience while being trained by another LCSW, and has passed a national exam on basic clinical skills. On a theoretical...

Dual Relationships

Dual relationships are prohibited under the Code of Ethics. Dual relationships is a nice way of saying if I have ever been your counselor or therapist, I can never be your friend, lover, boss or lawyer. On the flipside, if you’ve ever been my friend, lover, boss or lawyer, you cannot be my client. This ethical code is another important part of ensuring that no one gets taken advantage of by the existence of the therapeutic relationship. In practice, dual relationships can be difficult to navigate. At one extreme, it’s very simple. It is never, ever appropriate for a therapist or counselor to have a sexual relationship with a client, period. End of story. Ever. Once a client, always a client. In more subtle ways, dual relationships can get really complicated. What if I attend the same church as my client and we volunteer for the same committee? Am I obligated to leave the committee? I would say yes, and another social worker could rightfully disagree with me. What about belonging to the same church? Depends on the size of the church. This question can get complicated for therapists in rural areas or those of us who work with minority communities, especially if we are a member of that community ourselves. One way dual relationships are avoided is for counselors and therapists to be very limited with self-disclosure (how much they tell their clients about themselves). How many times can we chat at a networking event before I know you too well to be your counselor? How many tweets (@soaringhrt) can we exchange? What kind of information do I...

Speaking of Ethics

If you’re looking for a counselor or therapist, it may interest you to know that the strongest, most complete ethical statement for any profession was written by the National Association of Social Workers (NASW). Any member of NASW, such as myself, is obligated to follow this code and the actions of any social worker is compared to this code to determine whether or not it is ethical. Why does this matter? The Code of Ethics is in place to help guarantee that someone seeking help is not further harmed by a social worker. The very nature of the counseling relationship, where one person knows significantly more about the other person, creates an opportunity for some harmful behaviors, intentional or not. For the complete code of ethics, follow this link: http://www.socialworkers.org/pubs/code/code.asp In today’s post, I’d like to highlight the social worker’s ethical responsibility to clients, particularly confidentiality. Yesterday’s post referred to the idea of self-determination, stating that the client’s view of the problem and the solution is more important than the counselor’s. Confidentiality and dual relationships are the other two key responsibilities that I find challenging on a regular basis. Tomorrow’s post will explore dual relationships, which is somewhat entwined with confidentiality. Confidentiality means what a client shares with me is held in confidence. It means I don’t share what we talk about outside of our session, unless it’s necessary. The Code of Ethics says its only necessary if the client discloses a physical threat to harm themselves or someone else, if a child is in danger, or if I need to consult with a fellow social worker in order...

Identifying Goals for Counseling

This week I started to reflect again on the goals of counseling. Sometimes people I work with have anxiety about what they will be like after counseling is over. Will they still be themselves? How will their relationship with others change? How will we know counseling is over? Will they be working with me forever? One of the things I love most about my job is the ideals and ethics my training is grounded in. First among these ideals, is the idea that the counseling relationship is driven entirely by the client’s needs and desires. This means the people I work with are in the driver’s seat, and I’m offering new ideas, skills, and strategies to get them where they want to go. There is no magic “normal” that I’m trying to manipulate them into – the problem and the solution is ultimately decided by my client, my partner in healing. This partnership with the client taking the lead is exactly as it should be. I am extremely educated and skilled, but that doesn’t mean I know what’s best for you in your life. The minute I start to believe I have all the answers is the same minute I could cross ethical boundaries and do harm to my partner instead of helping. To answer some of the questions posed at the beginning of the blog: Yes, you will still be yourself. Nothing about you is intrinsically wrong, just some parts aren’t working anymore. Your relationship with others in your life may change, depending on what you decide is necessary. Counseling will be over when you are satisfied with the...