NYS Scope of Practice
History of the Clinical Social Work Scope of Practice
In 2002, New York State enacted a two-tier licensing law for professional social workers, a license for psychologists to replace their prior title protection statute, and licenses for four new groups of mental health professionals. The new social work law, which took effect on September 1, 2004, repealed the former certified social worker statute, which was a title protection statute (a law which protected the use of the title certified social worker but did not limit who could practice social work) and not a license (a law which delineates the services which a professional can provide, what is referred to as the profession’s, “scope of practice”).
The new social work law provided for two scopes of practice for professional social workers in New York, the licensed master social worker (a person with an MSW degree from an accredited MSW program who passes the licensing examination for newly graduated MSWs) and the licensed clinical social worker (an advanced practice clinical social work license for MSW graduates who meet additional requirements of graduate level clinical coursework, post-graduate supervised experience in providing clinical social work services and passing an advanced practice clinical social work licensing examination). The scope of practice of clinical social work in New York State is the broadest and most inclusive scope of practice in a clinical social work license in the United States.
The New York State Clinical Social Work Scope of Practice
Article 154 of the Education Law, Section 7701(2) sets forth the scope of practice of licensed clinical social work as,
“2. Practice of clinical social work.
a. The practice of clinical social work encompasses the scope of practice of licensed master social work and, in addition, includes the 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.
b. Diagnosis in the context of licensed clinical social work practice is the process of distinguishing, beyond general social work assessment, between similar mental, emotional, behavioral, developmental and addictive disorders, impairments and disabilities within a psychosocial framework on the basis of their similar and unique characteristics consistent with accepted classification systems.
c. Psychotherapy in the context of licensed clinical social work practice is the use of verbal methods in interpersonal relationships with the intent of assisting a person or persons to modify attitudes and behavior which are intellectually, socially, or emotionally maladaptive.
d. Development of assessment-based treatment plans in the context of licensed clinical social work practice refers to the development of an integrated plan of prioritized interventions, that is based on the diagnosis and psychosocial assessment of the client, to address mental, emotional, behavioral, developmental and addictive disorders, impairments and disabilities, reactions to illnesses, injuries, disabilities and impairments, and social problems.” (emphasis supplied)
To view the scope of practice of licensed master social work click here http://www.op.nysed.gov/prof/sw/swlaw.htm and http://www.op.nysed.gov/prof/sw/article154.htm.
Court Decision Regarding the Clinical Social Work Scope of Practice
In 2005, in a case where an attorney sought to preclude a licensed clinical social worker and a psychologist from evaluating his client who allegedly had an organically-based mental illness, asserting that, "it is my belief that these new statutes significantly impact on the practice of psychologists and clinical social workers. These new statutes strictly limit the scope of psychology and clinical social work practice to matters that are squarely within the four corners of mental, emotional and social functioning. These statutes clearly and unambiguously preclude psychologists and clinical social workers from making diagnostic or prognostic assessments about any physical illness or infirmity or any mental disorders which, either in whole or in part, are or may reasonably be assumed to be organic in nature or which result to some degree from a concurrent physical ailment or dysfunction. .... It is patently obvious that in order for a mental health practitioner to address in an appropriate, informed and thorough manner the mental, emotional and social aspects of a physical illness or infirmity, there must first be an accurate assessment of the nature, extent, causes, potential effects and likely prognosis of that physical illness or infirmity. Performance of that kind of assessment is squarely solely within the scope of the practice of medicine. Thus, the new psychology and clinical social work licensing statutes must clearly be viewed as proscribing the scope of the diagnostic and treatment practices and services of psychologists and clinical social workers in relation to the evaluation or treatment of the, mental, emotional and social aspects of physical illness, injury, disability and impairment, to the extent that the prescription and ongoing supervision of such services by the patient's treating physician is required. Physicians are the only professionals whose license permits them to make such assessments and to determine the appropriate treatment for the mental, emotional and social aspects of a physical illness or impairment in the context of the overall treatment plan established for the patient. ....” People v. RR, 12 Misc.3d 161, 165-166, 807 N.Y.S.2d 516, 519 (Sup Ct, NY County 2005).
In ruling on defense counsel’s application, the Court made three important determinations.
- First, the Court determined that, “[a]t the outset, this Court finds, as a matter of law, that in terms of clinical functions, the scope of practice of psychology and the scope of practice of licensed clinical social work, although described using some different words at times, do not vary in substance and are wholly equal and the same.” Id., 12 Misc.3d at 179, 807 N.Y.S.2d at 528 (emphasis supplied).
- Second, notwithstanding the fact that the new clinical social work and psychology licensing statutes did not mention biological or organic disorders, the Court went on to find that, “it is clear that the use of the biopsychosocial approach is an inherent part of, ‘social work theory, principles, and the methods,’ which licensed clinical social workers are legally authorized to apply in their provision of professional clinical social work services. .... neither the lack of use of the term biopsychosocial in describing the professional functioning of psychologists and licensed clinical social workers in their licensing statutes nor the fact that those statutes do not specifically indicate that biological factors should be considered by psychologists and licensed clinical social workers in their professional practices can be interpreted as manifesting legislative intent that psychologists and licensed clinical social workers may not use a biopsychosocial model, particularly given the fact that this model has been long endorsed by these professions as part of the standard of care and is essential to appropriate diagnosis and treatment planning.” Id. 12 Misc.3d at 187-188, 807 N.Y.S.2d at 534 (emphasis supplied).
- Third, the Court stressed and reinforced the critical importance of the use of a biopsychosocial approach by licensed clinical social workers and psychologists as part of the standard of care, finding that, “as a matter of law, the failure of a psychologist or licensed clinical social worker to utilize a biopsychosocial approach in the performance of diagnosis, assessment and treatment planning would constitute practice that, per se, violates the professional standard of care. This Court further finds that, as a matter of law, psychologists and licensed clinical social workers, as licensed health care providers, are required by their scope of practice and the standards of care of their professions to gather information and make observations related to the physical condition and symptoms, health history, medications (prescribed, over the counter, and complimentary and alternative treatments) utilized, substance use and abuse, and allergies of their patients as part of their initial assessments and to be alert throughout the course of treatment to mental or physical symptoms which may have physical causes or portend the existence of physical illness, new health history, medications (prescribed, over the counter, and complimentary and alternative treatments) utilized, and substance use and abuse, so that these may be explored, their impact on the patient's functioning assessed properly and treated, as necessary, through referral to or consultation with other health care professionals, as indicated. The failure to do so would constitute practice that, per se, violates the professional standard of care. Id. 12 Misc.3d at 185, 807 N.Y.S.2d at 532-533 (emphasis supplied).
- Finally, in denying the defense attorney’s application the Court concluded, “[t]his Court finds, as a matter of law, that the evaluation, making and rendering of diagnoses and prognoses, formulating treatment plans and the psychological-psychosocial treatment of mental disorders or of mental, emotional and behavioral symptoms which, either in whole or in part, are or may reasonably be assumed to be organic in nature or which may result to some degree from a concurrent physical ailment or dysfunction, are within the scope of practice of the professions of psychology and licensed clinical social work whose scopes of practice although described using some different words at times, do not vary in substance and are wholly equal and the same.” Id. 12 Misc.3d at 202-203, 807 N.Y.S.2d at 544 (emphasis supplied).