Clinical Social Workers = Therapists + ? + ?

A recent Twitter dialogue that started between @iggyp and me yielded a great question from @LovEternal asking what roles clinical social workers take on beyond the role of therapist? It seemed like a great excuse for a blog post 🙂

Clinical social work focuses on direct practice with individuals, families or groups. Providing therapy is certainly part of what most clinical social workers do. But they also will provide a range of other services that might be needed for their clients. For example:

  • Help to coordinate care with multiple service providers
  • Advocate for an agency to change a policy/procedure to better meet a client’s needs
  • Educate clients about key information that relates to their lives to help them understand themselves or their lives in a different way.
  • Work with a group so they can support each other and help each other to solve problems (and then don’t need the social worker anymore).

Social Circles of Influence

The National Association of Social Workers provides this definition:

“Clinical social work shares with all social work practice the goal of enhancement and maintenance of psychosocial functioning of individuals, families, and small groups. Clinical social work practice is the professional application of social work theory and methods to the treatment and prevention of psychosocial dysfunction, disability, or impairment, including emotional and mental disorders. It is based on knowledge of one or more theories of human development within a psychosocial context.”

“The perspective of person-in-situation is central to clinical social work practice. Clinical social work includes interventions directed to interpersonal interactions, intrapsychic dynamics, and life-support and management issues. Clinical social work services consist of assessment; diagnosis; treatment, including psychotherapy and counseling; client-centered advocacy; consultation; and evaluation. The process of clinical social work is undertaken within the objectives of social work and the principles and values contained in the NASW Code of Ethics.”

Small Distinctions?

These may sound like minimal differences when you read about them in generalities, but they can turn out to be big in practice.  I have provided long-term therapy with for many  people who grew up in severely abusive environments.  However, in the course of working with some of those clients, I have been called on several times to function in a pseudo-employee assistance role (meet with employer to create a return to work plan, in a case where there was no employee assistance program) and at other times to assess work environments in terms of what I knew of clients’ interpersonal trauma histories to determine what was needed to them. These are not tasks that fit the traditional role of therapist, and some therapeutic approaches (e.g., psychoanalysis) would view what I did as serious boundary violations. However, from the person-in-environment perspective of a clinical social worker, I assessed a gap between what was needed and what was available and then took action to bridge it, while at the same time educating my clients on the process, too.

Another example? Read this blog post on how Ignacio uses his Ipad in his social work practice to hear how what he does that goes beyond being a therapist.

How about some other examples?

Graphic produced by Bruce Dupree and featured by aafromaa

6 thoughts on “Clinical Social Workers = Therapists + ? + ?

  1. Hi Nancy,

    Thank you for writing such a detailed post on how clinical social workers differ from therapists. The distinction of “person-in-situation” perspective where social workers will often work to bridge the gap between a client needs and what is available is key.

    Social workers also often advocate on behalf of their clients with other agencies/”the system”, as well as try to bring about changes in social policy to lead to better conditions for the oppressed and disadvantaged.

    Related to this is a link to a very good article at the New Social Worker: The Difference Between Case and Cause Advocacy is U (You)



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  3. I have a straightforward psychotherapy practice and my social work background helps me see my clients in cultural context (gender, class, ethnicity, region, etc.) and to advocate for them in other systems. When the AIDS crisis began, I had the tools to create the AIDS/Mental Health Network and to intervene with health care providers for my stricken clients, friends, and colleagues. My best intervention was to call a doctor at a HMO and tell him that we would “support” him giving an expensive experimental-so-not-allowed drug (now in wide use) that would save the sight of one of my clients, by having 20 ACT-UP protesters in the hospital lobby the next morning. He called me back an hour later, letting me know that he was writing the prescription. The client had good eyesight until he died, six months later.


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