IDENTIFYING PROBLEMS AND SOLUTIONS IN CHANGING STATE LEGISLATION REGARDING LICENSED CLINICAL SOCIAL WORKERS PROVIDING PRIVATE INDEPENDENT MENTAL HEALTH SERVICES

Abstract

State regulated social work practice began in the 1960s; by the mid-1990s, all of the states within the United States regulated the profession through licensure. The purpose of licensure was ostensibly to protect the public and the profession; however, legislation defining social work practice varied vastly from state to state. The variation existed not only between states, but also within licensure categories with regard to the scope of practice of the social work profession. Licensed clinical social workers in some states could practice relatively independently, as they had the ability to diagnose, provide psychotherapy, and bill Medicaid, Medicare, and third party insurance companies; licensed clinical social workers in other states, however, could not engage in some, or all, of these practices. The disparity within the practice of clinical social work continues without resolve. The present qualitative study explored the barriers encountered and the solutions incorporated to overcome those barriers in three states during their attempts to secure legislation allowing licensed clinical social workers to independently provide mental health services. Grounded theory research was used to form a theory based on information learned from 12 Historians for use in states who have not yet achieved a fully independent level of clinical social work practice. Using strategic systems of solutions to overcome barriers in the legislative process should help those states desiring legislative change to reach their goals. Reaching a foundational scope of practice across all states with regard to licensed clinical social workers’ ability to independently provide mental health services facilitates the Association of iv Social Work Board’s goal of practice mobility and license portability. Achievement of this goal would facilitate social workers’ ability to practice across state lines and social worker relocations. Establishing a foundational scope of practice also improves clients’ access to mental health services.