7 minute read
NASW-NJ FOCUS Magazine - March 2023
Creating and Advancing Standards for Clinical Social Workers in Professional Practice
By Leslie Tsukroff, LCSW
In December 2017, the national office of NASW contacted local Chapters in search of qualified members to volunteer to serve on a Task Force to revise the document, Clinical Social Workers in Private Practice: A Reference Guide . At the time, I was the Chair of the NASW-NJ Ethics Committee, had created and presented several ethics and private practice-related continuing education programs for NASW-NJ, and had participated in many Chaptersponsored, private practice support, collaborative, and advocacy endeavors. Because of this experience, Chapter leadership suggested I apply to serve on the Task Force. I immediately submitted my resume and to my surprise, on February 28, 2018, I received notification that I was chosen to serve on this illustrious Task Force.
Several months after receiving my appointment letter, the Task Force met for a planning meeting during which the participants became acquainted and we discussed the overall mission of the Task Force and logistics of the work. The following month, we reviewed the existing document and brainstormed material to add to the revised document, volunteered to amend/create various topics, and revamped the definition of private practice—all in just two hours; it was a resounding success! After that first meeting, I think we all knew we had a lot of work to do, but we had no idea that it would take 3 years of monthly meetings (biweekly during the last 5 months) to complete. To date, the Task Force to Revise the Private Practice Guidelines is the longest running NASW project of its kind.
Initially, the Task Force was comprised of eight volunteers from across the country, but throughout the process, three participants resigned for personal reasons and one new participant joined. In the end, six members under the outstanding leadership of Mirean Coleman, NASW’s Clinical Manager, contributed to the document. Early on, I realized this would be a major commitment, one that would require not only participation in monthly meetings in which all participants collaborated on drafting and editing, but also many additional hours of editing, writing, or amending sections of the document.
Prior to joining the Task Force, I did not know what went into revising and publishing an NASW document and was surprised by the many steps involved in the process. Upon completion of the first draft, the document was posted on NASW’s website for 30 days to allow for the membership to provide public comment. We then reviewed membership input and decided whether to accept or reject the suggestions. If we rejected, we didn’t need to take any action, but if we accepted, we worked on revising parts of the document. In some cases, only minor corrections were required, while at other times, we had to start over. Throughout the process, we found ourselves in the position of accepting or rejecting recommended edits after the document was reviewed by various other entities including NASW’s legal team, the editor, and the Sub Task Force (a group of members who reviewed the document for accuracy of information, some of whom had created the 2002 Guide). These reviews, rewrites, and edits were a contributing factor to why it took us three years to complete the project. Another major contributing factor was our goal to significantly expand the depth and breadth of the original Guide.
Although the Task Force was created for the purpose of revising the existing guidelines, there were many sections that required significant amendments and updates, while other sections were newly developed. The 2002 version lacked critical information, as over the past 20 years, there have been many advancements in the practice of clinical social work. From the rise of digital technology to the proliferation of social media; the expansion of HIPAA; several evolutions of the NASW Code of Ethics; and a shift in health care access and reimbursement; and the professionalism of private practice, it was evident clinical social work had changed and private practitioners deserved a text that reflected those changes. While the previous version addressed the business of running a private practice, it lacked key material necessary for today’s entrepreneurs. As such, the Task Force added a more comprehensive and up-to-date overview of business practices, one that included: marketing and advertising, billing, fees, and reimbursement options, as well as working with insurance companies and third-party payers.
The initial Guide also had limited information on ethical and legal issues related to minors, so I volunteered to spearhead sections dedicated to minors’ rights and best practice standards when working with minors whose parents are divorced, separated or in the process of divorce.
The new Reference Manual expands on the 2002 Guide’s coverage of documentation, record keeping and practice agreements to align with current state and federal laws, compliance with insurance company requirements, informed consent standards, and supplemental practice standards drafted and coauthored by NASW. This includes more detailed information on medical record forms, practice policies and agreements, and consent for treatment documents, with the goal of reducing malpractice risk.
To complicate matters further, two years into the project, we found ourselves smack in the middle of a global pandemic. As a result, we expanded our guidance on the use of technology to deliver psychotherapy services; privacy and security as they relate to HIPAA and the storage, gathering, creating and sharing of information; privacy and confidentiality; conflicts of interest, dual-relationships and boundaries; and informed consent.
During the pandemic, members of the Task Force and private practitioners across the country became keenly aware that the world could shift overnight. It became apparent that having an advanced plan in place was necessary for continuity of care to clients and to ensure long-term viability of one’s practice. It was out of this realization that I took the lead on drafting a section that included advanced planning, developing a professional will, retirement and emergency, and disaster planning. Lastly, after a year of providing services and support to our clients during the global public health crisis and simultaneously managing our own pandemic fatigue, the Task Force felt the closing section of the Reference Manual should be dedicated to the importance of incorporating self-care into daily practice, not just during times of crisis.
It was truly an honor to serve on this volunteer Task Force and to be involved in developing this comprehensive and practical Reference Manual which is sure to become the preeminent resource for all private practitioners, not just clinical social workers. Being invited to share my expertise on issues impacting novice and veteran independent practitioners, as well as the clients they serve through the lens of social work ethics is a long-time passion of mine. I never dreamt that I would have been given the opportunity to collaborate with such knowledgeable and committed clinical social work co-authors from across the country and to help set the standard of care for the profession. I am grateful for the opportunity and hope to be included in the next update to “Clinical Social Workers in Private Practice: A Reference Manual.”
About the Author:
Leslie S. Tsukroff, MSW, LCSW is a recognized authority in professional ethics, risk management and private practice development in New Jersey. In addition to her mental health consulting business, she maintains a private practice in Somerset County, New Jersey. Learn more at https://www.leslietsukroff.com/
“Clinical Social Workers in Private Practice: A Reference Manual” can be purchased from NASW Press. Visit https://naswpress.org/product/53563/ clinical-social-workers-in-private-practice
