Establishing reliable roots

A report from the Clinical Committee

The clinical committee’s work has been intertwined with the NSCSW’s efforts to re-position social work in Nova Scotia’s mental health and substance use services. This year our committee focused on building a framework to regulate clinical social work in private practice. The committee hopes to strengthen clinical social work practice by developing regulatory policy to ensure practitioners have the necessary tools to support their clients through a bio-psycho-socialspiritual model of care. This model recognizes the complexity of mental health needs and the importance of environment and social context in the healing process.The intent is that through a relational approach to therapy, both practitioner and client bring expert knowledge to the table, emphasizing shared responsibility for creating a connected and supportive society.

The committee worked to define a specific scope of practice in clinical social work that focuses on providing mental health and well-being assessments with a unique focus on the social determinants of mental health. This approach seeks to situate clients within their social context, considering factors like culture, race, and socioeconomic status. Using research rooted in bio-psycho-social-spiritual approaches, the intent is for clinical social workers to build a culturally relevant, therapeutic environment. The scope of practice extends to individuals, couples, families, and groups, providing support for complex issues like mental health, addiction, trauma, grief/ loss/illness, and crisis.

Guided by broader concepts like human rights and social justice, clinical social work aims to ensure that clients receive the care they need in a safe, uplifting environment.

The committee explored new pathways toward entry to practice as a clinical specialist. Draft policy indicates that applicants must possess a Master of Social Work degree where at least 12 academic course credits (including six graduate-level credits) are aligned with the clinical scope of practice. Coursework would need to demonstrate an understanding of the conceptual, historical, political, gendered, and societal factors that contribute to mental health and well-being. Alongside this essential knowledge, applicants should have completed coursework covering assessments for mental health, addiction, trauma, grief/ loss/illness, and crisis issues. Expertise in research-based modalities of service to support persons, families, and communities affected by these issues is vital. The practical knowledge gained from completing a practicum in a clinical setting providing direct service will set applicants apart.

Assessing knowledge is a crucial aspect of the registration process for applicants. The committee recognized that there are many pathways to learning and built a process where if you haven’t taken the course or haven’t completed all of its requirements, there is still an alternative. An applicant can demonstrate equivalency to the required academic courses through 432 hours of formal and informal training on the NSCSW registration portal. This process calculates the remaining hours needed for completion based on a ratio of course credits and professional development hours.

The Committee considered the use of the Association of Social Work Boards exam to assess competence. Based on our research, and the data that underlines discrimination based on race, the exam’s use seems ill-advised, particularly in light of calls for racial justice and the legacy of social work’s involvement in the genocide of Indigenous peoples. Moreover, the exam’s reliance on standardized testing has led to concerns about racial disparities and infringing individual charter rights. Finally, the lack of evidence supporting the exam’s validity further underscores the need for a different approach to ensure credibility and accountability.

A secondary assessment is still crucial to the assessment of clinical social work competence. So the committee proposed that being a specialized clinical social worker requires active participation in professional clinical supervision. It’s not just about attending meetings but engaging in a process of development. Professional clinical supervision assesses our abilities in different areas, ensuring we can perform at a satisfactory level. This kind of process is essential to building the skills, values, and knowledge necessary for specialization in clinical social work Engaging in this process allows us to grow and learn, becoming better equipped to help those in need.

The committee has proposed that applicants demonstrate 1800 hours of supervised practice experience in a clinical setting post-MSW to develop skills related to assessments, a relational approach, collaboration, a critical clinical perspective, and reflexivity. For those starting down this path, it’s important to note that Social Worker Candidates must first complete their Candidacy Mentorship Program. The 1800 hours would also contain 24 hours of clinical social work supervision, receiving an assessment from a supervisor that demonstrates their skills, and creating a supervision plan to develop clinical abilities. Those who don’t meet supervision requirements may still be authorized to work in clinical practice settings with restrictions posted on their public profiles.

Finally the committee worked to create new clinical standards of practice. Clinical social work specialists possess a deep understanding of the emotional and social circumstances of the people they assist.

The standards aim to support and guide to those facing mental health, addiction, trauma, grief, loss, or crisis issues to articulate what they can expect when they receive the services from a clinical specialist.

For such individuals, progress towards recovery relies heavily on the quality of the professional’s relationship with them, their proficiency in assessing and treating mental health conditions, and their ability to secure additional resources. Policy and organizational dynamics can also play a role, along with the quality of service or program available.

In summary, the NSCSW has proposed a revised approach to assessing clinical social work competence that takes into account both professional and individual needs. This includes requiring 1800 hours of supervised practice experience in a clinical setting post-MSW, 24 hours of clinical supervision, an assessment from their supervisor demonstrating skills, and adherence to new standards for practice. These measures are intended to provide individuals with greater access to quality care by ensuring specialists have the necessary expertise and resources available to support people on their journey towards recovery. The committee is confident these initiatives will help reduce barriers of entry while improving accountability within the profession so we can better serve those who rely on us most.

2022 COMMITTEE MEMBERS:

Lida Abdulrahman, Jacquelyn Allan, Kelly Breau, Catrina Brown, Patrick Daigle, James Dubé, Brandy Gryshik (co-chair), Robyn Hazard, Alex Hill, Jim Morton, Andrea Shaheen (co-chair), Alec Stratford (staff), Errin Williams