Clinical Social Worker

clinical social worker

Have you always felt yourself drawn toward helping others in need? Maybe you often visit the soup kitchen or women’s shelter, extending an empathetic hand to those struggling to survive every day. Perhaps instead you find yourself talking through difficult experiences with your friends, helping to alleviate pain caused by problems in life. While this help allows victims to cope with their challenges, providing services that actually solve those challenges gives them chances to not just cope, but thrive.

Professionals in clinical social work recognize that victim outreach must not only come in the form of physical resources, but mental ones as well. By recognizing that many societal problems are actually rooted in mental health concerns, clinical social workers (CSWs) dedicate their lives to enhancing the well-being of all individuals that make up a community.

Who are Clinical Social Workers?

Social work is broken into two distinct groups of professionals: clinical social workers and direct service social workers. Though each helps to protect disadvantaged groups, CSWs have extensive training in diagnosing and treating mental health disorders, while still providing the community resources and services that traditional social workers offer.

The over 650,000 social workers in the United States make up the largest group of mental healthcare providers in the country, offering their services to a variety of individuals. According to the American Board of Examiners in Clinical Social Work (ABECSW), they help people reach solutions to a range of problems, including:

  • Destructive behavioral patterns
  • Substance addiction
  • Emotional problems of living
  • Troubled interpersonal relationships
  • Ineffective stress management
  • Negative impacts of economic, social, and cultural factors
  • Prejudice, racism, and human diversity
  • Gender and sexual orientation issues
  • Issues of deprivation, abuse, or victimization
  • Life consequences of illnesses or disabilities

These concerns call for numerous techniques and strategies to tackle effectively, requiring the social worker to take a holistic view of a client’s life through assessment, diagnosis, and treatment.

Who do Clinical Social Workers Reach Out to?

When it rains, it pours. As someone experiences a large amount of stress in their everyday life and then encounters a chaotic event, it often leaves them feeling completely overwhelmed and hopeless.

Consider someone already struggling to pay bills and support their family who is fired from their job. Now, this person must emotionally (and financially) cope with the stress and difficulty of finding a job while still attending to family responsibilities. Someone in this situation might bottle up emerging feelings of failure related to job loss, escaping their difficulties through drinking or drug use.

Meeting with a CSW would not only allow this person to work through those emotions tied to job loss, but would also introduce them to organizations in the community to ease the burdens of existing stressors, like career assistance services.

Clinical social workers frequently meet with clients undergoing crises – events that lead them to believe their lives are spiraling out of control. Clients in crisis mode do not believe they have the strength to cope, and react in negative ways to the anxiety, panic, or despair they feel.

According to Techniques and Guidelines for Social Work Practice, by authors Bradford Sheafor and Charles Horejsi, common causes of crises CSWs assist with include:

  • Death of a loved one
  • Loss of a job
  • Divorce
  • Serious illness or accident
  • House fires or other life-altering situations
  • Rape, mugging, or other traumatic events

Clients themselves might not understand the underlying problem that led them to become overwhelmed, requiring the social worker to seek out the crisis area.

Because clients experiencing a crisis often feel too overwhelmed to see a solution themselves, the social worker uses partialization strategies to break the large problem into smaller more manageable ones. This allows the client to regain their sense of control and explore possible treatments or interventions that allow them to more directly address their needs.

How do Clinical Social Workers Help?

According to “Clinical Social Work Standards for Delivery of Care and Guidelines for the Three-Party Model of Clinical Social Work Services,” published by the ABECSW, all CSW treatments must be assessment-based.

Assessments allow CSWs to gather information based on their client’s biological, psychological, social, economic, environmental, and cultural circumstances and conditions.

Beginning sessions with a client often involve simple question and answer exercises, allowing the client to express emotions and air their concerns. Hoping to gain a fuller understanding of the problem, they ask clients what their goals are, and what they believe needs to happen for them to accomplish those goals.

Using this information, the CSW then constructs a treatment plan with goals, objectives, timeframes, and intervention methods based on four aspects:

  • The presenting problem
  • Its underlying causes
  • Sustaining causes
  • Prognosis for responding to treatment

For example, consider a client who reports feelings of unhappiness bordering on depression because the relationship with his significant other has suffered over several months.

The CSW meets with this client, initially asking what has changed about the relationship and why those changes have occurred. The client might divulge that nearly all aspects of his life have been particularly taxing over the past several months, ever since his mother passed away.

Asked about the death, the client then reveals not having time to properly place the loss in perspective. Because the event happened so suddenly, the client never properly grieved for his mother, pushing away those feelings due to stress in other areas of life.

The CSW proposes that maybe the clients initial relationship concerns are actually a result of these bottled up emotions surfacing in other areas of life. The client might blame himself for not paying more attention to the death, and the CSW must reframe these thoughts in the mind of the client.

Reframing emotions surrounding the death allows the client to gain a sense of comfort and acceptance with his relationship to the loved one. Hoping to facilitate the grieving process, the CSW engages in a mixture of cognitive behavioral therapy and interpersonal psychotherapy, giving the client time to reimagine and revisit the death.

Only after treating the underlying cause of a client’s issue can a CSW then help them with their initial problem – like relationship concerns with a significant other. Potential solutions might involve locating community groups and relationship counseling organizations for the client to explore.

Education/Licensure for Clinical Social Workers

Clinical social workers require advanced training in mental health care and therapeutic techniques to create a holistic view of a client’s mental, emotional, and behavioral state.

To ensure you have the skills and experience necessary to provide for those in need, states require clinical social workers to earn master’s degrees in social work or psychology before practicing. If you’d like to learn more about a career in social work, you can request information from psychology schools and understand the licensing process in order to acquire the desired qualifications.

Empowering Clients from Within

While clinical social work often involves psychotherapeutic techniques such as cognitive behavioral therapy, one push in the field turns away from traditional views of therapy to show clients that they possess the inner strength needed to overcome many problems.

According to “Strengths-Based Social Work Assessment: Transforming the Dominant Paradigm,” by Clay Graybeal, many traditional clinical assessments focus on deficits in a person’s life, sometimes creating negative self-fulfilling prophesies. The strengths perspective rejects these deficits, reframing them as personal strengths in a client.

Rather than diagnose clients and place them into “boxes” of “depressed, abused, anxious, or addicts,” CSWs guide clients to believe in their own resilience and survivability, even in the face of their challenges. This often involves reconsidering how a client thinks about their problem, for example, stating, “My drinking creates problems in my life,” rather than “I am an alcoholic.”

Unlike traditional assessments and treatments, the client mainly leads strengths-based clinical social work, while the CSW pushes them in the right direction. To accomplish this, many CSWs introduce the ROPES model.

  • Resources – Personal, family, social environment, organizational, community
  • Options – What can be accessed now? What is available that I have accessed?
  • Possibilities – Future focus, imagination, creativity, vision of the future
  • Exceptions – When does my problem not happen? When is the problem different?
  • Solutions – Construct solutions. How would my situation change if a “miracle” happened?

The major differences between a strengths perspective and traditional psychotherapy model lie in how the client experiences it. Rather then requiring hours of therapy with “problem-focused” questions, strengths-based therapy strictly focuses on solutions. The ROPES model forces clients to truly examine the resources surrounding them, and what natural safety nets exist in their community.

Their self-guided solution exploration allows clients to feel empowered where previously they felt overwhelmed. By then constructing a step-by-step solution guide with the CSW based on their answers to ROPES (where do my resources lie, what can I access today, how can I prepare for the future), the client recognizes their strengths and approaches problems more positively.

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