You could make a convincing argument that the true hero of the HBO series Big Little Lies is character Celeste Wright's therapist, Dr. Reisman. As she nods, sighs, and interjects her way through sessions, she holds an emotional mirror up to Celeste, helping her to see the reality of her abusive relationship and the tough choices she needs to make.
Clinical social workers address situations like domestic violence, substance abuse, and mental illness with a psychosocial approach to help their clients navigate their life challenges.
In this article, we'll cover:
Using evidence-based practice methods and an understanding of psychology, social environment, and family structure, clinical social workers help individuals and groups of people to work through difficult situations.
Clinical social workers have a plethora of job options, from working in hospitals and schools to hospice agencies or even private practice. These jobs all require:
While many clinical social workers work as therapists, their skill sets are a little different from:
Clinical social workers approach therapy with a focus on social environment, taking into account background, family structure, social justice factors, and more while working with a client.
While clinical social workers (particularly LCSWs) do perform psychological interventions and call upon evidence-based methods, their practice also emphasizes finding social support and tailoring treatment to a person's environment.
Clinical social work is more practice-oriented than other forms of social work, which means that clinical social workers often work directly with clients. That could mean working as a substance abuse counselor helping clients to manage and overcome addiction, or working in a psychiatric hospital or emergency room providing diagnoses or psychotherapy to patients dealing with everything from grief to PTSD.
Some clinical social workers lead support groups or family counseling sessions, while still others manage administrative departments, supervise recent social work graduates, or even teach social work practice in university social work programs. With a little creativity and an open mind, the possibilities can be endless.
Interested in becoming a clinical social worker? You'll need a Master's in Social Work, or MSW. MSW programs typically take two years (four semesters) to complete. Students must undertake two-year-long internships, often called field placements, as well as a mix of classes covering everything from psychology to diversity and social justice.
Students who plan to pursue a clinical career will likely take more generalized classes during the first year of their social work education and choose a handful of clinical-focused electives in their second year.
While most MSW programs last for two years, there are alternatives. Students with a Bachelor of Social Work, or BSW, are often able to complete their degrees within a year, because the coursework they completed at the undergraduate level affords them advanced standing.
Students without BSWs who hope to speed up the process should look for accelerated programs, which require summer classes and run for 16 months. Students who plan to work while they study can opt for part-time programs, which can take three to four years to complete. There are online programs available as well, which often require in-person internships.
When applying to schools, look for a Council on Social Work Education, or CSWE, accreditation, which means the school is up to national standards and prepares graduates for licensure.
If you're pursuing a clinical career, it's worth seeking out schools with designated clinical tracks and/or a history of placing students in clinical internships. It's possible to earn a degree in social work outside of the United States, though international students who wish to gain US licensure must have graduated from schools that are determined to be equivalent to CSWE-certified American and Canadian programs.
After graduating with a bachelor's degree and a master's degree, the next step is to fulfil licensing requirements, which usually takes place through the Association of Social Work Boards (ASWB). Social workers must take the ASWB exam/exams to become a Licensed Master Social Worker in the state in which they will practice, though the test material does not vary state to state. Those who fail must retake the test until they pass and become a licensed social worker.
After passing that initial licensure test, LMSWs typically go on to complete several years of supervised training to become Licensed Clinical Social Workers, or LCSWs. The exact requirements vary from state to state (in New York, for example, it's 2,000 hours completed over at least three years); the work must be done under the supervision of an LCSW, psychologist or psychiatrist.
After hitting the required number of hours, LMSWs can apply to their state's social work licensure board for LCSW status. Those hoping to practice independently must earn certification as an LCSW, or, in some states, as a Licensed Independent Clinical Social Worker, or LICSW.
LCSWs finish training with a strong understanding of:
Wondering when to begin? The best time to pursue an MSW program depends on you. Some students know from an early age that they want to work as clinical social workers, and they charge straight into the program after completing a bachelor's degree. Others work for a few years before deciding a master's degree will give them a leg up. Still, others work in entirely different fields before pivoting to social work, inspired by (among other things):
A teacher, for example, might decide to pursue a career as a school social worker after seeing the need for one at his or her school.
MSW student bodies tend to be melting pots of all ages and backgrounds, especially in part-time programs. Plus, once you've become a social worker yourself, you'll be able to draw on your unique background to inform your practice.
Want more info on the process in your state?
Social work is a caring field all the way around, so you'll have plenty of support wherever you turn.
After passing the licensure exam and transitioning from an LMSW to LCSW, many clinical social workers find jobs as psychotherapists, practicing one-on-one or in groups. Common employers include:
Because clinical social workers are trained in many areas, the options should be broad.
After several years working at an agency, hospital or school, some clinical social workers choose to go into private practice. Some make it their full-time job, while others split time between agency work and private practice, or join therapy group practices. Others find ways to parlay their experience into alternative careers, such as working as consultants or even teaching in social work programs.
Some continue at agencies or working in administration. Clinical social workers hoping to advance quickly in their professional life or increase their social work earnings can make an effort to specialize in an area such as geriatric social work, or substance abuse and addiction social work, which are both growing fields. Entrepreneurial social workers might strike out on their own to advance, forming practice groups, or finding innovative ways to practice social work with clients.
While an MSW is typically the terminal degree for clinical social workers, some choose to continue onto a Doctorate of Social Work, while many choose to take certification courses, becoming specialized in areas such as school social work, child and family social work, medical social work, geriatric social work, grief counseling, and more. These shorter programs can boost a social worker's skills, allow for a narrower focus, and help to build connections in that specialized field.
Many universities offer in-person certification courses as well as online programs, which make it easy to work and study at the same time. Some social workers will complete additional programs after years, or even decades, in the field. Advanced programs can also allow a social worker to pivot from one specialization to another. While specialized certification programs are voluntary, all social workers will have to take Continuing Education Units, or CEUs, throughout their careers to retain licensure.
While specializations and certifications can boost a social worker's earnings, the increase depends on a few factors. Medical social workers often rank among the highest-paid, as do corporate roles. LCSWs who practice privately often earn more because they're billing patients directly, or through insurance, without going through an agency intermediary.
Many clinical social workers practicing as therapists split their time between sessions with patients, filling out reports, billing, and other paperwork. An agency social worker, on the other hand, might hold group sessions and meetings with clients. Many LCSWs choose to go into private practice so they can build their schedules around their own lives.
Clinical social work can make for a demanding career, but it can also be deeply satisfying. You may never find yourself on the tony beaches of Big Little Lies' Monterey, but you will help people. What's better than that?
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