The Clinical Social Work Association mission - Identity, Integrity, and Parity - guides our advocacy. This year our advocacy priorities, in order of importance, are:
Social Work Day on the Hill - On March 1, CSWA was ably represented by Margot Aronson, LICSW, CSWA Deputy Director of Policy and Practice, at a meeting of 400 social work students, faculty, and alumni at the Capitol Visitor Center Auditorium in Washington DC. This was a gathering sponsored by all major social work groups as it was last year. However, this year CSWA had a featured role as a discussant, with NASW, of the Improving Access to Mental Health Treatment Act, H.R. 3712 /S. 2173, which directly affects the interests of clinical social workers.
In addition to describing the bill, Margot gave a great summary of what clinical social workers do and how to explain the bill to members of Congress. She was besieged by students who were eager to become clinical social workers and were elated to have someone who knew the field to talk to. Rep. Barbara Lee (D-CA), prime sponsor of the House bill, was elated as well, saying she had never seen so many social workers on the Hill.
This event was a big step toward CSWA’s goal of building bridges with other social work groups and increasing our presence as advocates in Washington DC. Please send thanks to Margot firstname.lastname@example.orgThanks also go to Judy Gallant, LICSW, GWSCSW Legislative Chair, for her help on behalf of CSWA.
*Medicare Position Paper– this paper is the basis for giving LCSWs equal pay for ‘equal’ codes. Currently LCSWs are paid 25% less than psychologists and psychiatrists for psychotherapy services.
*Online MSW Education – the rise of online asynchronous MSW programs is cause for concern. The ability to teach students how learn the way to create human connections and understand the complex experience of each individual is gravely undermined if there is no direct contact with faculty, fellow students, and, in some schools, clients.
*Implementation of Mental Health Parity– the recent passage of the rules for federal mental health parity laws have not changed the denials of care or restrictions on care that have plagued mental health clinicians for decades. The primary obstacle is that insurers do not allow licensed clinicians to make clinical decisions about mental health treatment. Collaborative efforts with other mental health groups are a key to success.
*Privileging of Medication over Psychotherapy – over the past 30 years, psychotropic medication has become the primary treatment for emotional distress, recommended by primary care physicians and insurers. Building bridges with PCPs and making psychotherapy a fundamental part of the way that emotional disorders are treated is a major goal.
*Degradation of Psychotherapy for Treatment of Chronic Disorders – over decades emotional disorders that require long term treatment have been denied coverage by many insurers. Even with the passage of mental health parity, personality disorders, dysthymia, and anxiety disorders are covered as if crisis management is the only need for treatment that should be covered. Using parity, legal means, and our own expert judgment to make true mental health treatment a reality has been a primary goal.
Privileging of Manualized Treatment over Psychodynamic Treatment – along with #3, longer term modes of therapy like psychoanalysis and psychodynamic psychotherapy have been specifically rejected by some insurers, using Milliman/MCG Guidelines. This practice is a violation of the LCSW’s right to make clinical decisions and use valid methods of treatment.
Underfunding of Psychotherapy –reimbursement for psychotherapy has decreased over the past 20 years, leading to a real value of current third party payments at a 30-60% decrease from past reimbursement rates. The viability of earning a living as a private practitioner is in jeopardy unless this can be stopped.
Telemental Health Development and Confidentiality– the rise of telemental health psychotherapy is a complicated issue that raises clinical and regulatory concerns. Developing telemental health delivery systems that provide the level of confidentiality needed is a goal.
Underfunding of Public Mental Health Care – the recent excellent survey by Mental Health America shows exactly how each state funds mental health and addiction care in a variety of areas. Almost all states need more funding to meet adequate treatment standards, including wraparound services for the seriously mentally ill.
Treatment of Addiction– increased awareness of addiction and state regulation of endorsement to provide treatment for addiction may require more training in treatment of substance abuse for LCSWs who wish to work in this area.