Standards for Clinical Social Work in Social Work Practice:-
Clinical social workers shall adhere to the
values and ethics of the social work profession,
utilizing the NASW Codes of Ethics as a guide
to ethical decision making.
Standard 2. Specialized Practice Skills and
Intervention
Clinical social workers shall demonstrate
specialized knowledge and skills for effective
clinical intervention with individuals, families,
and groups.
Standard 3. Referrals
Clinical social workers shall be knowledgeable
about community services and make
appropriate referrals, as needed.
Standard 4. Accessibility to Clients
Clinical social workers shall be accessible to
clients during non emergency and emergency
situations.
Standard 5. Privacy and Confidentiality
Clinical social workers shall maintain adequate
safeguards for the private nature of the
treatment relationship.
Standard 6. Supervision and Consultation
Clinical social workers shall maintain access to
professional supervision and/or consultation.
Standard 7. Professional Environment and
Procedures
Clinical social workers shall maintain
professional offices and procedures.
Standard 8. Documentation
Documentation of services provided to or on
behalf of the client shall be recorded in the
client’s file or record of services.
Standard 9. Independent Practice
Clinical social workers shall have the right to
establish an independent practice.
Standard 10. Cultural Competence
Clinical social workers shall demonstrate
culturally competent service delivery in
accordance with the NASW Standards for
Cultural Competence in Social Work Practice.
Standard 11. Professional Development
Clinical social workers shall assume personal
responsibility for their continued professional
development in accordance with the NASW
Standards for Continuing Professional Education
and state requirements.
Standard 12. Technology
Clinical social workers shall have access to
computer technology and the Internet, as
the need to communicate via e-mail and to
seek information on the Web for purposes
of education, networking, and resources is
essential for efficient and productive
clinical practice.
Introduction
Clinical social workers represent the largest
group of behavioral health practitioners in the
nation. They are often the first to diagnose
and treat people with mental disorders and
various emotional and behavioral disturbances.
Clinical social workers are essential to a
variety of client-centered settings, including
community mental health centers, hospitals,
substance use treatment and recovery
programs, schools, primary health care
centers, child welfare agencies, aging services,
employee assistance programs, and private
practice settings.
Clinical social work has a primary focus on the
mental, emotional, and behavioral well-being
of individuals, couples, families, and groups.
It centers on a holistic approach to
psychotherapy and the client’s relationship to
his or her environment. Clinical social work
views the client’s relationship with his or her
environment as essential to treatment
planning.
Clinical social work is a state-regulated
professional practice. It is guided by state
laws and regulations. In most instances,
clinical social workers are required to have
the following credentials:
n a master’s degree from a social work
program accredited by the Council on
Social Work Education
n a minimum of two years or 3,000 hours
of post-master’s degree experience in a
supervised clinical setting
n a clinical license in the state of practice.
Clinical social work is broadly based and
addresses the needs of individuals, families,
couples, and groups affected by life changes
and challenges, including mental disorders
and other behavioral disturbances. Clinical
social workers seek to provide essential
services in the environments, communities,
and social systems that affect the lives of the
people they serve.
Goals of the Standards
Clinical social workers are committed to the
delivery of competent services to individuals,
families, couples, and groups. Therefore, they
shall recognize the client’s role in his or her
treatment planning and the client’s right to
have a knowledgeable, skilled practitioner
who is guided by sound ethical practice.
These Standards for Clinical Social Work Practice
set forth by the National Association of Social
Workers (NASW) are intended to guide clinical
social workers in all clinical settings. Specifically,
the goals of the standards are to:
n maintain or improve the quality of services
provided by clinical social workers
n establish professional expectations to assist
social workers in monitoring and evaluating
their clinical practice
n provide a framework for clinical social
workers to assess responsible, professional
behavior
n inform consumers, government regulatory
bodies, and others about the professional
standards for clinical social work practice.
The scope of clinical social work extends
across many practice settings and populations.
It is anticipated that these standards will
reinforce and support current clinical practice
in all settings, while affirming the value of
clinical social work services as a discrete
practice area.
Definitions
Client/Patient/Consumer
Social workers generally use the term “client”
to refer to the individual, group, family, or
community that seeks or is provided with
professional services. The client is often seen
as both the individual and the client system
or those in the client’s environment. The term
“consumer” is also used in settings that view
the client as the consumer, that is, one capable
of deciding what is best for her or himself and
encourages self-advocacy and self-judgment
in negotiating the social service and welfare
system. The term “patient” is more commonly
used by social workers employed in health care
settings (Barker, 2003). The term patient may
also be used for insurance reimbursement
purposes in health and mental health settings.
Clinical Social Work
Clinical social work is the professional
application of social work theory and methods
to the diagnosis, treatment, and prevention
of psychosocial dysfunction, disability, or
impairment, including emotional, mental,
and behavioral disorders (Barker, 2003).
Counseling
This is a procedure that is often used in
clinical social work and other professions to
guide individuals, families, couples, groups,
and communities by such activities as
delineating alternatives, helping to articulate
goals, and providing needed information
Person-in-Environment Perspective
This orientation views the client as part of
an environmental system. It encompasses
reciprocal relationships and other influences
between an individual, relevant others, and
the physical and social environment
Psychodynamic
This word pertains to the cognitive,
emotional, and volitional mental processes
that consciously and unconsciously motivate
an individual’s behavior. These processes are
the product of the interplay among a person’s
genetic and biological heritage, the
sociocultural milieu, past and current realities,
perceptual abilities and distortions, and his
or her unique experiences and memories
Psychotherapy
Psychotherapy is a specialized, formal
interaction between a social worker or other
mental health professional and a client (either
individual, couple, family, or group) in which
a therapeutic relationship is established to
help resolve symptoms of mental disorder,
psychosocial stress, relationship problems,
and difficulties in coping in the social
environment. Types of psychotherapy include,
but are not limited to family therapy, group
therapy, cognitive–behavioral therapy,
psycho social therapy, and psychodrama
Therapy
This is a systematic process designed to
remedy, cure, or abate some disease, disability,
or problem. This term is often used by social
workers as a synonym for individual
psychotherapy, conjoint therapy, couples
therapy, psychosocial therapy, or group
therapy (Barker, 2003).
Standards for Clinical Social Work
in Social Work Practice
Standard 1. Ethics and Values
Clinical social workers shall adhere to the
values and ethics of the social work
profession, utilizing the NASW Code of Ethics
as a guide to ethical decision making.
Interpretation
The social work mission is rooted in six core
values: service, social justice, dignity and
worth of the person, importance of human
relationships, integrity, and competence
(NASW, 1999). All social workers have a
responsibility to embrace these values as a
service to clients, the profession, self, colleagues,
and society. In delivering clinical social work
services, the social worker’s primary
responsibility is to his or her client. Clinical
social workers shall acknowledge the right of
clients to receive competent psychosocial
services and demonstrate a commitment to act
on professional judgment and convictions,
which are informed by the NASW Code of Ethics
(1999).
Clinical social workers shall be prepared for
the challenges that encompass the assessment
and treatment of people with mental disorders
and behavioral or emotional disturbances.
This includes maintaining a commitment to
the client while simultaneously demonstrating
responsibility to the practice setting, society,
and local, state, and federal policies and
regulations governing the social worker’s
clinical practice. In the event that conflicts
arise among competing interests, social
workers are directed to the NASW Code of
Ethics as one of the reference points for
decision making. Services should only be
provided in a setting in which the professional
relationship can be maintained. Clinical social
workers should adhere to the NASW Code of
Ethics with regard to limits on private and/or
dual relationships with clients.
Standard 2. Specialized Practice Skills
and Interventions
Clinical social workers shall demonstrate
specialized knowledge and skills for effective
clinical interventions with individuals, families,
couples, and groups.
Interpretation
Drawing on knowledge of systems theory,
person-in-environment orientation,
psychodynamic theory, interpersonal
dynamics, and family systems, clinical social
workers shall be familiar with social,
psychological, cultural, and health factors that
influence the mental, emotional, and
behavioral functioning of the client. They
shall have knowledge of theories of personality
and behavior and be aware of sociocultural and
environmental influences, as well as conditions
that have an impact on the physical and
emotional state of the client.
In addition to the above, clinical social
workers shall have the ability to:
n establish and maintain a relationship of
mutual respect, acceptance, and trust
n gather and interpret social, personal,
environmental, and health information
n evaluate and treat problems within their
scope of practice
n establish achievable treatment goals with the
client
n facilitate cognitive, affective, and behavioral
changes consistent with treatment goals
n evaluate the effectiveness of treatment
services provided to the client
n identify appropriate resources and
assessment instruments, as needed
n advocate for client services
n collaborate effectively with other social
work or allied professionals, when
appropriate.
When additional knowledge and skills are
required to address clients’ needs, the clinical
social worker shall seek appropriate training,
supervision, or consultation, or refer the client
to a professional with the appropriate
expertise. Clinical social workers shall limit the
scope of their practice to those clients for
whom they have the knowledge, skill, and
resources to serve. They shall be accountable
for all aspects of their professional judgment,
behavior, and decisions.
Standard 3. Referrals
Clinical social workers shall be knowledgeable
about community services and make
appropriate referrals, as needed.
Interpretation
To ensure that clients receive optimal
psychosocial services, it is sometimes beneficial
to collaborate or coordinate services with
appropriate community programs to
strengthen or improve the continuity of care.
Clinical social workers shall be knowledgeable
about available community resources and
advocate on behalf of the client for
appropriate services. The clinical social
worker shall maintain collaborative contacts
with social work or other related professionals
and make appropriate referrals, as needed.
The clinical social worker shall not share
information about the client without the
client’s informed consent or as otherwise
indicated in Standard 5.
Standard 4. Accessibility to Clients
Clinical social workers shall be accessible to
their clients.
Interpretation
Clinical social workers shall be available to
provide clinical services to clients during
regularly scheduled appointment times or
sessions. In addition, the clinical social worker
shall develop emergency plans or be available
to the client for emergency coverage during
vacations, holidays, illnesses, and at other
times when the office may be closed.
Arrangements or plans and procedures for
emergency coverage shall be made in
partnership with competent mental health
professionals or reputable institutions and
should be discussed with the client at the
initial face-to-face interview.
In addition, the office setting should be
accessible and/or have helping devices for
persons with disabilities, or office limitations
should be discussed prior to scheduling
appointments.
Standard 5. Privacy and Confidentiality
Clinical social workers shall maintain adequate
safeguards for the private nature of the
treatment relationship.
Interpretation:
Confidentiality is a basic principle of social
work intervention. It ensures the client that
what is shared with the social worker will
remain confidential, unless there is an ethical
or legal exception. All information related to
or obtained from the client by the clinical
social worker shall be viewed as private and
confidential. Clinical social workers shall be
familiar and comply with local, state, and
federal mandates governing privacy and
confidentiality, such as the federal Health
Insurance Portability and Accountability Act
(HIPAA) requirements and state medical
records laws.
Information obtained by the social worker
from or about the client shall be viewed as
private and confidential, unless the client
gives informed consent for the social worker
to release or discuss the information with
another party. There may be other exceptions
to confidentiality as required by law or
professional ethics. Social workers should be
familiar with national, state, and local
exceptions to confidentiality, such as mandates
to report when the client is a danger to self or
others and for reporting child or elder abuse
and neglect. The clinical social worker shall
advise the client of confidentiality limitations
and requirements at the beginning of
treatment.
Professional judgment in the use of
confidential information shall be based on
best practice, as well as legal, and ethical
considerations.
Standard 6. Supervision and Consultation
Clinical social workers shall maintain access to
professional supervision and/or consultation.
Interpretation
Clinical social workers should ensure that
professional social work supervision is
available to them in a clinical setting for
the first five years of their professional
experience (NASW, 2004). If clinical social
worker supervisors are not available or
accessible, case consultation may be obtained
from qualified professionals of other related
disciplines. Those clinical social workers with
more than five years of clinical experience
shall use consultation on an as-needed, selfdetermined
basis. Clinical social workers
shall adhere to state and federal statutes and
regulations regarding supervision and
consultation in their states of practice.
When appropriate, clinical social workers
should offer their expertise to individuals,
groups, and organizations, as well as offer
training and mentoring opportunities to
beginning social workers or those making the
transition into clinical social work. In addition,
experienced clinical social workers who are
able should offer supervision to social workers
seeking state licensure for clinical social work
practice.
Standard 7. Professional Environment and
Procedures
Clinical social workers shall maintain
professional offices and procedures.
Interpretation
Agencies providing clinical social work
services and clinical social workers in private
or independent practice shall develop and
implement written policies that describe their
office procedures, such as the client’s rights,
including the right to privacy and
confidentiality; notices and authorizations;
procedures for release of information, fee
agreements; procedures for payment;
cancellation policy; and coverage of services
during emergency situations or when the
clinical social worker is not available. These
policies shall be made available to and
reviewed with each client at the beginning
of treatment. Clinical social workers should
maintain appropriate liability insurance and
have a current working knowledge of risk
management issues.
In addition to the above, the treatment setting
shall be properly maintained to ensure a
reasonable degree of comfort, privacy, and
security for the social worker and the client.
Standard 8. Documentation
Documentation of services provided to, or on
behalf of, the client shall be recorded in the
client’s file or record of services.
Interpretation
Clinical social workers must document all
services rendered to clients and keep the
records in a secure location, maintaining
them as private and confidential records.
Documentation must reflect an accurate
account of services. Progress notes, reports,
and summaries of services shall be regularly
recorded in the client’s file and be consistent
with all applicable local, state, and federal
statutory, regulatory, or policy requirements.
Records must meet current federal provisions
regarding privacy, security, and electronic
transactions standards and code sets.
Standard 9. Independent Practice
Clinical social workers shall have the right to
establish an independent practice.
Interpretation:
Clinical social workers may establish an
independent solo or group practice. When
doing so, they shall ensure that all services,
including diagnostic and treatment planning,
meet professional standards. When clinical
social workers employ staff, they, as
employers, bear responsibility for the
competency of all services provided;
maintaining clinical and ethical standards;
and upholding all local, state, and federal
regulations.
To avoid conflicts of interest, clinical social
workers who are both employed by agencies
and have independent practices shall not refer
agency clients to themselves without prior
agreement with the agency and consent of the
client. In addition, the clinical social worker
shall have offered alternative options to the
client, such as transferring the client to
another treatment provider within the agency
or terminating services.
Clinical social workers in private or
independent practice may bill third-party
payers or their clients for services rendered.
Clients shall be provided with all invoices and
receipts in a timely manner. When a client can
no longer afford services—or a third-party
payer or an agency terminates services—an
alternative mutually agreed upon with the
client may be instituted, which could include,
for example, a referral, termination of services,
a sliding scale, or pro bono services. If services
continue, consideration must be given to any
applicable federal or state laws and regulations
as well as insurance or managed care contracts
that may limit the type of continuing care.
When a client chooses to terminate treatment,
the clinical social worker will offer to aid the
client in exploring barriers to treatment and
re-examine the treatment plan to help the
client reach termination constructively. When
appropriate, the clinical social worker shall
refer the client to another qualified treatment
provider.
Standard 10. Cultural Competence
Clinical social workers shall demonstrate
culturally competent service delivery in
accordance with the NASW Standards for
Cultural Competence in Social Work Practice.
Interpretation
The increasingly diverse population seeking
psychosocial services requires that clinical
social workers raise their awareness and
appreciation of cultural differences. Clinical
social workers shall have, and continue to
develop, specialized knowledge and
understanding about history, traditions,
values, and family systems as they relate to
clinical practice with individuals, families,
and groups. Clinical social workers shall be
knowledgeable about and demonstrate practice
skills consistent with the NASW Standards
for Cultural Competence in Social Work Practice
(2001). In addition, clinical social workers
need to be knowledgeable about the
deleterious effects of racism, sexism, ageism,
heterosexism or homophobia, anti-Semitism,
ethnocentrism, classism, and disability-based
discrimination on clients’ behavior, mental and
emotional well-being, and course of treatment.
Clinical social workers must also recognize
racial, ethnic, and cultural differences that may
be interpreted as barriers to treatment and
develop skills to ameliorate such barriers.
Standard 11. Professional Development
Clinical social workers shall assume personal
responsibility for their continued professional
development in accordance with the NASW
Standards for Continuing Professional Education
and state requirements.
Interpretation
To practice effectively, clinical social workers
must remain knowledgeable about emerging
theories and interventions, best practice
models in the social work profession, and
changes in policies and regulatory reforms
such as the HIPAA regulations. Clinical social
understanding by staying abreast of research
to ensure that their practice reflects the most
current knowledge. Clinical social workers
should also seek continuing education about
risk management and professional liability
issues.
Numerous opportunities in professional
development are available through NASW
and other professional organizations or
institutions, coalitions, and service agencies at
local, state, and national levels. Clinical social
workers should regularly participate in and
contribute to professional conferences and
training activities and contribute to and
promote professional publications.
Standard 12. Technology
Clinical social workers shall have access to
computer technology and the Internet, as the
need to communicate via e-mail and to seek
information on the Web for purposes of
education, networking, and resources is
essential for efficient and productive clinical
practice.
Interpretation
Clinical social workers are increasingly using
the Web, computers, and other electronic
technology to improve the quality of services
for clients, to communicate with other
professionals, and for documentation
purposes. Clinical social workers should keep
abreast of electronic changes that may affect
practice. Technology may be integrated into
clinical practice; however, appropriate
safeguards for client privacy shall be used.
Clinical social workers should engage in
ongoing training in technology applications
relevant to clinical social work practice
including assessment and treatment, research,
policy, education, and resource tracking and
development.
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