Summer, 2000

Inside this Issue:

What is Clinical Content?

Welcome New Board Members!

Board Meeting Dates

Welcome New Licensees

About Your Address

In Remembrance

Queries

How Does Your Garden Grow?

State and National Test Statistics

Disciplinary Actions

WHAT IS CLINICAL CONTENT?

The 1999 Social Work Practice Act requires LCSWs to obtain twenty (20) clock hours in programs approved by the Board in order to renew the license each year. Ten (10) of these clock hours must be in "clinical content including diagnosis and treatment of mental disorders".

The LCSW who is an administrator, faculty member, or community organizer may not provide direct mental health services to the public, but the LCSW credential allows the licensee to provide those services independently and the licensee should be at least minimally prepared to do so. Furthermore, the LCSW should be knowledgeable enough to make appropriate referrals for mental health treatment, which is often a difficult and complex task.

Clinical social work practice includes, but is not limited to, the practice of psychotherapy. Psychotherapy involves the use of treatment methods in "a specialized formal interaction between a social worker and an individual, couple, family or group in which a therapeutic relationship is established, maintained and sustained." Psychotherapy consists of "diagnosis and treatment of mental, emotional and behavioral disorders, conditions and addictions" and requires the social worker’s knowledge of unconscious processes as well as intrapersonal, interpersonal and psychosocial dynamics.

The broader scope of clinical social work practice "requires the application of specialized clinical knowledge and advanced clinical skills in the areas of prevention, assessment, diagnosis and treatment of mental, emotional, behavioral and addiction disorders." One of the methods used by social workers in clinical practice is counseling. Counseling is defined as a method used to "assist individuals, couples, families and groups in learning how to solve problems and make decisions about personal, health, social, educational, vocational, financial and other interpersonal concerns."

Another method used by social workers in clinical practice is supportive counseling. Supportive counseling is defined as "the methods used by social workers to help individuals create and maintain adaptive patterns. Such methods may include building community resources and networks, linking clients with services and resources, educating clients and informing the public, helping clients identify and build strengths, leading client and community groups, and providing assurance and support." 

The required ten (10) clock hours a year in "clinical content including diagnosis and treatment of mental disorders " may relate to the practice of psychotherapy or to the broader clinical arena which includes the methods of counseling and supportive counseling. For instance, if you work in an agency in which you provide supportive counseling in order to link clients with services and resources, a conference on working with culturally diverse populations would constitute clinical content appropriate to your current practice. On the other hand, you and your clients surely would benefit if you attended a workshop on assessment of depression and suicidal ideation. Social workers who are not practicing psychotherapists still need sufficient clinical skill to accurately assess mental, emotional, behavioral and additive disorders in order to make appropriate referrals for their clients in need of different or more intensive services.

WELCOME NEW BOARD MEMBERS

Board Meeting Dates for 2000:

Welcome New LCSWs

Welcome New GSWs

The following social workers have been granted the GSW certification by the Board since the last newsletter:

Welcome New RSWs

The following social workers have been granted the RSW registration by the Board since the last newsletter:

About your address.....

Q:What do I do with client records after the client dies?

A: Hold on to your records. Client records remain in the possession of the social worker or the agency in which the social worker is employed. Although a client has a right to information in the social worker’s record while alive, this right is not a traditional property right heritable upon the client’s death.

Client confidentiality must be maintained after death except as provided under applicable law. Exceptions to maintenance of client confidentiality after death include, but are not limited to, when the confidential communications are relevant to a deceased client’s wrongful death, survivorship or workmen’s compensation proceeding asserted as a consequence of the death or injury of the deceased client. Confidentiality is also superceded if the communication to the social worker is relevant to the health condition of the client in a proceeding in which the client is either a party or relies upon the condition as an element of his claim or defense or even after the client’s death where a party is deriving his right from the client and relies upon the patient’s health condition as an element of his claim or defense. (LA Code of Evidence, Article 510 (B)(2)(b)(c).

If the client was a minor at the time of death, the parents consented to treatment and had the right to access social work records while the child was living. There would be no reason to deny access to those parents or legal guardians upon the child’s death. However, limitation to access the deceased client’s records whether a minor or an adult may still be required by LA. R.S. 40:1299.96 (A)(2)(d) in the event that the disclosure of the information would, in the judgment of the social worker, reasonably be expected to endanger the life or safety of any other person.

Access to a deceased client’s records is also accorded other state and federal regulatory agencies as well as peer review committees under R.S. 13:3715.3. The Louisiana State Board of Social Work Examiners may also access a deceased client’s records in its regulatory authority over claims against social workers under R.S. 13:3715.1 (J).

In all other respects, the maintenance of the social work records after the death of a client must be in compliance with Rule 111 (G) which requires that such records be kept "at least for a period of six years after the last date of service" for an adult client and for "six years after client reaches majority" for a minor client.

Q:What is the age of majority?

A: An individual reaches the age of majority on his or her 18th birthday.

Q:What do the words "burden of proof" mean in regard to our social work Standards of Practice?

A: In most matters before the Board, the burden of proof is on the party alleging the misconduct which includes the complainant and the Assistant Attorney General presenting the case on behalf of the State of Louisiana against the respondent social worker. The burden of proof is substantiated by a preponderance of the evidence, which means simply that the fact to be established is more likely to be true than not. It is not proof beyond a reasonable doubt.

In Rule 113 (C) the words "burden of proof" are used in connection with the social worker’s responsibility when engaging in any dual relationship with a client or former client. "The social worker must fully demonstrate that the client or the former client was neither exploited nor harmed by such relationships."

Once it is established that the social worker engaged in a dual relationship with a client or former client, the complainant and the Assistant Attorney General representing the State of Louisiana are relieved of the burden of proof. The burden now rests on the social worker to prove that the complaining client was neither exploited nor harmed by the dual relationship "regardless of the intent of the social worker."

Q:I have a bachelor’s degree in social work and I am licensed as a substance abuse counselor. Am I required to apply for the RSW registration if I am not working as a social worker? Can I contract fee for service as a substance abuse counselor?

A: As a licensed substance abuse counselor, your practice is regulated by the Substance Abuse Practice Act (LA R.S.37:3375). Subpart B of this section specifically provides "Nothing in this chapter shall be construed to authorize a substance abuse counselor to practice medicine, social work or psychology or to provide counseling for disorders other than substance abuse."

If you do not choose to register for the RSW, you may not use that designation or call yourself a social worker. As a licensed substance abuse counselor you must consult the Substance Abuse Board to determine their rules in regard to contracted services. There is not need to answer to two regulatory boards unless you step out of the scope of practice of substance abuse.

There is no need to answer to two regulatory boards unless you step out of the scope of practice of substance abuse counseling and begin to practice social work. If this occurs you would be required to meet the qualifications of R.S.

Q:We work in a hospital/clinic setting. One of our clients is an inpatient at the facility who has threatened to harm family members. What is the social worker’s responsibility in regard to "duty to warn" ? We have been told that the facility uses a "team approach" and that the therapist who is providing family therapy will assume the responsibility of warning the family of any threats.

A: Generally three criteria must be met for a Tarasoff duty to warn to exist: (1) There must be a serious threat of severe bodily harm, (2) the person making the threat must have the ability to carry it out and (3) there must be an identifiable victim. If your hospital/clinic or agency has an established policy related to "duty to warn", your responsibility would be to report through appropriate channels and document in your progress notes all the steps you have taken to ensure that the "duty to warn" occurs and who is responsible for that action.

LA. R.S. 92800.2.B states that this duty is discharged by the psychiatrist, psychologist or social worker "if he makes a reasonable effort to communicate the threat to the potential victim or victims and to notify law enforcement authorities in the vicinity of the patient’s or potential victim’s residence."

She presents as a soft spoken Louisiana country girl but was actually born and reared in England. She plays a mean third base for the Louisiana Senior Olympics Softball Team in her spare time. She has been Suzanne Pevey’s right-hand gal, running the office which manages not only our social work board’s business but that of two other boards as well. She has found time (and energy!) to hike the Alaskan Chilkoot Trail three times. And, she’s never lost her unflappable sense of humor even in the face of Murphy’s Law when everything that can go wrong, does.

Board members and former Board members have benefited from Yvonne’s care including her organizational skills, her "can do" attitude, and her ability not to take herself (or them) too seriously. But she will be missed the most by her co-workers in the Board office. Suzanne Pevey noted, "Flower has been a dedicated employee and a good friend who has shared her honesty, humor, and clear thinking with all of us. It will be our memories and experiences with her that will get us through this difficult time of change." Debbie Pratt stated, "The first things that come to mind when I think of Yvonne have always been her humor and her subtle way of dealing with difficult people. I have always admired the way she handles a crisis. More that anything I value her friendship." Judy Graham observes, "Yvonne is the glue and the laughter that makes our time at the Board office fun, eating at the office will never be the same again!" And finally the observation of Emily Efferson: "I missed Yvonne when she visited England or hiked in Alaska because our office is not the same without her. Working with Yvonne has been a wonderful experience. I will always remember our in-depth conversations about life and Yvonne’s conversations with herself, and will treasure her words of wisdom."

Following are the statistics comparing the Advanced and Clinical Examinations for Louisiana State and National candidates for the calendar year 1999:

DISCIPLINARY ACTION
Interested parties may obtain a complete copy of any Board disciplinary decision by requesting it in writing from the Board.

Nancy M. Cuccia, BCSW, #3096, was sanctioned by the Board on February 4, 2000. Ms. Cuccia filed a petition for judicial review in the 19th Judicial Court, but withdrew her petition on August 2, 2000. Therefore, Ms.Cuccia’s BCSW license was revoked on August 15, 2000, for violation of:

Gwendolyn Gail Varnado, BCSW, #1696, was sanctioned by the Board on April 13, 1999. Ms. Varnado appealed the Board’s decision in the 19th Judicial Court which issued an order staying the Board’s decision on April 30, 1999 until the appeal was complete. The 19th Judicial Court upheld the Board’s decision on July 27, 1999. Ms. Varnado then appealed the Board’s decision in the Court of Appeals, First Circuit which upheld the trail court’s judgment on June 23, 2000. Therefore, Ms. Varnado’s BCSW license was suspended for a period of ninety (90) days effective July 23, 2000 followed by two (2) years of probation for violation of:

Valerie B. Wolf, BCSW, #908, was sanctioned by the Board on July 19, 2000. Ms. Wolf’s BCSW license was revoked for violation of: