A CALL FOR ADVOCACY IN SUPPORT OF CLINICAL SOCIAL WORK IN AUSTRALIA

Mickey Skidmore, AMHSW, ACSW, MACSW

As we embark on a New Year, I am mindful of the juxtaposition of hope as well as challenges when it comes to aspirations, hope, attitudes and viewpoints. I desperately do not want embrace a negative attitude of criticism and complaining, yet there are plenty of head scratching realities that have yet to realise the hope that we cling to with new beginnings and new opportunities that comes with a new year.

As I approach the twilight of my career, I remain passionate about the place and the role of Clinical Social Work in Australia. It has be postulated to me more than once that in many ways Australia is often around 20 years behind many of the trends that are common place in the United States. I have been in Australia for ten years now. Yet, from my perspective, clinical Social Work practice in Australia remains very much in the dark ages.

Sadly, there are still GP’s who hold the false belief that Clinical Social Workers are not eligible providers for the  Australian Medicare scheme. Sadly, only the Teacher’s Health Fund and recently, BUPA recognised Clinical Social Workers as qualified providers for their private health funds. Sadly, it remains a fairly regular occurrence that clients will either cancel their appointments or decline engagement when they discover you are a Clinical Social Worker and not a Psychologist. It remains puzzling that the overall public consensus in Australia is that only Psychologist are qualified clinicians for psychotherapy treatment. It is curious that the AASW would accept this as the status quo in Australia.

The DVA have reflected perhaps the most hopeful development in their recognition of Accredited Mental Health Social Workers since I’ve been in Australia. Despite this encouraging improvement however, AMHSW are still regulated structurally to secondary or less than status as evidenced by being compensated at a lower rate than Psychologist for essentially the same work and risk profiles.

As an educator, preparing the next generation of professional Social Workers, I again find it difficult to navigate the potential mind field that is Social Work practice in Australia. On one hand, it is thrilling and rewarding that the stories I convey to my students from my significant clinical experiences often inspires, and offers one version of what Clinical Social Work practice could look like. On the other hand, I find myself tempering these anecdotes with caution, as there remains considerably powerful systemic and political forces in place that discourage any progression of the Social Work profession. There is little interest or appetite in realising the clear and obvious benefits of realising Clinical Social Work to a similar potential that is recognised in many other parts of the world.

While the AASW (the national organisation of the profession) has supported and emphasised many efforts to highlight Clinical Social Work, the attitudes described above in both professional circles and the general public remain entrenched. After decades of failed attempts, legislation was finally passed in SA to register Social Worker. It has been more than a year now since this development, but AASW has been both slow and reserved regarding such an opportunity to build on development. 

They have launched a micro-credentialling scheme for its members intended to reflect enhanced expertise and recognition to potential employers. However, on a practical basis, these credentials are more of a revenue stream for AASW than anything. The AMHSW (Accredited Mental Health Social Work) credential holds the most practical traction, as the criteria for this credential qualifies for accessing the Medicare scheme and is also recognised by the DVA nationally. While the criteria for the ACSW (Accredited Clinical Social Work) credential is even more stringent, by itself, it is not recognised by Medicare. In NSW government, the only requirement for employment consideration is that one be eligible for membership of AASW membership (not actual membership itself). This criteria is met by completing a qualified Social Work program from a University. Even after employment, there are no ties with these credentials and professional advancement.

I have chronicled numerous criticisms and a wide range of concerns regarding the state of Social Work practice in my experiences in Australia, and thus, I will not repeat these complaints here. However, there is much to be done in order for professionals and the general public to recognise and value Clinical Social Work to be on par with our Psychology colleagues. I remain hopeful that further gains can be made with more robust AASW campaigning.

In short, in my view this issue is about advocacy. Just as we advocate for our clients, we must advocate for our own profession. Moreover, this is not an opinion, or a point of view, but rather based on significant and ever-growing evidence, underscored in well-established research. 

While I may never see the realisation of this vision in my lifetime, it nonetheless remains a professional passion that I will advocate for. So for now, I remain as hopeful as I possibly can with the beginning of yet another year to advance this effort.