Sunday, July 27, 2008

Public Practice

  1. The miracle is not that we do this work, but that we are happy to do it.
    - Mother Teresa

    I met another social worker at a gathering recently. I told her where I worked and she said, “I’m in private practice.” It’s like I said I worked at Target and she said, “I work at Saks.” Or whatever. Don’t misunderstand – some of the social workers I most admire work in private practice. My own dear clinical supervisor, one of the truly important mentors in my life, works in private practice.

    I’m a little envious, I suppose. I think it takes a lot to rent some office space and have enough confidence, courage, and self-discipline to go it alone. I don’t think I’d be good at it. I don’t know if I’d have the patience or focus.

    I guess I’ll start saying, “I’m in public practice.” That’s right, I deal with whoever walks in the door. Old, young, immigrant, bigot, alcoholic, meth/crack addicted, rich, middle class, shockingly poor, wheelchair bound, untreated mentally ill, angry, in denial, chronically depressed, perpetually victimized, troubled, hopeless, and absolutely amazing and inspiring. Those are my people. I often have “just when you’ve heard it all” moments.” Some days I might trade it for scheduled appointments and routine visits. I must like all the crisis and trauma because I keep coming back. I look forward to going to work on Monday mornings as much as I run out of there on Friday afternoons promptly at 5:00.

    A social worker friend of mine worked in a non-profit residential treatment program with children for many years. Her, I admire tremendously. Can you imagine an 8 year old in residential treatment who asks to call you mommy? She says that we are “secular clergy.” Sounds like an oxymoron, yes? But, an apt description.

    Next time I’m at one of those functions, “Oh, you’re in private practice? Well, I’m in public practice.” Should be fun.


Anonymous said...

I have to say that from the UK, it just seems so unusual that social work exists in 'private practice'. Is it like counselling? Why would social workers do that? Here, I suppose a social worker is very much a conduit of the state care provision (or control.. that's another debate I guess) so to take the profession away from the colossus of State is something that is not imaginable apart from into the voluntary sector where invariably the links are very close anyway.

I'm not sure it would be the same job if I worked only with people who employed me on a private basis... hmm.. must think about that!

prin said...

i suppose it's safer and i probably am a bit jealous but i still think it's a cop out. i don't consider those in private practice "real" social workers. i think we take a pledge to serve the underserved and if you can afford to go to a social worker in private practice then i don't truly understand why you need a social worker or what it is that they do. they certainly aren't any better at what they do than the rest of us. I would think they would be out of touch, as far as resources go, not being in the mainstream and therefore not able to provide the quality of life, but then i said i just don't get what it is that they do.

CJ Social Worker said...

CB - yes - here in Texas (and probably all over the US) if you have an clinical license, you can open up your own shop - much like a psychologist - and provide psychotherapy. They get signed up with insurance companies and everything. The only things we can't do that a PhD psychologist can are some types of testing and we can't testify in court about sanity.

Prin - I get your points. But, I also think it is good for social workers to be in private practice so consumers get our type of counseling - one that incorporates a more systemic and holistic approach. What bugs me is the idea that somehow private practice is a step above public practice. Like I said, some of my favorite social workers are in private practice - but you'll never hear them saying it like it is better. AND - big one - they still introduce themselves as social workers...instead of "psychotherapists."

Tanya said...

I'm with Prin on this one: social workers should be in the public sector. For one thing, I don't think being a clinical social worker even qualifies us for therapy. Of course, I don't think LPCs or LMFTs are any more qualified than social workers to do therapy, and there are a ton of them out there that have hung their shingles out.

That being said, I make referrals to social workers all the time. But I try to make referrals to psychologists first if I can. And my MIL is a social worker in private practice. But she's also in retirement...she worked at a public mental health center for years.

Many social workers get hired at public agencies to provide therapy to the under served, ie, mental health clients and child welfare families. So are they still doing social work? I guess I have a problem with the therapy thing in general...sometimes I wonder if the whole concept isn't a crock and Freud just duped us a century ago.

CJ Social Worker said...

Well, Freud...OK - that's a whole other post...

I DO think we are qualified to provide therapy. In fact, our master's degree is 63 hours - whereas most MAs are about 36. Our master's puts us in between the average MA and a the 2 years of clinical supervision.

It isn't the general idea of private practice - it is getting away from our roots that bugs me.

TxGoodie said...

"What bugs me is the idea that somehow private practice is a step above public practice."

Isn't that just another form of the pecking order though? And defined by the numbers following the dollar sign on the bank deposit? Some how making the bigger bucks is supposed to mean something other than the higher bracket come April 15th...

I think you do a wonderful job and you'd do it where ever you parked your diplomas!

Ok, I'm slightly biased, but it's still a thankless job you and yours do and I'm here to say THANK YOU one and all!

I'll be in The Building on the 5th and perhaps twice a week more for 3 months depending on who makes The Cut....hope to see you soon.


Anonymous said...

Interesting post. I think this divide that seems to exist between private and "other" social work practice is just plain silly. I am a clinical social worker at a prison and find myself daydreaming about private practice - mostly for the freedom, but I keep coming back through the gates each day.