Pragmatism and Clinical Practices

By Dirk Felleman
Journal of Social Work Values and Ethics
Spring 2005

Abstract

The increasing preference for technological therapies in health care is perceived by many as a serious threat to the future of socially based therapies. While this concern is not without merit there is another more hopeful possibility to be found in recent adaptations in the ethical evolution of medical practices. In particular the inclusion of pragmatism into clinical ethics holds the possibility of a mutually beneficial relationship between clinical social workers and medical professionals.

Introduction

Unlike other mental health professions, like medicine and clinical psychology, which gain their professional authority through their expert status as masters of scientifically based techniques of diagnosis and treatment, social work does not produce its own tools and so is not a ‘true’ profession in the classic sense. Social work has attempted to bolster its self-image by investing in academic ventures creating journals and doctoral programs but the standard in academia is still one of scientific knowledge and this leaves social work to imitate sociology and or psychology raising legitimate institutional questions of the value of such duplication. Likewise in the realm of professional practice, which is now almost exclusively run by corporate health conglomerates, the scientific techniques of medicine and psychology can be measured in terms of outcome equations, relating to statistical norms, which easily translate into the bookkeeping practices of the business sector, leaving social workers to serve these professions or find a new source of professional identity. This essay will offer social work an alternative vision for the future by calling on the resources of pragmatism, not to try and mimic or co-opt the applied sciences by creating an alternative and or inclusive foundation, but more like a work of art which allows one to appreciate a familiar scene in a new way.

The entire article is here.

Verification of Postdoctoral Experience: Pitfalls for Students

By Rachael Baturin, MPH, JD
The Pennsylvania Psychologist
June 2012

One of the requirements for students interested in becoming licensed in Pennsylvania is to complete one year of postdoctoral experience. It is very important for potential supervisees to review the postdoctoral experience requirements before they start this experience as there are a lot of nuances to the law, and the postdoctoral experience requirements vary from state to state. There have been cases where supervisees did not review the requirements before starting their experience, their experience did not qualify for the postdoctoral year, and they needed to repeat it.

This article will discuss some of the pitfalls that supervisees and supervisors have faced when trying to complete the verification of postdoctoral experience form, which must be sent to the State Board of Psychology upon completion of postdoctoral requirements. If readers would like to review all postdoctoral requirements in Pennsylvania, they can be found in the Pennsylvania State Board of Psychology’s regulations, Section 41.32 and Section 41.33, available on the State Board’s website: http://www.pacode.com/secure/data/049/chapter41/chap41toc.html.

Practical Issues

First, the supervisee should check to see whether the supervisor has been subject to any disciplinary actions by the State Board of Psychology. If they are currently being disciplined, they may not qualify as a supervisor. After December 1, 2015, postdoctoral supervisors must have completed either a course in supervision or 3 hours of continuing education in supervision.

Second, supervisees are required to have at least half of their training in diagnosis, assessment, therapy, other interventions, consultation, and individual supervision received as a supervisee, and the other half may be in teaching in association with either an organized psychology program preparing practicing psychologists and/or a postdoctoral training program, supervision provided as a supervisor, professional development, or research. For example, if a supervisee is doing 40 hours per week of research and 20 hours per week of direct services, the student should count 20 hours of research and 20 hours of direct services per week because at least half must be in direct services. There have been cases where the supervisee submitted a verification form on which it appeared as though 50% of the time was not in providing direct services because the supervisee was submitting too many research hours.

An hour of diagnosis, assessment, or therapy does not necessarily have to be an hour of direct patient contact. For example, a supervisee could spend an hour in therapy with a child and then spend another hour talking to the pediatrician and the school. Both of those hours should be counted toward fulfilling the 1,750-hour requirement for the postdoctoral year.

As another example, if the supervisee is just starting supervision and is seeing clients fewer than 15 hours per week, the supervisee could ask the supervisor for a research project to undertake in order to obtain additional hours, as long as they do not exceed 50% of the postdoctoral hours.

Next, supervisees are required to have 2 hours of face-to-face meetings with their supervisors per week. If you need to complete your experience in two different settings, you are still required to have 2 hours of face-to-face meetings with your supervisor at each site unless the sites are interrelated. For example, if one site is owned by ABC Corporation and the other is owned by XYZ Corporation, then the supervisee is required to get 2 hours of supervision at each site. However, if both sites were owned by ABC Corporation and one was the main office and the other a satellite office then the supervisee would be required to obtain only 2 hours of supervision for both sites. Also, supervisees must be present at each site for at least 6 consecutive months for the experience to count. There have been cases where students failed to meet this requirement and had to repeat the experience.

Last, the supervisor is required to maintain records or notes of the scheduled supervisory sessions, observe client/patient sessions of the supervisee or review verbatim recordings of these sessions on a regular basis and must prepare written evaluations or reports which are discussed with the supervisee. Once again, cases exist in which the supervisor failed to produce the written evaluations and the experience did not count.

Dual Relationships

The supervisor and supervisee must not be in a dual relationship. The supervisor cannot be related to the supervisee by blood or marriage, nor can the supervisor have a therapeutic relationship with the supervisee. In addition, supervisees are not allowed to pay supervisors for supervision (although supervision may be paid by a third party). The supervisor must be free from the supervisee’s control or influence and must be allowed to stop the supervisory relationship if necessary.