clinical social work association

On August 5, 2022, the Association of Social Work Boards (ASWB) published data on pass rates for the Clinical Social Work Examination, which it oversees, as well as data on the other three levels of social work licensure (2022 ASWB Exam Pass Rate Analysis for Social Work Licensing Exams [aswb.org]). Publication of this initial data was long overdue. The noted disparities in pass rates, which vary by almost 40% for white and Black social workers were striking. Here CSWA provides historical context and suggestions for steps ahead.

History of Clinical Social Work Licensure

The clinical social work examination has been the national standard for independent clinical practice since 19­­­­­­­­­­­­­50 when ASWB (formerly AASWB) began creating examinations and states began licensing clinical social workers (formerly called psychiatric social workers), beginning with California. As clinical licensure became the norm over the next 54 years (the last state to achieve licensure was Michigan in 2004), the profession established a general standard for licensure based on four elements: 1) obtaining an MSW at an accredited school of social work; 2) having 2-3 years of supervised experience, post-MSW; 3) passing the ASWB Clinical Examination; and finally, 4) having a social work licensure law approved by each state legislature and overseen by each state’s Board of social work. All four areas have different oversight mechanisms and little connection to each other. Correspondingly, there are no two states that have the exact same standards.

There is now a nationwide patchwork system which makes transferring licensure from one state to another problematic. The Council on Social Work Education (CSWE) has overseen schools of social work, but the standards for doing the work that leads to an MSW are quite elusive. Similarly, specific standards for supervised experience vary widely across the states.

Clearly, clinical social work is a young profession. LCSWs were approved to provide psychotherapy through Medicare in 1965, yet, there has been much fragmentation in the field. Efforts to standardize and integrate all parts of clinical social work were understandably set aside by stakeholder organizations in favor of creating licensure in all states and jurisdictions and achieving vendorship for clinical social workers.

Next Steps

There has been a widespread condemnation of ASWB for withholding information about the pass rates and/or being indifferent to the way that the clinical exam has yielded disparate pass rates for BIPOC and older clinical social workers. CSWA is in discussions with the new ASWB Executive Director, Stacey Hardy-Chandler, PhD, about the ways that ASWB, CSWA, and other stakeholders can work together to improve not only the clinical examination, but also the collective preparation of pre-licensed social workers to ensure an equitable exam experience. To this end, ASWB has also issued a statement about their intentions following the release of their report, which includes the following:

• “Continuing to evaluate all aspects of the licensing exam development process, beginning with an in-depth review of item generation, and then implementing a comprehensive, user-centered investigation of test-takers’ experiences
• Offering a collection of free resources designed for social work educators to help them understand the exams and candidate performance so they can better prepare their students for the exams and to increase access to exam resources
• Bringing a greater diversity of voices into the exam creation process through the Social Work Workforce Coalition
• Hosting community input sessions to expand the range of perspectives involved in the creation of the next iteration of the exams
• Launching the Social Work Census, an in-depth survey of social workers, to better understand who today’s social work practitioners are and what they do”

Need for the Clinical Examination

CSWA is aware of strong opinions of many, including LCSWs, that the clinical examination should be eliminated. There are three key reasons that CSWA does not support this idea:

1. In order to practice independently, LCSWs need to substantiate they have sufficient expertise to practice psychotherapy independently. The examination is a primary means of assessing that ability.

2. Passing the examination is written in to each states’ and jurisdictions’ laws and regulations.

3. The Social Work Compact, currently in development, which would allow LCSWs more flexibility to work in states with a multi-state license, will require LCSWs to pass a national examination.

Summary

CSWA believes that ASWB is now poised to attend to the inherent inequities exposed in the ASWB Clinical Examination process. We hope to work with ASWB toward that goal and encourage others to do so as well. Additionally, CSWA will press forward to advocate for meaningful integration of our education programs and licensing boards, efforts that can significantly impact ways the clinical examination is approached and regarded.

Contacts:

Kendra Roberson, PhD, LICSW, President
Clinical Social Work Association  
president@clinicalsocialworkassociation.org

Laura Groshong, LICSW, Director, Policy and Practice  
Clinical Social Work Association  
lwgroshong@clinicalsocialworkassociation.org