Legislative Information

Changes in Virginia’s Social Work Licensing Regulations

Changes in the regulation of professional standards of practice were proposed by the Virginia Board of Social Work in fall 2007. Public comment was solicited in November and December, and the Board is making final decisions based on testimony, calls, and letters. The new regulations are expected to go into effect in April 2008, and social workers at all levels are urged to check the website of the Virginia Board of Social Work (http://www.dhp.virginia.gov/social/) at that time.

As proposed, certain of the changes raised concerns: there was a procedural issue with regard to supervision of LCSW candidates and, more significantly, an ethics issue with regard to regulations governing sexual relationships with former clients.

By way of background, several years ago, a licensing regulation was put in place in Virginia - with so little publicity that there were no comments from social workers – stating that social workers are prohibited from sexual relationships with former clients before a minimum of two years have passed after termination of treatment. The Virginia Board has now proposed that the two years be extended to five, with required documentation to demonstrate that any such relationship that ensues is not exploitative.

Concerned that, like the current regulation, the proposed change might be contrary to the ethical standards of which clinical social workers are justly proud, Alice Kassabian, chair of GWSCSW’s Virginia legislative committee, contacted nationally recognized social work ethics specialists for their thoughts. Then GWSCSW sent a special mailing outlining the issues, with relevant regulatory passages and other background information, to GWSCSW Virginia members and licensees. The Society’s testimony below reflects their feedback.

During the process, GWSCSW worked closely with the Virginia Society for Clinical Social Work, whose testimony – co-signed by NASW’s Virginia Chapter – recommended that the regulation use the Clinical Social Work code of ethics wording: "Clinical social workers do not, under any circumstances, engage in romantic or sexual contact with either current or former clients.”

GWSCSW TESTIMONY
VIRGINIA BOARD OF SOCIAL WORK
PROPOSED REGULATION REVISIONS 11/08

We of the Greater Washington Society for Clinical Social Work (GWSCSW) have carefully reviewed the proposed regulations published this November for public comment.

GWSCSW represents the clinical social workers of the Northern Virginia suburbs surrounding Washington DC. In developing our position stated here, GWSCSW polled our stakeholder members, i.e., those who are Virginia residents and/or licensees. We have also been in close contact with our sister organization, the Virginia Society for Clinical Social Work, and consulted as well with nationally-acknowledged social work ethics specialists Frederic Reamer, David Phillips, and Sister Vincentia Joseph.*

While in most respects, we support the reforms addressed by the Board’s proposed changes, we have serious concerns in two areas: regulation with regard to sexual relationships with former clients, and regulation with regard to supervision.

REGULATION WITH REGARD TO SEXUAL RELATIONSHIPS WITH FORMER CLIENTS

The current proposal of the Virginia Board of Social Work would extend a prohibition of sexual relationship with a former client from the current period of two years to a period of five years, with increased requirements for documentation indicating that such a relationship, should it occur, is not exploitative.

Our concern is that, as in the case of the current two-year period of prohibition, the proposed five-year period is an arbitrary time limit inviting loopholes and litigation, and ultimately undermining the ethical standards of which clinical social workers are justly proud. Neither time-line is protective of the public health, safety, welfare or best interest of the public.

Our Clinical Social Work Association (CSWA) Code of Ethics states: "Clinical social workers do not, under any circumstances, engage in romantic or sexual contact with either current or former clients." Similarly, the National Association of Social Workers (NASW) Code of Ethics prohibits sexual relationships between social workers and former clients: Social workers should not engage in sexual activities or sexual contact with former clients because of the potential for harm to the client. If social workers engage in conduct contrary to this prohibition or claim that an exception to this prohibition is warranted because of extraordinary circumstances, it is social workers - not their clients - who assume the full burden of demonstrating that the former client has not been exploited, coerced, or manipulated, intentionally or unintentionally.

David Phillips, commenting on the proposed Board regulations, writes,

It is universally recognized in the field of social work that work with clients depends on the development of a trusting relationship. The trust, support and communication do not just disappear because an arbitrary time period has passed. A client’s feeling about the professional relationship may continue to be intense and influence his or her perceptions, decisions and behavior for many years. The distinction between two and five years after treatment is irrelevant and in fact any issue of time chosen is not relevant. Sexual relationships with former clients are harmful no matter how much time has passed since the treatment ended.”

He notes that it is “common knowledge that the American Home Assurance Company has statistics which indicate that boundary violations are the number one cause of malpractice actions against social workers.”

Frederic Reamer, in his note regarding the proposed Virginia regulations, writes:

I continue to endorse the language in the NASW Code of Ethics, which prohibits sexual relationships between social workers and former clients, regardless of the amount of time that has passed since termination of the professional client relationship (as you know, the NASW code acknowledges the possibility of an exception under truly extraordinary conditions and places full responsibility in the social worker's hands).

And in response to our query, Sister Vincentia Joseph writes:

I share your concerns and would retain the wording in our NASW Code. This wording was considered carefully at the time of Code revision. We see it as applying to all social workers… As [Dr. Reamer] pointed out, it is hard to define client - many who do generic work consider themselves clinical. Some, in terms of dual relationships, would determine the seriousness of a boundary issue on the basis of the type of case, the intensity of the relationship, and the duration. I believe that, particularly where there is sexual/romantic involvement, there is always vulnerability.

…More importantly, as you point out, this regulation would introduce a conflict for the social worker in terms of the difference between the State Board's Code and our professional Code.

Taking into account these thoughtful comments of Dr. Phillips, Dr. Reamer, and Sister Vincentia, as well as the strongly-felt preferences of our polled membership, we therefore recommend that the language in the Virginia social work regulations regarding sexual relationships with former clients eliminate the arbitrary time limits and instead be consistent with the NASW and CSWA social work Codes of Ethics which prohibit such behavior.

REGULATION WITH REGARD TO SUPERVISION

The Board’s proposed regulations on the supervision of social workers earning their hours for the advanced license present several potential problems. As currently proposed, the regulations require the would-be supervisee, when signing on with the Board to begin these hours, to be responsible for choosing a supervisor who is not only properly licensed but who has had a graduate-level Supervision course or 14 hours of Supervision Continuing Education Units (CEUs) within five years of beginning the supervision.

We are concerned, first, that the supervisee is thus put in the position of having somehow to confirm that his/her supervisor has indeed had the hours of supervision needed, but as a practical matter can only do so by taking the supervisor’s word for it. A registry of clinical social workers certified by the Board and published on-line would alleviate the burden on the supervisee, and allow the Board to maintain standards in an open and user-friendly way.

A second Society concern is that, as currently proposed, the regulations would seem to require anyone who frequently supervises new people to have 14 hours of Supervision CEUs every five years. Is it possible that the coursework “to be obtained by a supervisor within five years immediately preceding registration of supervision” is meant to be required only once, rather than with each new supervisee? In either case, we would suggest that with a certification registry, the Virginia Board of Social Work could require initial coursework with a possible periodic follow-up requirement of 3 to 6 CEUs to maintain certification.

Finally, we note that the proposed Virginia regulations specify 14 hours of supervisory training. In Maryland, this standard has been established at 12 hours, and a number of clinical social workers in the northern Virginia corridor maintain licenses in Maryland as well, and already have been certified for supervision. We would strongly advocate that, insofar as is reasonable, parallel standards be adopted.

GWSCSW RECOMMENDATIONS:

With regard to sexual relationships, the Greater Washington Society recommends that:

The language in the Virginia social work regulations regarding sexual relationships with former clients should have no arbitrary time period, but rather, the language should be consistent with NASW and CSWA social work Codes of Ethics that prohibit this behavior.

With regard to supervision, the Greater Washington Society recommends that:

The Board should establish a certification registry of supervisors who have completed the Board’s requirements;
The Board should clarify the meaning of “within five years immediately preceding registration of supervision”, and consider adopting a periodic follow-up of no more than 3 to 6 supervision CEUs for maintaining supervision certification; and
The Board should amend the initial requirement from 14 CEUs to 12 CEUs.

Thank you for the opportunity to be heard on these very important regulatory issues. We will be happy to answer any questions and look forward to working with you in the future.

Susan Post, GWSCSW President
Margot Aronson, GWSCSW Vice President for Legislation & Advocacy
Alice Kassabian, Chair, GWSCSW Virginia Legislation & Advocacy Committee

*Quoted:

Frederic G. Reamer, PhD, Professor, School of Social Work, Rhode Island College, Providence, Rhode Island
David Phillips, DSW, author, clinician, consultant on legal and ethical issues in social work practice; educator and lecturer on social work ethics in Graduate Schools of Social Work New York, New York
Sr. Vincentia Joseph, Professor Emeritus, The National Catholic School of Social Services.