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To: Editors of The Washington Post

The saga of suspected anthrax killer Bruce E. Ivins involves a history of psychological and substance abuse issues that makes for a compelling news story. Questions about his diagnoses and treatment are certainly valid. But Washington Post reporter Anne Hull does public health a disservice when she writes of his counselor, "[Jean] Duley is not a psychiatrist, a psychologist or even a social worker; in the highly stratified world of mental health, she is an addictions counselor who earns $20 an hour.”

Our federal and state systems do indeed “stratify” professionals in terms of what they may be reimbursed by insurance for their services. But the implication that quality of treatment is determined by a hierarchy of titles is inaccurate and misleading. Qualified, supervised addictions counselors can provide specialized and valuable services. Social workers – the “or even” of Ms. Hull’s article –undergo stringent state licensing exams at a number of levels to be able to practice. Clinical social workers – those with the highest level of training and licensing -- provide the vast majority of psychotherapy in our time, and do so within a context of continued training, clear ethical standards, and vigilance to both individual and societal mental health. Our understanding either of Ivins or Duley is not enhanced by sweeping statements which misrepresent mental health professionals.


Susan W. Post
President, Greater Washington Society for Clinical Social Work