President's Message

Mary Moore

June brought the Annual Membership Dinner and a good opportunity for us to thank our membership and enjoy networking with each other. 

In July, Legislative and Advocacy Branch Director Judy Gallant organized an effective response to a letter many of our members already in network with BCBS received earlier this summer from BCBS. The concern of many members was that we were being asked to opt in or out of a new “High Performance Network” (HPN) and being given a very short lead time and limited information about the new plan to do so. Judy organized questions from our members and then arranged a conference call with five representatives from BCBS, including the VP of Government Affairs for CareFirst, the Senior Director of Provider Relations and the VP of Network Management. Attending from GWSCSW were Judy, Margot Aronson and myself. Margot was also representing CSWA. Pam Metz Kasemeyer, an attorney who lobbies for us, was also instrumental in the call and presentation.

What we were able to learn is that this new network is intended for large (think Apple, Amazon-size) companies who self-insure. It will be a network which does not provide out-of-network benefits and they do not expect it will have a large number of members. In our case, they said, it will likely be an employee of a large company with their headquarters out of this area. It will not be part of Carefirst. We asked, but the deadline to opt out by August 1 was not negotiable. However, they did inform us that, as they continue to develop the program and get more information out to providers about the details of the program,  we can opt out with 90 days’ notice at any time. They said that they expect the providers’ manual to be available in Spring 2020 and the program to begin January 2021. So that gives us plenty of time to review the details and then opt out if we choose. Please see Judy’s article in this newsletter for more details.

As I write this, we have heard Bob Mueller’s testimony about a week ago. Democrats are seriously considering impeachment of the President. This is a moment in history where it is important to stay in touch with what is going on. Many of us are weary of the political polarization and of the actions of the current administration, both in our private lives and in our therapy offices. I personally am very concerned about the growing trend toward authoritarianism and the disappearing middle class. Social and economic justice are under threat. Our 230 year-old democracy is being tested by other countries sowing strife and we are being led by an administration that doesn’t seem to care about Russian interference, as long as it helps them. It is so important to seek support from each other if we are feeling overwhelmed by these events in our world today.

Many of us are concerned about the continued harmful way immigrants and asylum seekers are being treated at the southern border, including separation of children from parents, even though this was supposedly stopped. We know the long-term harmful psychological effects this has on children and parents. NASW put together a very good toolkit for social workers to participate in advocating for this vulnerable population, shared on our listserv July 30 by member Eryca Kasse: https://www.socialworkers.org/News/1000-experts/media-toolkits/child-immigrant-crisis.

I hope you have had a good summer, some recharging vacations, and time with family and friends.

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REGISTER NOW: kassabian conference


THE ALICE KASSABIAN MEMORIAL CONFERENCE

ON BEING A WHITE THERAPIST: COUNTERTRANSFERENCE,
COLOR AND CULTURE IN A DIVERSE PSYCHODYNAMIC PRACTICE

NOVEMBER 9, 2019

Click here to register

Our GWSCSW's 8th Annual Alice Kassabian Memorial Conference focuses on a challenging and timely topic that currently animates the external and internal worlds of our clinical social work practice.  We believe we  can benefit from having an informed and mindful conversation about it!

The Conference will be on Saturday, November 9, 2019, 9:00 AM to 12:30 PM, at the Cosmos Club in Washington, D.C.

Barbara Berger, PhDOur Presenter, Barbara Berger, Ph.D., BCD, a clinician, educator and author, brings a wealth of knowledge and experience to the Conference discussions. She has a full time clinical social work practice in Chicago. She is also Faculty Emerita and member of the Board of Trustees at the Institute for Clinical Social Work in Chicago. She has served as Editor of The Clinical Social Work Journal and The Psychoanalytic Social Work Journal. Barbara is also former President of the American Association for Psychoanalysis in Clinical Social Work and Chair of the Social Work Academy in the National Academies of Practice, elected as Distinguished Practitioner in 2002. Among her many honors were the Award for Distinguished Service from The Institute for Clinical Social Work in 2012, and the Lifetime Achievement Award from the American Association for Psychoanalysis in Clinical Social Work in 2013. Most importantly, Barbara Berger is cherished for her capacity to teach with clarity, respect, and intelligence in her down-to-earth engaging style.

Our own Kerry Leddy Malawista, MSW, Ph.D., will be the Conference Discussant. She is a clinical social worker, a psychoanalyst and maintains full-time private practices in Potomac, Maryland and in McLean, Virginia. She is on the faculties of the Washington Center for Psychoanalysis, the Contemporary Freudian Society, George Washington University’s PsyD Program, and the Washington School of Psychiatry. Kerry is also a well-known prolific writer on clinical issues.

As you know, the Alice Kassabian Memorial Conference honors the memory of our former President, clinician, teacher, advocate for social justice and excellence in clinical practice. The Conference is also a celebration of our own Clinical Society community. Reviews over the years have been consistently exuberant. So please place November 9 on your calendar, register as soon as you can and be guaranteed a memorable and meaningful morning with treasured colleagues.

Dolores Paulson, Audrey Walker, Golnar Simpson, Susan Post

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Tea with Strangers

Gil Bliss, LCSW

I have often had clients ask me how they can start to meet people in order to create a community of possible friendships. They're not looking for a romantic encounter, although that might be OK, but usually they are people who are new to the area for one reason or another. Sometimes they have returned from some time away and their old friendships have evolved in different directions. I have suggested trying to find a book club at a library or going on something like meetup.com to start their search. These are reasonable suggestions, for the most part, but most of my clients don't latch on to them.

The problem of creating a community is near to my own heart. Like so many of us, I work alone and really appreciate when someone calls or is available to get together. As a result, my radar is on when I am reading my daily trove of newspapers and books. That's how I came upon a group called Tea With Strangers. Tea With Strangers was started by a Baltimorean who wanted to give people a chance to meet others in a safe setting.

I decided that the best way to find out about how this goes was to attend one of the gatherings. This took some deep breathing on my part, because I am one of those extrovert/introvert personalities who is anxious before social events with people that I don't know. I arrived at a place called R House in Baltimore at 6:30PM. The events are scheduled for two hours, but people can stay later if they want to. R House is a very open setting with 7 or 8 places to buy food, as well as a bar.

People arrived pretty much on time. Our group was larger than usual because a couple of people showed up who were not expected. The age range was fairly wide, from mid-20's to me as the oldest at 71. The host stated his purpose, which was to keep the conversation safe and otherwise leave it up to us to move the conversation along.

Soon the talking took off, and within the two-hour time frame, we were all exchanging experiences and ideas with each other. I left feeling comfortable and impressed. I'm thinking about becoming a host, but I am aware that I tend to immerse myself in projects too quickly.

Tea With Strangers has taken hold in New York, London, Baltimore, DC and San Francisco. There is no charge to attend. The website is www.teawithstrangers.com. I highly recommend this as a resource. 

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Inside out

Judith Asner

It’s going on three years since my  lifelong therapist, Dr. Bonnie Anthony, died. I had seen other therapists before her,  but she was the one I instantly bonded with. Walking through the dark hall to her office was like coming home. She had the amazing talent of understanding and validating everything I said, even if she disagreed with it. She had magnetic light blue eyes that looked at you as if you were the only person in the world. I felt like a caterpillar when I started with her. Over the years I morphed into a butterfly. 

With some distance now, I see what she symbolized to me: the big sister I always wanted. I remember how my friend Carol idolized her older sister, Charlotte, and I wished that I had a Charlotte of my own. The pain of losing Bonnie must feel like the pain of losing a big sister. I know I’ll always love her and I know I’ll always miss her. 

It makes me stop and think: I wonder how my long-term patients feel about me? Should we be talking more about our relationship and it’s possible ending? Anything can happen. As Bonnie jokingly said, “We’ll go until one of us dies.” I laughed, but I never expected it to happen so soon and so fast. 

I guess I just want to say that the love for a therapist can be very deep.  We need to think about that. About how important we really are to our people. And vice versa. 

Bonnie really felt like my big sister. Maybe once she was.... 

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Editor's Note: This is a new feature of our newsletter, suggested by Judith Asner. We would welcome your "inside" thoughts about ideas related to your practice or life as a social worker. Please send them to npines12@aol.com and thanks. 

POSTING TO THE GWSCSW LISTSERV - To post to this group, send email to:  listserv-gwscsw@googlegroups.com

If you are not on the listserv, contact admin@gwscsw.org  

Response to Gilbert Bliss: I accept Carefirst BCBS, Cigna,
Magellan & Medicare Insurances

Letter to the Editor

As a social worker who accepts a variety of insurances, I read Gilbert Bliss’ recent newsletter article, Insurance Redux, with much interest. It is heartening to read that Mr. Bliss has come to recognize one positive aspect of accepting insurance: that the steady stream of referrals insurance provides can mean less time required for marketing oneself and subsequently more time and energy to devote to other sorts of interests. Mr. Bliss briefly mentions that accepting insurance might also be more in keeping with social work ethics, but that consideration appears secondary in his article. I would like to suggest that there are additional reasons for considering taking insurance and also for honoring those who do.

In my 12 years of practice, I have been continually surprised and disheartened by the mental health community for negative opinions regarding therapists who accept insurance. The judgments are many and most paneled providers I know recognize them well. These criticisms include the idea that insurance providers are second-rate clinicians lacking in professional skills, who need referrals because they can’t generate their own. Another misconception is that taking insurance is a lazy person’s pursuit, only for those too lethargic or insecure to pursue clients on their own. I was once told that insurance providers “like to feel important” and having a lot of calls makes them feel that way. Taking insurance is sometimes considered “okay” for newbies, but only long enough to build their skill set and caseloads, certainly not to be considered long-term if one wishes to gain prestige or credibility.

Working with insurance companies is not always easy, and there are many justifiable reasons why practitioners might decide against this option. However, for many of us who choose to work within insurance constraints, there are compelling reasons and rewards for doing so. One big motivator is that it aligns directly with our profession’s ethical code, the sensibility that attracted us to this career choice in the first place. Middle-class, working-class and elderly people should be able to access affordable mental health services with fees that are realistic in their lives. Young families, people early in their careers, and elderly people don’t have the luxury of spending $130-$200 per visit, the current rate for many un-paneled practitioners. People need to have the ability to use their insurance for this. Mental health practitioners who are willing to work through the hurdles of the insurance industry and agree to payments at a lower rate than their peers, should be applauded, not looked down upon.

I have facilitated a network of 25 therapists who have accepted multiple insurances for many years. These are hardworking, dedicated therapists who accept insurance for a variety of reasons. They take their work seriously, they study hard, and they become specialized in practice areas that interest them. Every insurance provider I know is committed to the clients they work with and they certainly don’t need an onslaught of calls to feel important. In fact, most of us feel heartbroken at the number of calls that come in from people desperately seeking services they can afford. Many of these callers have already contacted multiple therapists. The sense of urgency is often strong; insurance-covered psychiatrists in particular are a critically needed service.

It seems to me that the conversation among social work colleagues should be about the best way for our community to address the availability of affordable mental health services. The first ethical principle of the NASW Code of Ethics sets this very tone: “Social workers elevate service to others above self-interest”.

Many thanks,

Evelyn Goldstein LCSW-C

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The GWSCSW newsletter is circulated to more than 850 members, prospective members, and other clinical social work professionals in the area. GWSCSW members rely on the newsletter to locate upcoming professional events and activities for continuing education, professional development, and networking opportunities.

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the next chapter

Grace Lebow, Senior Seminar Chair

Recently I wrote this, my first poem, when I was about to turn 90, and I am pleased to share it with you. There is no telling what we are capable of doing in the "Next Chapter" of our lives.

What a wonderful time to explore our potential and to take on new challenges, such as classes at places like Olli and the Osher Lifelong Learning Institute at American University. It is a time to feel pride in our social work careers and in our Identities as social workers. For me, that has been in developing social work Peri-Retirement and Retirement Seminars for members of GWSCSW. This allows me the opportunity to be a Board member , to connect with my colleagues, and to keep up with social work activities.

I am fortunate to have a creative bent and have been painting in various media, mostly in water colors, in this next chapter of my life. What a Joy! I belong to book clubs and bring my social work and life experience to discussions.

There is more but rather than tell you about what I am engaged in, I would prefer to open this space for other GWSCSW members to share their experiences, not as Retired but rather as ' Re Tired ‘ members of our society. Please email me if you would like to be interviewed about your next chapter: gracelebow@comcast.net


In the Fall, I found the perfect leaf
beckoning to me from the ground. So lifelike, yet so fragile  with burnt sienna and golden ocher and a leaf line spouting veins, matching the lifeline in my hand and with a soul that feels like mine. Spellbound, I looked and I looked.

There lay the flawed beauty so scarred, so worm eaten, fire scale circling tiny holes, 
an edge chewed ragged. Bending closer I see the spine centered and strong. Joyful, I take in nature’s precious gift.

I pick up the fragile leaf, startled by a lullaby rising to my ear: 

Leaf and Life are one and the same. We dance in the wind. Holes burn into our hearts. We tremble, we tumble, we land and we crumble. Yet our spines stay strong. Might we dance again?


In This Issue | SEPTEMBER 2019

Membership Renewal: October 1, 2019

Please take the time to renew your membership to continue to receive member benefits, including a reduced rate for educational events, listserv membership, and valuable networking events. 



Group Forming:
Bulimia Across the Life Cycle: A Group for Non-Acute Women with Residual Conflicts and Parts

It has been my observation that the acute phase of bulimia (binge-purge syndrome) can be greatly diminished and/or arrested with a multimodal approach to treatment. The theoretical orientation is psychodynamic. And the adjunctive treatments and skills from DBT, CBT, Reality Therapy, EMDR, Hypnosis, Yoga, Group Therapy, Coaching, and Internal Family Systems produce structure, awareness and a sense of control for the client.

While the acute symptom of bingeing and purging may go away, internal “parts” of a person always remain inside. The person may still have a Critic, a Hungry Child, a Fat part, a Bad Body Image part, a Skinny part, all needing care, compassion and expression. The healthy Self, the seat of the soul, develops a relationship with these parts, speaks to them, and helps them release trapped traumatic memories and experiences of childhood. That formerly trapped energy is then available for more creative, balanced living. Without an Internal Critic on our shoulder, we can hum. This is Self-Energy, released for life at its best.

The goal of this group is to help women, who are no longer actively engaged in acute bulimic, behavior become more comfortable in their skins. The group will work from the IFS model of Self, facilitating the healthy Self’s relationship “parts.” The end result should be the development of Self-to-Part relationships, a release of the trauma held in "parts," an increase in Self-Energy, self-awareness, self-acceptance and self-compassion. As such, members should expect a high quality life and peace of mind.

The group will meet on Wednesday afternoons from 4 to 5:15 starting in October.

The fee is $80 per session, with members encouraged to continue their individual psychotherapy. There will be 1 to 2 intake sessions at $200 each. 

**Please note that this is not a group for people with Anorexia Nervosa.

Please email or phone me if you would like to discuss your client’s appropriateness for this exciting group.

Contact:
Judith Asner
Tel: 301-654-3211 | Judithasnertherapy@gmail.com | http://www.judithasner.com

*Certified Imago Therapist
*Certified Hudson Institute Coach
*EMDR Practitioner
*IFS Level 3+
*Graduate, One-Year Group Program
*Founder, 1980, of one of DC’s first outpatient eating disorders treatment centers


Celebrating the Role of Intuition in Clinical PracticE

Marilyn Stickle

The common definition of intuition is “knowing without knowing how you know.” It is no mystery then that it has remained in the shadows of theory and practice. Over the past century psychoanalytic scholars, beginning with Freud, have tried to answer the question of how we know things by exploring unconscious communication and anomalous experiences. A review of the history and current understanding of intuition can be found in "Intuition in Psychotherapy: From Research to Practice"  (Stickle & Arnd-Caddigan).

Our book describes qualitative research conducted with clinical social workers who discuss their application of intuition in psychotherapy practice. The findings suggest that while clinicians have not been trained to use their intuition, nor is it generally discussed among colleagues, many use it with consistency and positive outcomes. Our research suggests that intuition is a common factor used in cross-theoretical preferences and practice settings.

I’ve spent decades reading the science and application of intuition and translating it into clinical practice. Many people, including clinicians, practitioners of other disciplines and ordinary people, have confided in me, often telling their stories of uncanny experiences and synchronous events for the first time. The surprise in our research is that clinicians are able to articulate their intuitive experiences and reflect outcomes made by decades of research that they themselves are unaware of.

On a personal level, my exploration of clinical intuition began when there was little written about its application in psychotherapy. I began doing in practice what I had done all of my life, simply listening to the nuances of words and observing the subtle behaviors of people with whom I interacted. As I began to listen intuitively, my internal dialogue shifted from theoretical proficiency as my primary way of understanding, to deepening awareness of my experience in the presence of each person. I began to pay more attention to the images and words that formed in my mind and to my subtle impressions as patients spoke. Paying attention to the overall flow of sessions, I memorized the feel of those with positive outcomes.

Over time, my ability to focus on patients has sharpened, as reflected in my visual experience, where everything in the room has ceased carrying equal weight. My other senses have telescoped as well, aligning my awareness increasingly with that of patients. Overall, my level of interaction has increased as I process my impressions out loud to check their accuracy in an enlivened exchange. In doing so, my patients and I grasp what is being communicated more deeply. Treatment has become more efficient, effective and humane with the active inclusion of intuitive processes.

In addition to our newly published book, this fall there will be two opportunities to attend continuing education programs that will review the literature and teach application of intuitive processes. Please join us on Fridays, October 4th and November 1st from 9:00-12:15 in my office at 5319 Lee Highway in Arlington.  

Register for Marilyn's Intuition workshop here


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One of your important member benefits!

Join Us at the ANNUAL FREE AND FABULOUS

2019 Legislation & Advocacy Luncheon
     

Margot Aronson speaking at the Fall 2015 Legislative and Advocacy Program’s luncheon “Everything You Always Wanted To Know About Legislation and Advocacy But Were Afraid To Ask”

THIS IS THE YEAR FOR L&A:

OUR SOCIETY’S ROLE IN LEGISLATION & ADVOCACY

Sunday, October 27, 2019, 11:30 am-3:00 pm

Maggiano’s Tyson’s Galleria
2001 International Drive | McLean, Virginia 22102

The news can be overwhelming: mass shootings, family separations at the Mexican border, DHHS rollback of protections against discrimination, and the list goes on.  Then there are the insurance companies reluctant to cover psychotherapy treatments of any depth, the Medicare audits, and the need to keep up with state legislation and the Board of Social Work's regulation changes.  Our mission is to protect our clinical practices and to work to ensure Americans’ access to affordable quality mental health care.  And beyond?  Watching the news, our social work values remind us to ask:  What can we do as individuals to strengthen our voice? What can we do together?

Join us for a stimulating discussion with our Virginia lobbyist, Sue Rowland, our Maryland lobbyist, Pam Metz Kasemeyer, our DC co-chair of L&A, Margot Aronson. Adding to the perspectives will be Judy Gallant, Judy Ratliff, Adele Natter – and YOU!

Please note: the luncheon is a free member benefit, but advanced registration is required. If a vegan main dish is requested, please note it on your registration and the restaurant will accommodate this. Several vegetarian choices are being served.

Three (3) CEUs are available for $60.

CLICK HERE TO REGISTER


Legislation & Advocacy  | Federal

Laura Groshong, LICSW, Director, Policy and Practice

LCSWs and the Use of Texting in Mental Health Treatment

Text Therapy – Start Feeling Better Today with Talkspace Online Therapy.  A Convenient and Affordable Solution That Provides Access to Therapy Whenever You Need. 100% Private & Secure. Secure & Confidential. 1 Million Happy Users. 2000+ Licensed Therapists. As Low As $49/Week.  (Talkspace Website, 

https://help.talkspace.com/hc/en-us )

Texts are primarily used for social purposes: short missives conveying limited information.  Much has been written about the negative impact of reliance on this mode of communication (Turkle, 2012), but the popularity of texting is obvious, particularly among those under the age of 30 who have texted regularly throughout their lives. Therefore, the increasing use of texting in the context of therapy cannot be ignored.

While there is no definitive research as yet, it appears that texting can play a useful role in some mental health treatment. Certainly for anyone who is most comfortable with texting as the preferred form of communication, this may be where a treatment relationship can best begin.

Responsibilities of the LCSW Providing Text Therapy

Clinical social workers should be knowledgeable about the promise of digital innovations in treatment, and equally about the potential downside. LCSWs choosing to engage in text therapy must be willing to explore ethical complications, perhaps even license violations, in the terms of agreement with the client and/or the texting platform. 

The first issue:  is text therapy really psychotherapy?

  • Psychotherapy -- also called "talk therapy" or just plain therapy -- is a process whereby psychological problems are treated through communication and relationship factors between an individual and a trained mental health professional. Modern psychotherapy is time-limited, focused, and usually occurs once or twice a week for 45-50 minutes per session (Herkov, M., “What is Psychotherapy?”, PsychCentral, October 8, 2018.)

This simple definition of psychotherapy, paired with the already quoted Talkspace web advertisement, illustrate the very real differences that exist between psychotherapy and text therapy. Psychotherapy (whether in person or through synchronous videoconferencing) is a continuous process based on an established emotional relationship, an ongoing dialogue between two people in real time about complex issues with deep emotional content.  Texting, on the other hand, is by its nature short, often with a gap in the timing of communications between client and therapist; it is not consistent with a dialogue based on emotional meaning, as with psychotherapy.

  • Talkspace User Agreement - This Site Does Not Provide Therapy. It provides Therapeutic conversation with a licensed therapist.   (Essig, T., “APA Cancels Talkspace Ads Moving Forward”, Forbes Magazine, July 29, 2018.)

While texting platforms may emphasize, in the small print of the User Agreement, that the services provided are not psychotherapy, most continue to display the term “text therapy” prominently in their ads.  This can create confusion for clients seeking psychotherapy and may give an appearance of misleading advertisement.

How, then, do we as LCSWs conceptualize and engage in text therapy?  Perhaps “text therapy” might more accurately be called “text assessment” or “text coaching”.  Texting might also be the means for starting the therapeutic process, to be converted to an in-person or videoconferencing process if it becomes an ongoing psychotherapy.

Reading any contract with care is essential, and this is most certainly true for provider contracts offered by texting platforms.  Does the contract address issues such as diagnosis, HIPAA compliance, state-to-state licensing laws, and dual relationships?  Does the platform set limitations on helping a client understand the differences between in-person treatment and text therapy, or on recommending in-person therapy when such treatment is indicated?   

LCSW Standards of Practice

The use of ongoing asynchronous texting changes the process of therapy for LCSWs.  The therapeutic alliance is significantly different when the primary means of communication is not direct ongoing communication between the client and therapist, as the asynchronous method of communication tends to preclude in-depth exploration of emotional understanding.  Further, a key part of psychotherapy, the “frame”, is lost if client and therapist text and reply at different times, or if the client is limited – as with some agreements - to making and receiving two texts a day to a therapist five-days-a-week.

LCSWs base their understanding of a client on a biopsychosocial assessment, leading to a diagnosis. ASWB Technological Guidelines (2015) identify additional factors that may contribute to determining whether a client is suitable for text therapy:  age, technological skills, disabilities, language skills, cultural issues, and access to emergency services in the client’s community.  How does the platform provide for assessment?  Can you ensure that our standards of practice will be upheld by the texting platform?

When more intensive treatment is called for, will the platform respect and support the licensed provider’s clinical judgment?  LCSWs know that a client with a psychotic disorder, an autistic-spectrum disorder, or an acute episode of depression or anxiety may need in-person communication or hospitalization.  Are there contractual provisions for such a situation? 

Regulatory Considerations

Benign as texting seems, some texting platforms ask clinicians to communicate in ways that may violate state laws and regulations and/or federal laws and rules.

Most states require a clinical social worker to be licensed in both the state where the LCSW resides and the state where the client resides, if different, to provide therapeutic services.  A text platform’s claim that text therapy is not psychotherapy but rather “therapeutic communication” is a blurry distinction not necessarily recognized by state social work boards. It is the LCSW’s obligation to ascertain and comply with relevant regulations of both state boards. 

Licensed therapists are also responsible for making sure that the text platforms used by both client and therapist are HIPAA compliant.  Further, the texts themselves are personal health information sent electronically (PHI) and must be kept private and secure.  It has been reported that one text platform permitted employees – even non-clinically-trained employees – to review the content for training purposes.  A Business Associate Agreement might provide a guarantee of the LCSW’s confidentiality standards, if the platform agrees to sign. (HIPAA Basics for Providers, 2018, https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/HIPAAPrivacyandSecurity.pdf )

Ethical Considerations  

Most states use the NASW and CSWA Codes of Ethics as the basis for ethical clinical social work practice. Some text platforms have contractual terms that require the therapist to meet sales targets through their text exchanges.  For a clinical social worker to engage in such a dual relationship, i.e., as a corporate representative for the texting services and, at the same time, as a therapist addressing mental health problems, is a clear and serious ethical violation.

Some companies use marketing techniques that also may be ethical violations.  One example, potentially misleading advertising, has been mentioned.  Advertising with testimonials from former clients is another.  From the NASW Code of Ethics (2016 4.07(b)) : Social workers should not engage in solicitation of testimonial endorsements (including solicitation of consent to use a client's prior statement as a testimonial endorsement) from current clients or from other people who, because of their particular circumstances, are vulnerable to undue influence.

Would the company agree to keep the LCSW provider from being caught up in these sorts of business-driven ethical dilemmas?

Summary

Basic to mental health treatment is thoughtful consideration of the conditions being treated and of the biopsychosocial needs of the client. The challenge for the LCSW is incorporating these basics, along with accepted standards of practice, regulatory requirements, and ethical considerations, into the texting format as contracted by the particular text platform.  It is the responsibility as LCSWs to apply clinical social work standards of practice, ethics, and regulations to any work we choose to do.

References

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Legislation & Advocacy | District of Columbia

Margot Aronson

DC Board of Social Work update

The effort of the DC Board of Social Work to develop policy to enable LGSWs to work in private practice settings in order to gain their supervised work experience for the LICSW application is nearing its final shape; the Board is planning to vote on a final policy statement at the September Board meeting. Creating such a policy has required considerable work on the part of the Board: although LGSW training and supervision in agencies is monitored by the Department of Behavioral Health, at present there is no comparable system in place for monitoring LGSW training and supervision in private practice. In fact, just this spring the ASWB (Association of Social Work Boards) established a task force to consider issues in supervision, in light of a variety of questions and concerns raised by Boards across the country.

GWSCSW members anxious to have the new policy in place have diligently attended the Open Session of Board meetings over the past 8 months. They presented a carefully crafted petition for the Board to review, presented information based on their clinical experience, and gradually earned a role as a sought-after resource. For its part, the Board maintained transparency and decorum as they deliberated (not always an easy feat); they followed through with research when needed; and where in the early sessions patience at times wore thin on one side or the other, the July meeting was collegial, collaborative, and mutually respectful, as well as very productive.

The Board will not be meeting in August; the next meeting will be Sept 23, with the Open Session beginning, as usual, at 10 AM. Hopefully the policy statement will be ready for a final vote.

Wanda Wheeler, LICSW, joins the DC Board

At the July meeting, Board Chair Velva Spriggs, LISW, introduced Wanda Wheeler, LICSW, who joins Danielle Nelson, LGSW, and Selerya Moore, Consumer Member, on the Board. A warm welcome to Ms. Wheeler!

The Board is still lacking its LSWA member.

Of the 5,386 licensed DC social workers, 3,718 are LICSWs; 1,533 are LGSWs, 56 are LISWs, and 79 are LSWAs.

House of Representatives Hearing on DC Statehood Bill

Please take note that a House of Representatives hearing on H.R.51, Washington DC Admission Act for DC Statehood, will take place on Thursday, September 19, 2019 at 10 AM in the in Rayburn House Office Building, Room 2154. Will you be there?

Statehood requires approval by a simple majority vote of each House of Congress and the President’s signature. It is the simplest and most constitutional way to make the people of the District of Columbia full citizens of the United States of America. Maybe not in this Congress… but every step counts!

Margot Aronson, LICSW, chairs the GWSCSW L&A committee for DC. A past GWSCSW president, she has also served as newsletter editor and director of Legislation & Advocacy. Margot currently advocates on mental health and LCSW practice issues for us all at the national level as the Clinical Social Work Association Deputy Director for Policy and Practice.

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Legislation & Advocacy | Maryland

Judy Gallant

Martin Schnuit, LCSW-C, Appointed to MD Board of Social Work Examiners

We extend our hearty congratulations to our member Martin Schnuit, who, backed by a recommendation from GWSCSW, was appointed by Maryland Governor Larry Hogan to the position on July 1, 2019. Mr. Schnuit received his MSW from the University of Maryland in 1995 and has worked in a variety of settings. For over 20 years he has maintained a private practice in both Anne Arundel County and Baltimore City. He specializes in the treatment of anxiety disorders, phobias, and obsessive compulsive disorder. As a Board-approved supervisor, he has mentored and provided clinical supervision to MSW's for years. In addition to his GWSCSW membership, Martin is also a member of NASW, and is a clinical fellow of the Anxiety & Depression Association of America. We wish you great success in your new position, Marty!

We continue our reporting on bills from the 2019 Maryland General Assembly, begun in our June newsletter article:

Substance Use Disorder Issues

House Bill 116/Senate Bill 846: Public Health – Correctional Services – Opioid Use Disorder Examinations and Treatment (passed) establishes specified programs of “opioid use disorder” screening, evaluation, and treatment in local correctional facilities and in the Baltimore Pre-trial Complex. The program begins in four counties and phases-in to include all counties and the Baltimore Pre-trial Complex. The State must fund the programs of opioid use disorder screening, examination, and treatment of inmates, and the bill establishes requirements for screening and treatment.

House Bill 599/Senate Bill 631: Health Insurance – Coverage for Mental Health Benefits and Substance Use Disorder Benefits – Treatment Criteria (passed) was heavily amended by the committees. Initially, the bill required carriers to submit two extensive reports to the Maryland Insurance Administration on how the carrier complied with federal mental health parity and addiction equity laws and on the carrier’s data for mental health benefits, substance use disorder benefits, and medical/surgical benefits by parity act classifications. The committees amended the bill to only require carriers to use the American Society of Addiction Medicine criteria for all medical necessity and utilization management determinations for substance use disorder benefits. The bill also repeals the limitation on a carrier charging a co-payment for methadone maintenance treatment that is greater than 50% of the daily cost for methadone maintenance treatment.

Child Advocacy Centers Expansion and OP Civil Commitment Pilot Program Revisions

House Bill 1007/Senate Bill 739: Child Advocacy Centers – Expansion (passed) alters and establishes numerous requirements for child advocacy centers in the State. The Governor’s Office of Crime Control and Prevention must ensure that every child in the State has access to a child advocacy center. The bill also requires the Governor to include at least $300,000 in the annual budget bill for child advocacy centers.

House Bill 427/Senate Bill 403: Behavioral Health Administration – Outpatient Civil Commitment Pilot Program – Revisions (passed) requires the Behavioral Health Administration (BHA) within the Maryland Department of Health (MDH) to allow an eligible individual to request enrollment in, and allow an immediate family member of an eligible individual to request voluntary enrollment for the individual, in an existing authorized pilot program for outpatient civil commitment. BHA must include specified information in its annual report for individuals admitted into the program, both voluntarily and involuntarily.

As always, do not hesitate to contact Judy Gallant at judy.gallant@verizon.net with input on the laws discussed above, or other issues in Maryland mental health policy.

Judy Gallant, LCSW-C, is the director of the Society’s Legislation & Advocacy program, as well as chair of the Maryland Clinical Social Work Coalition, our GWSCSW legislative committee in Maryland. She maintains a private practice in Silver Spring.

Pamela Metz Kasemeyer, JD, and her firm of Schwartz, Metz & Wise, PA, represent us in Annapolis and guide our advocacy strategy. Ms. Kasemeyer is an acknowledged authority on Maryland’s health care and environmental laws and has represented a variety of interests before the Maryland General Assembly and regulatory agencies for more than 25 years.

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The Mentor Program is always looking for new mentors to work with newer social workers who are looking for guidance and help as they start their careers. You determine how much time you want to give; this is worked out with the mentee. For questions please contact Nancy Harris, coordinator of the Mentor Program, at (301) 385-3375, or nlharris1214@gmail.com. Thank you for your support of this important benefit of GWSCSW membership!

Communications Branch 

Kate Rossier, Director of Communications | Email: kazrossier@hotmail.com

We are working on a newly-updated website, which we hope to have ready soon. Many people are owed thanks for this: most of all, Donna Dietz, who researched website platforms, then met with a consultant to see how we could best tweak our website to be as responsive and easy to use in the multiple ways we need it to work, and to Mary Moore, our esteemed President, who has a past-life in IT and an enormous amount of knowledge and web-savvy. Thanks also to various Board members who were willing to read and comment and suggest changes to make this ever better!

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EDUCATION Branch 

Susan Post, Director of Education | susan.post@gmail.com

Our committees have been evolving over the last few months. Shauna Alonge has joined Leila Jelvani as co-chair of the Continuing Education committee and they are hard at work on the schedule for fall and winter. The MD/DC Brown Bag committee is sad to say goodbye to Amy Johnson and is looking for a new volunteer to co-chair with Robin Seiler. If you are interested, please contact Robin at  rsseilerjr55@gmail.com or the GWSCSW volunteer coordinator, Beth Pascoe at bethdpascoe@yahoo.com (who also happens to be co-chair of the VA education committee).

The very popular annual Alice Kassabian Memorial Conference will be held November 9, 2019, so put that on your calendars. As always, issues related to social justice will be discussed, this year in the context of racial and cultural diversity.

Also in the fall will be a two-part workshop on planning for emergency coverage of your practice. This workshop will offer ethics CEUs to all who need them last-minute for license renewal.

The full schedule for CE events will show up on the GWSCSW website as it evolves, and of course you’ll be getting emails when it becomes time to register. AND – think about being a presenter yourself, on any topic you know and find interesting. Contact Leila Jelvani, leila.jelvani@gmail.com. Our education programs are intended at least in part to give our members the opportunity to teach each other!

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Committee Reports

Continuing Education Committee
Shauna Alonge| Leila Jelvani
cecommittee@gwscsw.org

The Continuing Education Committee is accepting proposals for Fall 2019 and Spring 2020. Do you have a topic that you know others are interested in learning about? Would you like to share your expertise? This is a great opportunity to highlight your experience while promoting your practice. For shorter presentations, consider offering a Brown Bag lunch topic, typically lasting 1 ½ hours.

Click here to submit a proposal. Once submitted, the proposal will be reviewed by the Education Chair and the Continuing Education Committee. 

Legislation & Advocacy Committee
Judy Gallant
dirlegislation@gwscsw.org

Annual L&A Luncheon scheduled for Sunday, October 27, 2019, 11:30 am-3:00 pm: REGISTER TODAY!!

DON’T MISS this FREE benefit of your membership! It is always a fun and informative event where you can learn more about what is happening in each of our jurisdictions and share your ideas about what is important to you. Look for additional information in the boxed announcement in this newsletter.

Answers to BCBS/HPN network questions

In June, many of our members received a letter from Blue Cross Blue Shield Associations about a new “High Performance Network” or HPN being planned and asking providers to become part of the new network

On July 26, 2019, Mary Moore, Margot Aronson, Pam Metz Kasemeyer and I spoke with 5 representatives from BCBS, including the VP of Government Affairs for CareFirst, the Senior Director of Provider Relations and the VP of Network Management.

We started off requesting that the deadline for our ability to opt out be extended to September 1. We were told they couldn’t do that, but that because the Network won’t be effective until Jan.1, 2021, there is no risk to providers, as we can opt out of the HPN network at any time with 90 days notice. We would need to send a letter to Provider Relations, as specified in our original CareFirst contract, saying that we wish to terminate ONLY with HPN. They acknowledged that things are still being worked out at their end; performance standards will be provided in a manual which will not be published until next year. They readily said that as expectations from them become clearer, providers could easily decide they don’t want to sign up for providing services under these conditions and can send a termination letter at that time. Our decision to participate or not to participate with HPN will NOT affect any of the other product lines we participate with, such as the CareFirst PPO, RFP, and the Blue Choice network.

Some context they gave was helpful. HPN is designed as an EPO, which they described as an HMO with leeway. EPOs generally have more flexibility than HMOs but not as much flexibility as PPOs. They expect HPN to have a very small set of members. HPN is a national network product, not a locally-insured product. So, for example, members of Carefirst whose coverage is through a contract with their local school system, could never become part of HPN while employed by the school system. The product will not be sold by Carefirst, or any of the regional BCBS Associations. HPN can only be offered by large employers (such as Amazon or Boeing) who have self-funded (ERISA) plans; the BCBS Associations are the Administrators.

In terms of continuity of care, if we are seeing a patient under CareFirst and they change their plan to HPN, it will be as if they are changing to a new insurance company. If the provider does not become a provider with HPN and the patient wishes to continue to see them, an exception to the rules of their contract would need to be requested. Medical and clinical people from HPN would review the request and grant it based on medical necessity.

They stated that there are no new liabilities for providers; we have the same responsibilities with HPN as in other networks. "The responsibility for seeing in-network providers lies ultimately with the patients, and their contracts will clearly state that. If none of the in-network providers are available to them and they ask us for alternatives, there is no problem with our giving them out- of-network referrals. " Again, an exception to the terms of their contract can be requested, and the decision will be made based on medical necessity. The member’s insurance card will have contact numbers on the back of it.

I hope this information answers many of the questions you sent to us. We obviously could not get to everything, so if there are any glaring omissions in information you were hoping for, please let me know.

Be sure to contact one of us with any questions or suggestions you might have, or to join one of the committees: in DC, Margot Aronson at malevin@erols.com or Adele Natter at anatter@verizon.net; in Maryland, Judy Gallant, judy.gallant@verizon.net; and in Virginia, Judy Ratliff, jratliff48@hotmail.com. We look forward to hearing from you.

Membership Committee
Cindy Crane, Nancy Harris, Catherine Lowry
membership@gwscsw.org

JOIN US IN WELCOMING NEW MEMBERS TO OUR FALL BRUNCH
Click here to RSVP: Fall 2019 New Member Brunch! FREE!

Sunday, October 20, 2019 | 11:00 AM-1:00 PM 
7313 Millwood Road Bethesda, MD

Any GWSCSW member who has joined in the past 2 years is warmly invited to join us! And all current members are invited to come meet new members!

This is a chance to learn more about what GWSCSW can provide you, how you can get involved, plus a chance for us all to get to know each other better and enjoy a beautiful brunch!

Mentoring Committee
Nancy Harris
mentoring@gwscsw.org

The Mentor Program is always looking for new mentors to guide the newer social workers who are looking for guidance and help as they start their careers. You determine how much time you want to give; this is worked out with the mentee. For questions please contact Nancy Harris, coordinator of the Mentor Program at (301) 385-3375, or nlharris1214@gmail.com. Thank you for your support of this important benefit of GWSCSW membership!

Newsletter Committee
Nancy Pines
npines12@aol.com 

Your newsletter welcomes ideas and articles about clinical social work and practice. We are also very interested in hearing from members who have specialized knowledge or adjunct therapy practices they want to share. As above, letters to the editor are OK too.

Please consider your own life experiences and how they may have affected how you practice. One of the things I love about our profession is how we are always learning. Why not share your expertise and life lessons with fellow members? Send an email with your story/article ideas to npines12@aol.com. 

I am looking for a new "proofer," a volunteer who likes to edit and who reviews the newsletter once it is in digital form. This is in case I have missed anything! Please let me know if you are interested, at the above email address 

Social Media Committee
Chana Lockerman
socialmedia@gwscsw.org

The Committee is excited to continue the work of sharing exciting content related to social work and mental health and updating the GWSCSW Facebook page with articles. Please visit the page, like or comment on the posts. Let us know if you have an idea about how to make the page more relevant to YOU. We are working on getting more traffic to the Facebook page. Please like the page if you haven’t already, and share the page with your fellow colleagues! Feel free to email us at socialmedia@gwscsw.org if there is something you would like us to post about on the listserv. We are also available to field any personal questions you may have about your own social media pages and accounts. Contact Chana Lockerman chana@rockcreekcounseling.com with any questions or suggestions for future Tech Tips columns.

Volunteer Committee
Beth Pascoe
volunteer@gwscsw.org

If you are interested in volunteering, we need you! Check out our website to see all the committees and details on what they do. Getting involved with GWSCSW is the best way to enjoy all the benefits it has to offer. 

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Tech Tips: exploring social workers’ experiences with technology

Chana Lockerman

Instead of “tips”, this column is also exploring social workers’ experiences with technology. How does technology inform your social work practice? What do you wish existed, but doesn’t yet? What do you wish never existed? How are you helped or hindered? To get the conversation started, I’m sharing my own experience and I hope in forthcoming columns to share yours.

The bulk of my agency work involved off-site sessions in clients’ homes and schools. Because I often was far from the clinic at the end of the day, I ended up carrying a lot of paperwork around. It made me nervous to say the least. Sometimes I saw 15 clients before stepping foot in the clinic, and the number of paper notes I had to carry grew and grew. I enjoyed the work and being on the go was fun and exciting, but the issues around transporting paperwork weighed on me. I thought about how I would feel if my own therapist was walking around with my file in her bag or her car. I found a solution that eased my conscience when I found a lock box that fit in the trunk of my car. It had two locks with different combinations, and felt like a godsend. It was bulky and heavy, but I felt much lighter.

When I started my private practice in 2014, I knew that technology would play a role. I was subletting space from another therapist and planning to offer home visits and I wanted a practice that didn’t rely on paper charts. Once I left my agency job, the lock box retired to my basement. I chose my first electronic medical record company on the recommendation of a friend and because they had a reputation for great customer service. It took hours to learn, but eventually I felt comfortable with it. I also learned to file my own insurance claims, and my technology-informed office was on it’s way.

A couple of years went by and I had regrets about the EMR (electronic medical record). It didn’t collect fees or integrate with insurance billing. Moving to another EMR meant moving every single client’s file over from one system to the next, and it was a very long process. It turned out to be a great choice. The new system takes care of insurance billing, collects credit cards, automatically charges for co-pays, and offers telehealth infrastructure.

Mostly because it was easily available, I decided to give telehealth a try. First I attended a training on the topic and talked with therapists already using the technology, then decided to jump in. I offered a current client a telehealth session. It went really well. And telehealth quickly became a mainstay of my practice. I limit its use in a few important ways. It is only available to current clients who come in to the office for weekly sessions. Now, if they are home sick, or with a sick child, we can still have our scheduled session. I specialize in perinatal mental health and the technology allows me to start evaluating postpartum moms in the early days after birth, before they are able to come into the office. I always explain that if they aren’t doing well, they will need to come see me in person, but we can make this determination together instead of waiting for them to progress enough in their physical recovery to come in and get evaluated.

What is your technology journey? What excites you? What scares you? If you would like to share your story, please email me chana@rockcreekcounseling.com.

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OUT & ABOUT

Marilyn Stickle attended the Institute of Noetic Sciences (IONS) Conference in Silicon Valley in July, where leading scientists and thought leaders gathered to celebrate the 50th anniversary of the first walk on the moon. and Edgar Mitchell, the Institute’s founder. She gave a poster presentation entitled “Intuition in Psychotherapy,” that celebrates the June publication of her co-authored book and the mission of IONS: the application of science in direct (practice) experience.

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GWSCSW Job Board

GWSCSW is proud to feature a job resource to connect career opportunities with our members.

Visit the GWSCSW job board to look for jobs or to post a job today.

Manage Your Career:

  • Search and apply to positions that value your credentials!
  • Upload your anonymous resume so employers can contact you, but you maintain control of your information and choose to whom you release your information.
  • Receive an alert every time a job becomes available that matches your personal profile, skills, interests, and preferred location(s).
  • Access career resources and job searching tips and tools.

Recruit for Open Positions:

  • Post your jobs, or your institution's jobs, where the most qualified professionals will find and apply to them.
  • Email your jobs directly to job seekers via the exclusive Job Flash email.
  • Search the resume database and contact qualified candidates proactively.

See some featured jobs below.

classified advertising

Advertisements, accompanied by full payment, must be received by  GWSCSW by the first of the month preceding publication. Material should be sent to admin@gwscsw.org. For questions about advertising, call 202-537-0007.

Adolescent/Young Adult Therapy: CBT, DBT, Medical Illness Counseling, Unified Protocol, Group Therapy. Powerful interventions for depression, anxiety, anger, perfectionism, fear, shame, rumination, social anxiety, ASD and more. Rathbone & Associates. Rely on Experts. 301-229-9490 www.rathbone.info.

Professional CEUs: See our current schedule at www.rathbone.info, click on “Professional Trainings.” Current topics, quality speakers, practical skills.

BETHESDA BRIGHT SUNNY FRONT OFFICE

First floor, directly off attractive entrance/lobby in low-scale well- maintained secured bldg. Walk to Metro, parking, handicap accessible, small waiting area. Available after July 15th days, evenings, weekends, reasonable Please email or call for details and pictures.

Sally Burman LCSW-C | saburman@aol.com or 301 367 7113 Text: 301 229 5598

Dupont Circle/Farragut North and West

Dupont Circle/Farragut North and West, office available, for all-day Tuesday and Wednesday evenings after 4:00 pm, with very reasonable rates. Office is available September 1st for Tuesdays and September 15th for Wednesday evenings. Office is Metro accessible, ADA-compliant, corner window office. Office building has evening security guard to assist with entry weekday evenings. Space is one in a three-office suite, with comfortable waiting room, kitchenette, and private bathroom for tenants. Contact Laurie Emmer-Martin at emmermartinccc@gmail.com or 202-870-9991 if interested.

Also second office is available for 3 full weekdays and/or weekends. Rate based on number of hours/days requested. Contact Sylvia Stevens at sylviarstevens@gmail.com

Sublet -- heart of Old Town Alexandria

I am looking to sublet my office space in the heart of Old Town Alexandria. The building has controlled-access with a receptionist and my office is on the 4th floor. Lovely natural light and decorated very zen. The pictures are not complete and I plan to add some plants and a wall mirror. There is a small fridge which I'm happy to share.

The days I'm using it are Tues/Wed/Thurs and bi-weekly Monday afternoons only. This would leave you the full day Fridays/Sat/Sun and then a full day bi-weekly Mondays or Monday mornings only weekly if you'd like. I'm offering fair (really decent) rates at $60/day. I'd want you to sign a sublet agreement that goes month to month; rent would be expected at the first of every month.

Jacqueline.lubovich@yahoo.com

Classified Ads: 75¢ per word | Minimum price $15 (20 words)
Display Ads: Full page 7 x 9¼ $325 | Half page $250| Quarter page $125 | Eighth page $75  

Electronic submission (JPG) preferred. Publication does not in any way constitute endorsement or approval by GWSCSW, which reserves the right to reject advertisements for any reason at any time.

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About News & Views

Do you have thoughts or feedback about something you read in our latest issue? Perhaps something struck a chord?

We want to hear from you! Your opinions about clinical and legislative articles, practice-building tips and regular columns are most welcome. Send your feedback to: newsletter@gwscsw.org

Questions? Contact Nancy - npines12@aol.com

News & Views Committee

Nancy Pines, Editor
Newsletter Editorial Board: Adele Natter, Shoba Nayar
Advertising: admin@gwscsw.org

News & Views is published four times a year: March, June, September and December.

Articles expressing the personal views of members on issues affecting the social work profession are welcome and will be published at the discretion of the editorial board. Signed articles reflect the views of the authors; Society endorsement is not intended. Articles are subject to editing for space and clarity.

News & Views Submission Guidelines

Articles – Focus on your area of expertise and practice, ethical dilemmas, responses to events in the media or other topics relevant to clinical social work. Articles should be 500–700 words.

Out & About – Share news about you: an article you’ve written, if you’ve been in the news, taught a class, earned a new certification or are a singer, artist or writer. Submissions should be 50 words or less. Send all submissions to npines12@aol.com

Submissions will be reviewed and are subject to editing for space and clarity.

Next submission deadline:  October 30, 2019

Need to reach a Board member?  Click here for the listing of the GWSCSW Board of Directors

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