A State by State Licensure Guide

Mental Health: Social Work vs. Professional Counseling

Interested in working one on one with people who have mental disorders, emotional challenges and/ or addictions? Chances are you’ll do more direct therapy with a degree in either social work or counseling than you would with one in psychiatry or psychology.

There’s a fair amount of overlap between mental health counselors and mental health social workers – in fact, both perform psychotherapy! For this reason, people often go back and forth before committing to one track.

Counselors are adept at helping people work through their emotions, develop coping strategies, and adapt to their environments. Social workers do those things, too, but they may also spend a lot of time doing the reverse: adapting the environment to the client. This may include contacting others on behalf of a client. Social workers may, for example, call employers or potential employers of people who have special needs. Social workers have more preparation for work as case workers or case managers, but this is not to say that counselors aren’t sometimes employed in these roles. (And, while case management is sometimes thought of as a bachelor’s level position, complex and difficult cases often fall within the scope of practice of the master’s trained social worker.)

Mental Health in a Team Setting

Counselors and social workers who are employed in large hospitals or medical centers are typically part of interdisciplinary teams that include psychiatrists and psychiatric nurse practitioners. In these settings, a person is expected to make contributions based on the strengths of a unique discipline. Social workers are versed in psychosocial assessment and examining human behavior within a broad context.

A social worker in an inpatient mental health ward might have a large role in discharge planning. She might, for example, have the responsibility of putting together community re-entry plans. Again, there is a focus on preparing the community for the individual – not just the other way around. If this is your vision, a social work degree is excellent preparation.

However, psychiatric hospitals hire mental health counselors as well. In these setting, they, too, take on broad roles: communicating with family members, advocating for patients’ needs. Psychiatric hospitals do not always differentiate the two roles.

Psychotherapy and Private Practice

Mental health counselors and clinical social workers both go into private practice doing psychotherapy and counseling. While they have different professional titles, they may compete for the very same clients. Some clients have a preference for therapists of a particular discipline. Often, though it comes down to liking a particular therapist’s approach.

Practical Considerations

You may get to the same place with a degree in either social work or counseling. When making a decision about which field to pursue, you’ll want to consider more than just the typical job description. Are there laws in your state that favor one profession over another? Individual states do set the scope of practice differently. While you may do casework or basic counseling with a bachelor’s, mental health practice takes a master’s and post-degree practice. The level of preparation is usually similar, but it’s not necessarily identical – and this can be an issue with regard to third party reimbursement of mental health services. When it comes to Medicare, social workers currently have the advantage; however, this is a focus area of professional counseling advocates, and the situation will likely change.

Another consideration can be the strengths of individual programs. Social work programs vary a good deal in the attention they give to psychotherapy. Some states don’t specify the minimum amount of clinical coursework that social workers must have as part of their graduate education. In these cases, it’s an individual choice: What does it take to feel prepared to offer mental health counseling?

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