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Public Comments for NASW Standards for Clinical Social Workers in Social Work Practice NASW’s Task Force for Clinical Social Work Practice Standards is seeking public comments on the attached document, NASW Standards for Clinical Social Workers in Social Work Practice . The draft standards provide guidance to clinical social workers across all clinical settings and serve as benchmarks that describe the professional services clinical social workers perform. Your comments are important to us and will help the task force to create a model set of standards. All comments are confidential. NASW appreciates your comments, and the task force looks forward to reviewing them. The public comment period begins on July 28 and ends on September 15 . Your comments are important to us and will determine how the task force moves forward. Comments should include the following: • Name • Professional Background • Page number of the information on which you are commenting Edits are not necessary and will be performed after all comments are received. When evaluating the guidelines, please respond to the following questions and statements by email: • Is the content clear and understandable? • Are there additional topics that should be added? If so, state them and share why. • Are there topics that should be deleted? If so, state them and share why. • Describe main strength(s) of the guidelines. • Describe any weaknesses of the guidelines. • List other comments. NASW values your feedback. All comments must be submitted no later than September 15, 2023. Should you have any questions please contact cswstandards@socialworkers.org .

2 NATIONAL ASSOCIATION OF SOCIAL WORKERS NASW Standards for Clinical Social Workers in Social Work Practice

3 National Association of Social Workers Yvonne Chase, PhD, LCSW, ACSW, MSW NASW President Anthony Estreet, PhD, MBA, LCSW-C Chief Executive Officer Clinical Social Work Standards Taskforce John C. Gramuglia MBA, LICSW, MLADC, LCS, Chair Carrie McDonnell, LICSW, LCSW-C, Cochair Durina Keyonnie, LCSW Tracy Connor, LCSW Jennifer DiBiase, LCSW-R, APHSW-C Tyler Argüello, PhD, DCSW Laurie Conaty, MSW, LCSW, LCAS Yvonne Woods, PhD, MSW, LCSW Laura W. Groshong, LICSW Angie Lutts, LCSW Nick Szubiak, MSW, LCSW NASW Staff Barbara Bedney, PhD, MSW NASW Chief of Programs Mirean Coleman, MSW, LICSW, CT NASW Director of Clinical Practice Denise Johnson, LCSW-C Senior Practice Associate Janice G. Harrison Executive Assistant ©2023 National Association of Social Workers. All Rights Reserved.

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4 Table of Contents About the Association Introduction Goals of the Standards Standards for Clinical Social Work in Social Work Practice • Standard 1. Ethics and Values • Standard 2. Specialized Practice Skills and Interventions • Standard 3. Referrals • Standard 4. Accessibility to Clients • Standard 5. Privacy and Confidentiality • Standard 6. Supervision and Consultation • Standard 7. Professional Environment and Procedures • Standard 8. Documentation • Standard 9. Independent Practice • Standard 10. Cultural Diversity, Equity, and Inclusion • Standard 11. Professional Development • Standard 12. Technology • Standard 13. Termination Glossary References

About the Association 1 The National Association of Social Workers (NASW) is the largest membership organization of 2 professional social workers in the nation. Members include over 110,000 social workers from 50 states, 3 the District of Columbia, New York City, the U.S. Virgin Islands, Guam, Puerto Rico, and American social 4 workers practicing abroad. NASW ’ s primary functions are promoting the professional development of its 5 members, establishing, and maintaining professional standards of practice, advancing sound social 6 policies, and providing services that protect its members and enhance their professional status. 7 8 Acknowledgement 9 NASW would like to thank the Clinical Social Work Association (CSWA) for the participation of Laura 10 Groshong, LICSW, director of policy and practice, in the revision of the NASW Standards for Clinical 11 Social Work in Social Work Practice . 12 13 Introduction 14 Clinical social workers represent one of the largest groups of mental and behavioral health practitioners 15 in the United States and its territories. They are often the first to diagnose and treat people with mental 16 disorders and various emotional and behavioral disturbances. Clinical social workers are essential to a 17 variety of client-centered settings, including community mental health centers, hospitals and hospices, 18 substance use treatment and recovery programs, courts and other criminal justice settings, schools, 19 primary healthcare centers, child welfare agencies, businesses, aging and rehabilitation services, 20 employee assistance programs, nonprofit organization, religious institutions, private practice, and the 21 uniformed services. 22 23 Clinical social work has a primary focus on the mental, emotional, and behavioral well-being of 24 individuals, couples, families, groups, organizations, and communities. It centers on a holistic and 25 systematic approach to psychotherapy and the client ’ s relationship to their environment. Clinical social 26 work views the client ’ s relationship with their environment as essential to treatment/care planning — 27 from assessment and diagnosis to treatment and follow-up. 28 29 Clinical social work is a state-regulated professional practice. Clinical social workers must meet and 30 maintain the minimum requirements of practice in their state and jurisdiction. 31 32 Clinical social work is broadly based and addresses the needs of individuals, families, couples, groups, 33 and communities affected by life changes and challenges in various areas of functioning, including 34 mental, behavioral, and physical health conditions. Clinical social workers seek to provide essential 35 services in the environments, communities, and social systems that affect the lives of the people they 36 serve. 37 38 Goals of the Standards 39 Clinical social workers are committed to the delivery of culturally competent services to individuals, 40 families, couples, groups, and communities. Therefore, in practicing cultural humility, they should 41 recognize the client ’ s role in treatment/care planning and the client ’ s right to have a knowledgeable, 42

6 skilled, caring, responsive, and compassionate practitioner who is guided by sound ethical, evidence- 43 based research; comprehensive clinical assessment; client-focused treatment; and holistic practice. 44 45 These standards for clinical social work practice set forth by NASW are intended to guide clinical social 46 workers in all areas of specialization and clinical settings. Specifically, the goals of the standards are to 47 ■ maintain and improve the quality of services provided by clinical social workers. 48 ■ establish professional expectations and guidelines to assist social workers in monitoring and 49 evaluating their clinical practice. 50 ■ provide a framework for clinical social workers to assess responsible and ethically sound 51 professional behavior. 52 ■ inform consumers, government regulatory bodies, and others about the professional 53 standards for clinical social work practice. 54 ■ encourage engagement in lifelong learning to continually improve and update social work 55 theory, knowledge, methods, and skills to remain relevant, effective, and responsive to clients ’ 56 needs in a rapidly changing society. 57 58 The scope of clinical social work extends across many geographic regions, practice settings, and 59 populations. It is anticipated that these standards will inform, reinforce, enhance, and support current 60 and future evidence-based research and client-centered clinical practice in all settings, while affirming 61 the value of clinical social work services as a discrete and efficacious practice area. 62 63 Standards for Clinical Social Work in Social Work Practice 64 Standard 1. Ethics and Values 65 Clinical social workers shall adhere to the values and ethics of the social work profession, utilizing the 66 NASW (2021) Code of Ethics as a guide to ethical decision making. 67 68 Standard 2. Specialized Practice Skills and Interventions 69 Clinical social workers shall demonstrate the knowledge, skill, and ability to effectively intervene with 70 the population and client configuration that they are providing clinical social work services to. 71 72 Standard 3. Referrals 73 Clinical social workers shall be knowledgeable about community services and make appropriate 74 referrals, as needed. 75 76 Standard 4. Accessibility to Clients 77 Clinical social workers shall be accessible to their clients. 78 79 Standard 5 . Privacy and Confidentiality 80 Clinical social workers shall maintain adequate safeguards for the private nature of the treatment 81 relationship. 82 83 84

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7 Standard 6. Supervision and Consultation 85 Clinical social workers shall maintain access to professional supervision and/or consultation in 86 accordance with standards 2.05 and 3.01 of the NASW (2021) Code of Ethics . 87 88 Standard 7. Professional Environment and Procedures 89 Clinical social workers shall maintain professional workspaces, policies, and procedures. 90 91 Standard 8. Documentation 92 Documentation of services provided to, or on behalf of, the client shall be recorded in the client ’ s file or 93 record of services. 94 95 Standard 9. Independent Practice 96 Clinical social workers, when licensed to do so by state laws, shall have the right to establish an 97 independent practice. 98 99 Standard 10. Cultural Competence 100 Clinical social workers shall demonstrate culturally inclusive service delivery in accordance with the 101 NASW (2015) Standards and Indicators for Cultural Competence in Social Work Practice . An increasingly 102 growing diverse population seeking clinical supports requires that clinical social workers optimize and 103 commit to diversity, equity, and inclusion to ensure individuals, families, groups, and communities are 104 provided an opportunity to grow, contribute, and develop. 105 106 Standard 11. Professional Development 107 Clinical social workers shall assume personal responsibility for and are obligated to engage in continuing 108 professional development across the entirety of their career. This shall be in accordance with the NASW 109 Standards for Continuing Professional Education (2003) as well as state requirements for continuing 110 education. 111 112 Standard 12. Technology 113 Clinical social workers shall have access to computer technology and the internet, as the need to 114 communicate via email and to seek information on the Web for purposes of education, networking, and 115 resources is essential for efficient and productive clinical practice. Those who provide telehealth services 116 shall be knowledgeable of all rules and regulations that govern the jurisdiction in which the social 117 worker and client are located. 118 119 Standard 13. Termination 120 Clinical social workers shall appropriately prepare clients for termination of services. 121 122 123 124 125 126

8 Standard 1. Ethics and Values 127 Clinical social workers shall adhere to the values and ethics of the social work profession, utilizing the 128 NASW (2021) Code of Ethics as a guide to ethical decision making. 129 130 Interpretation 131 The social work mission is rooted in six core values: service, social justice, dignity and worth of the 132 person, importance of human relationships, integrity, and competence (NASW, 2021). All social workers 133 have a responsibility to embrace these values as a service to clients, the profession, self, colleagues, and 134 society. 135 136 In delivering clinical social work services, the social worker ’ s primary responsibility is to their client. It is 137 also important to note the clinical social worker may see clients who are mandated for treatment and 138 need to meet the demands of the institution that mandates the treatment. An example of this would be 139 a clinical social worker who is contracted to provide services for a criminal justice agency. 140 141 Clinical social workers shall acknowledge the right of clients to receive competent psychosocial services 142 and demonstrate a commitment to act on professional judgement and convictions, which are informed 143 by the NASW (2021) Code of Ethics . 144 145 Clinical social workers shall be prepared for the challenges that encompass the assessment and 146 treatment of people with mental disorders and behavioral or emotional disturbances. This includes 147 maintaining a commitment to the client while simultaneously demonstrating responsibility to the 148 practice setting, society, and local state and federal policies and regulations governing the social 149 worker ’ s practice. In the event that conflicts arise among competing interests, social workers are 150 directed to the Code of Ethics as one of the reference points for decision making. Services should only be 151 provided in a setting in which the professional relationship can be maintained. Clinical social workers 152 should adhere to the Code of Ethics with regard to limits on private and/or dual relationships with 153 clients. 154 155 Standard 2. Specialized Practice Skills and Interventions 156 Clinical social workers shall demonstrate the knowledge, skill, and ability to effectively intervene with 157 the population and client configuration that they are providing clinical social work services to. 158 159 Interpretation 160 Drawing on knowledge of evidence-based practices and community standards of care, clinical social 161 workers shall be familiar with psychosocial, cultural, and health factors that influence the mental, 162 emotional, and behavioral functioning of the client configuration with whom they are working. 163 164 Additionally, clinical social workers shall have the ability to 165 ■ establish and maintain a relationship of mutual respect, acceptance, and trust. 166 ■ gather and interpret social, personal, environmental, and health information. 167 ■ evaluate and treat problems within their scope of practice. 168

9 ■ establish achievable treatment goals with the client. 169 ■ facilitate cognitive, affective, and behavioral changes consistent with treatment goals. 170 ■ evaluate the effectiveness of treatment services provided to the client. 171 ■ identify appropriate resources and use assessment instruments, as needed. 172 ■ advocate for client services. 173 ■ collaborate and work effectively with social work and other professionals, when appropriate. 174 175 When additional knowledge and skills are required to address clients ’ needs, the clinical social worker 176 shall seek appropriate training, supervision, or consultation, or refer the client to a professional with the 177 appropriate expertise. Clinical social workers shall limit the scope of their practice to those clients for 178 whom they have the knowledge, skill, and resources to serve. 179 180 Standard 3. Referrals 181 Clinical social workers shall be knowledgeable about community services and make appropriate 182 referrals, as needed. 183 184 Interpretation 185 To ensure that clients receive optimal psychosocial services, it may be beneficial to collaborate or 186 coordinate services with appropriate community programs to strengthen or improve the continuity of 187 care. Clinical social workers shall be knowledgeable about available community resources. When 188 appropriate, clinical social workers shall advocate on behalf of the client for appropriate services. The 189 clinical social worker shall maintain collaborative contacts with social work or other related 190 professionals and make appropriate referrals, as needed. They should not share information about the 191 client without the client ’ s informed consent or as otherwise indicated in Standard 5. 192 193 When services are provided to a client who resides in another community (for instance, telehealth 194 services), a clinical social worker shall advise client of a restricted knowledge of community services base 195 so that the client can give informed consent for care with these restrictions (or decline the care). A 196 clinical social worker must be knowledgeable about resources where the client resides. 197 198 Standard 4. Accessibility to Clients 199 Clinical social workers shall be accessible to their clients. 200 201 Interpretation 202 Social workers have an ethical responsibility to help people in need and address social issues (NASW, 203 2021). People face many challenges in accessing healthcare services and use of technology. Realizing 204 that medical emergencies can occur at any given moment, it is important that clinical social workers be 205 available to provide clinical services to clients during regularly scheduled appointment times or sessions. 206 Equally important is that clients should know how they can gain access to their social work provider 207 when an emergency arises. 208 209

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10 Levesque et al. (2013 ) identified five dimensions of accessibility: approachability, acceptability, 210 availability and accommodation, affordability, and appropriateness. The first step in accessing the 211 healthcare system is the identification of needs. Seeking services, reaching services, obtaining services, 212 and actually having that need fulfilled are also central to the process (Levesque et al., 2013). The 213 healthcare setting shall therefore be physically accessible and have helping/assistive devices for persons 214 who may be physically challenged. 215 216 The physical accessibility standards issued under the Americans with Disabilities Act of 1990 (ADA), 217 Section 504 of the Rehabilitation Act of 1973, and Section 1557 of the Patient Protection and Affordable 218 Care Act of 2010 all prohibit discrimination based on disability. These statutes together require 219 healthcare providers to make reasonable modifications in policies and practices and provide auxiliary 220 aids and services when necessary to facilitate effective communication. 221 222 In addition to providing physical and digital access to clients, the clinical social worker shall develop 223 emergency plans or be available to the client for emergency coverage during vacations, pandemics, 224 natural disasters, inclement weather, holidays, illnesses, and at other times when the office may be 225 closed. Arrangements or plans and procedures for emergency, virtual clinics, or telehealth coverage 226 shall be made in partnership with competent mental health professionals or reputable institutions and 227 should be discussed with the client at the initial in person or telehealth interview. All office policies 228 should be discussed with the client prior to scheduling appointments. 229 230 Last, the office setting shall be physically accessible and provide a safe environment. When providing 231 services virtually, clinical social workers shall ensure that clients have guidance on what to expect, as 232 well as the capability and resources to access the telehealth platform. In accordance with the ADA 233 (1990), any office limitations should be discussed prior to scheduling appointments. 234 235 Standard 5. Privacy and Confidentiality 236 Clinical social workers shall maintain adequate safeguards for the private nature of the treatment 237 relationship. 238 239 Interpretation 240 Confidentiality is a basic principle of social work intervention and is a cornerstone of creating safe 241 therapeutic relationships because it ensures the client that what is shared with the social worker will 242 remain confidential. Information related to or obtained from the client by the clinical social worker is 243 viewed as private and confidential. Clinical social workers are mandatory reporters and shall be familiar 244 and comply with local, state, tribal, and federal mandates governing privacy and confidentiality, such as 245 the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) rules and state medical 246 records laws. The NASW (2021) Code of Ethics standard 1.07 also requires social workers to respect 247 clients ’ right to privacy and to protect the confidentiality of all information obtained while providing 248 professional services. 249 250

11 Clinical social workers explain the ethical and/or legal limitations of confidentiality at the beginning of 251 treatment and during the course of treatment so the client has a clear understanding. There may be 252 other exceptions to confidentiality as required by law or professional ethics, such as mandates to report 253 when the client is a danger to self or others and for reporting child or elder abuse and neglect. The client 254 may choose to give informed consent for the clinical social worker to release or discuss the information 255 with another party to facilitate support, treatment, and collaboration of care. This release of 256 information is documented and stored in the client ’ s chart. It is important to note that because a release 257 of information has been granted by the client, the clinical social worker should have a legal justification 258 or a health insurance purpose for disclosing client information of any kind. 259 260 Professional judgment in the use of confidential information shall be based on best practice, as well as 261 legal and ethical considerations. 262 263 Standard 6. Supervision and Consultation 264 Clinical social workers shall maintain access to professional supervision and/or consultation in 265 accordance with standards 2.05 and 3.01 of the NASW (2021) Code of Ethics . 266 267 Interpretation 268 Clinical social workers receive guidance through supervision and/or consultation. The purpose of 269 supervision is to provide education, accountability, and direction to supervisees. Board-certified 270 supervisors are responsible for the work of their supervisees, whereas consultants are not responsible 271 for the work of their consultees. The consulting relationship is not hierarchical. Clinical social workers 272 may provide consultation to colleagues who are seeking recommendations on specific issues. Both 273 supervisors and consultants provide guidance to those who seek supervision or consultation. Clinical 274 social workers should ensure that professional social work supervision is available to them in a clinical 275 setting for the first five years of their professional experience (NASW, 2004, as cited in NASW, 2005). If a 276 supervisor is not available or accessible, case consultation may be obtained from qualified professionals 277 of other related disciplines. Clinical social workers with more than five years of clinical experience use 278 consultation on an as-needed, self-determined basis. In addition, clinical social workers shall adhere to 279 state and federal statutes and regulations regarding supervision and consultation in their states of 280 practice, as well as the Best Practice Standards in Social Work Supervision (NASW & Association of Social 281 Work Boards [ASWB], 2013) relating to supervisor and supervisee responsibilities and accountability. 282 283 When appropriate, clinical social workers should offer their expertise to individuals, groups, and 284 organizations, as well as offer training and mentoring opportunities to beginning social workers or those 285 making the transition into clinical social work. Supervisors should abide by any state or jurisdiction 286 standards for approved supervision. 287 288 Standard 7. Professional Environment and Procedures 289 Clinical social workers shall maintain professional workspaces, policies, and procedures. 290 291 292

12 Interpretation 293 Agencies providing clinical social work services and clinical social workers in private practice shall 294 develop and implement written policies that describe their office or work space procedures, such as the 295 client ’ s rights, including the right to privacy and confidentiality, limits to confidentiality, required notices 296 and authorizations, procedures for release of information, fee agreements, procedures for payment, 297 cancellation policy, termination procedures, telehealth policies, coverage of services during emergency 298 situations or when the clinical social worker is not available, and contact information for the appropriate 299 licensing board. These policies shall be made available to and reviewed with each client prior to 300 beginning services. Clinical social workers should maintain appropriate professional liability insurance 301 and have a current working knowledge of risk management issues. 302 303 Additionally, the workspace shall be properly maintained to ensure a reasonable degree of comfort, 304 privacy, and security for the social worker and the client. In-person settings shall meet all federal, state, 305 tribal, and local requirements regarding posting notices and professional licenses. If services are 306 provided via telehealth, clinical social workers must meet any licensure requirements of the jurisdiction 307 where they are licensed and any licensure requirements of the jurisdiction where the client is physically 308 located. Clinical social workers also need to verify the rules and regulations of their professional liability 309 insurance and third-party payers to ensure that telehealth services are covered. 310 311 Standard 8. Documentation 312 Documentation of services provided to, or on behalf of, the client shall be recorded in the client ’ s file or 313 record of services. 314 315 Interpretation 316 Clinical social workers must document all services rendered to clients and keep the records in a secure 317 location, maintaining them as private and confidential records. Documentation may include assessment 318 and diagnosis, interventions, and clients progress toward treatment plan goals. Progress notes should be 319 recorded after each session and be consistent with all applicable local, tribal, state, and federal 320 statutory, regulatory, or policy requirements. 321 322 Standard 9. Independent Practice 323 Clinical social workers, when licensed to do so by state laws, shall have the right to establish an 324 independent practice. 325 326 Interpretation 327 Clinical social workers may establish an independent solo or group practice. When doing so, they shall 328 ensure that all services, including diagnostics and treatment planning, meet professional standards. 329 When clinical social workers employ staff, they, as employers, bear responsibility for the competency of 330 all services provided; maintaining clinical and ethical standards; and upholding all local, state, tribal, and 331 federal regulations. 332 333

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13 To avoid conflicts of interest, clinical social workers who are both employed by agencies and have 334 independent practices shall not refer agency clients to themselves without prior agreement with the 335 agency and informed consent of the client. As part of informed consent, clinical social workers should 336 provide clients with all available options, including but not limited to, transferring the client to another 337 treatment provider within or outside of the agency, referrals to other appropriate treatment providers, 338 and/or terminating services and supporting the client in choosing the option most appropriate for them. 339 340 Clinical social workers in private practice may bill third-party payers or their clients for services 341 rendered. Clients shall be provided with all invoices and receipts in a timely manner. When a client can 342 no longer afford services — or a third-party payer or an agency terminates services — an alternative 343 mutually agreed upon with the client may be instituted. For example, a referral, termination of services, 344 a sliding scale, or pro bono services could be offered. If services continue, consideration must be given 345 to any applicable federal, state, tribal, or local laws and regulations as well as insurance or managed care 346 contracts that may limit the type of continuing care. 347 348 Standard 10. Cultural Diversity, Equity, and Inclusion 349 Clinical social workers shall demonstrate culturally inclusive service delivery in accordance with the 350 NASW (2015) Standards and Indicators for Cultural Competence in Social Work Practice . An increasingly 351 growing diverse population seeking clinical supports requires that clinical social workers optimize and 352 commit to diversity, equity, and inclusion to ensure individuals, families, groups, and communities are 353 provided an opportunity to grow, contribute, and develop. 354 355 Interpretation 356 Cultural Diversity 357 Clinical social workers shall have, and continue to enhance, cross-cultural knowledge, understanding, 358 and application of differences in race, gender, religion, sexual orientation, ethnicity, nationality, 359 socioeconomic status, language, disability, religion, history, traditions, beliefs, values, worldviews, and 360 family systems as they relate to clinical practice with individuals, families, groups, and communities. 361 362 Equity 363 Clinical social workers shall be knowledgeable about social determinants and disparities to further 364 promote justice and fairness within systematic procedures. They shall have and continue to enhance 365 knowledge and awareness of historical and intergenerational adverse effects and their outcomes among 366 individuals, families, groups, and communities. Clinical social workers shall be knowledgeable and skilled 367 in practice about oppression as reinforced by societal norms and institutional biases. 368 369 Inclusion 370 Clinical social workers shall foster inclusion and belonging through creating inviting environments based 371 on policies and practices. They must also be self-aware of personal biases that may be interpreted as a 372 barrier to treatment. Clinical social workers shall be knowledgeable about diverse groups and apply 373 practice skills consistent with the NASW Standards and Indicators for Cultural Competence in Social 374 Work Practice . 375

14 Antiracism 376 Antiracism is a commitment to actively resisting and dismantling the system of racism to obtain racial 377 equity. It involves acknowledgment of the existence of racism throughout history including in the social 378 work profession. In accordance with our Code of Ethics , social workers will take a stance against racial 379 hatred, bias, violence, systemic racism, and the oppression of specific groups on an individual, 380 interpersonal, institutional, and structural level. In clinical practice, social workers should demonstrate 381 cultural humility by applying critical reflection, self-awareness, and self-regulation to manage the 382 influence of bias, power, privilege, and values in working with clients and constituencies. Clinical social 383 workers shall acknowledge clients as experts of their own lived experiences. 384 385 Standard 11. Professional Development 386 Clinical social workers shall assume personal responsibility for and are obligated to engage in continuing 387 professional development across the entirety of their career. This shall be in accordance with the NASW 388 Standards for Continuing Professional Education (2003) as well as state requirements for continuing 389 education. 390 391 Interpretation 392 Competent, ethical, science-based, and effective practice is actuated through the clinical social worker ’ s 393 continuing professional development efforts. Clinical social workers are obligated to routinely engage in 394 approved continuing education opportunities. These professional development opportunities shall 395 reinforce foundational knowledge, ethics, and skills for social work practice — and they shall provide 396 comprehensive professional development related to emerging theories and interventions, enhancing 397 cultural competence and humility, endorsing compliance with existing and new standards of care in the 398 social work profession, as well as confirming changes to policies and regulatory reforms. Clinical social 399 workers must stay abreast of research in social work and their related areas of specialization to ensure 400 that their practice aligns with evidence-based knowledge, skills, and interventions. Clinical social 401 workers are additionally obligated to maintain currency with state (and other relevant authorities ’ ) 402 regulations around the definition and scope of clinical social work practice. Areas in which clinical social 403 workers should maintain currency in their continuing education efforts include the following: 404 ▪ Reporting requirements related to vulnerable populations 405 ▪ HIPAA 406 ▪ Technology, telehealth, and electronic health records 407 ▪ Risk management and liabilities 408 ▪ Interprofessional and emerging science in specialized areas of practice 409 ▪ Implicit personal biases, knowledge of social and health inequities across populations, and best 410 practice standards in working with cultural differences and diverse clients 411 412 Reliable and valid opportunities for professional development are available through NASW as well as 413 other professional organizations, institutions, and agencies. Clinical social workers shall verify 414 certification of continuing education for alignment with local, state, tribal, and national standards, 415 policies, and laws. Clinical social workers should regularly engage with advancing the profession. This 416 can include attending, providing, and participating in professional conferences or continuing education 417

15 trainings, and contributing to social work education (e.g., as faculty), field education (e.g., as a field 418 instructor), or professional or scholarly publications. 419 420 Standard 12. Technology 421 Clinical social workers shall have access to computer technology and the internet, as the need to 422 communicate via email and to seek information on the Web for purposes of education, networking, and 423 resources is essential for efficient and productive clinical practice. Those who provide telehealth services 424 shall be knowledgeable of all rules and regulations that govern the jurisdiction in which the social 425 worker and client are located. 426 427 Interpretation 428 The NASW, ASWB, CSWE, & CSWA Standards for Technology in Social Work Practice (NASW, ASWB, 429 Council on Social Work Education, & Clinical Social Work Association, 2017) has become the standard for 430 how technology is used in social work practice. 431 432 The major areas covered in the standards include provision of information to the public; designing and 433 delivering services; gathering, managing, and delivering information; and social work education and 434 supervision through videoconferencing. Use of technology to provide treatment also requires an 435 informed consent form that outlines the limits of communication to include email, texting, and social 436 media. A videoconferencing platform that is HIPAA compliant, i.e., provides a Business Associate 437 Agreement, should be used. Payment for services should include a platform that is encrypted and 438 password protected. 439 440 Clinical social workers should also be aware of the benefits and risks associated with using technology. 441 For instance, when providing telehealth, clinical social workers shall educate clients on the benefits and 442 risks while assessing appropriateness for services. It is imperative that clinical social workers have a clear 443 understanding of the way matters of diversity, equity, and inclusion are impacted in the use of 444 technology. Some clients are not skilled in the use of technology in ways that maintain confidentiality 445 and do not have access to a computer or smartphone with video capacity. Alternative options such as in- 446 person visits or provider referrals should be offered to clients when virtual services are not appropriate. 447 Audio-only treatment is another option for clinical social workers, though there is some debate about 448 the value of working with only audio services. 449 450 Finally, new ways of receiving treatment from clinical social workers through technology are in need of 451 evaluation and should be approached with caution, carefully evaluating the needs of each patient. 452 Clinical social workers who use technology to provide services should be aware of the ethical guidelines, 453 standards of care within their professional community, and any federal, state, tribal, or local regulations 454 that impact the use of technology-based services. 455 456 457 458 459

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16 Standard 13. Termination 460 Clinical social workers shall appropriately prepare clients for termination of services. 461 462 Interpretation 463 Clinical social workers shall consider termination of services an ethical and necessary procedure of 464 clinical work with clients. Termination can occur for a variety of reasons. 465 466 If a client has met all treatment goals and is no longer in need of services, the clinical social worker shall 467 prepare client for termination of services. 468 469 If a client ’ s treatment ends prior to obtaining their treatment goals, the clinical social worker will follow 470 policies and best practices regarding engagement for follow-up. When appropriate, the clinical social 471 worker shall refer the client to another qualified treatment provider. 472 473 If a clinical social worker leaves a role, agency, or private practice prior to achieving treatment goals, the 474 clinical social worker will provide both the agency (if treatment setting) and their clients with reasonable 475 notice, when possible. Clinical social worker will discuss issues surrounding termination within the 476 therapeutic setting as appropriate and provide clients with information regarding the process (the 477 transfer of the client to another treatment provider within the agency or referrals to providers outside 478 of the agency). 479 480 Glossary 481 Client/Patient/Consumer 482 Social workers generally use the term “ client ” to refer to the individual, group, family, or community 483 that seeks or is provided with professional services. The client is often seen as both the individual and 484 the client system or those in the client ’ s environment. The term “ consumer ” is also used in settings that 485 view the client as the consumer, that is, one capable of deciding what is best for them and encourages 486 self-advocacy and self-judgment in negotiating the social services and welfare system. The term 487 “ patient ” is more commonly used by social workers employed in healthcare settings (Barker, 2014), and 488 may also be used for insurance reimbursement purposes in health, mental health, and substance use 489 settings. 490 491 Clinical Social Work 492 The professional application of social work theory and methods to the treatment and prevention of 493 psychosocial dysfunction, disability, or impairment, including emotional and mental disorders (Barker, 494 2014). 495 496 Counseling 497 A procedure that is often used in clinical social work and other professions to guide individuals, families, 498 couples, groups, and communities by such activities as delineating alternatives, helping to articulate 499 goals, and providing needed information (Barker, 2014). 500 501

17 Person-in-Environment Perspective 502 This orientation views the client as part of an environmental system. It encompasses reciprocal 503 relationships and other influences between an individual, relevant others, and the physical and social 504 environment (Barker, 2014). 505 506 Psychodynamic 507 This term pertains to the cognitive, emotional, and volitional mental processes that consciously and 508 unconsciously motivate an individual ’ s behavior. These processes are the product of the interplay 509 among a person ’ s genetic and biological heritage, the sociocultural milieu, past and current realities, 510 perceptual abilities and distortions, and a person ’ s unique experiences and memories (Barker, 2014). 511 512 Psychotherapy 513 A specialized, formal interaction between a social worker or other mental health professional and a 514 client (either individual, couple, family, or group) in which a therapeutic relationship is established to 515 help resolve symptoms of mental disorder, psychosocial stress, relationship problems, or difficulties in 516 coping in the social environment. Types of psychotherapy include, but are not limited to, family therapy, 517 group therapy, cognitive – behavioral therapy, psychosocial therapy, and psychodrama (Barker, 2014). 518 519 Telehealth 520 The practice of delivering clinical healthcare services via technology-assisted media or other electronic 521 means between a practitioner and a client who are located in two different locations. Also sometimes 522 referred to as telemental health. 523 524 Therapy 525 A systematic process designed to remedy, cure, or abate some disease, disability, or problem. This term 526 is often used by social workers as a synonym for psychotherapy, psychosocial therapy, or group therapy 527 (Barker, 2014). 528

18 References Americans With Disabilities Act of 1990, P.L. 101-336, 104 Stat. 327 (July 26, 1990). Barker, R. L. (2014). The social work dictionary (6th ed.). NASW Press. Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, 110 Stat. 1936 (August 31, 1996. Levesque, J. F., Harris, M. F., & Russell, G. (2013). Patient-Centered access to health care: Conceptualising access at the interface of health systems and populations. International Journal for Equity in Health , 12 , Article 18 . https://doi.org/10.1186/1475-9276-12-18 National Association of Social Workers. (2005). NASW standards for clinical social work in social work practice. https:// https://www.socialworkers.org/LinkClick.aspx?fileticket=YOg4qdefLBE%3d&portalid=0 National Association of Social Workers. (2015). NASW standards and indicators for cultural competence in social work practice. Author. National Association of Social Workers. (2021). Code of ethics of the National Association of Social Workers. Author. National Association of Social Workers & Association of Social Work Boards. (2013). Best practice standards in social work supervision. Author. National Association of Social Workers, Association of Social Work Boards, Council on Social Work Education, & Clinical Social Work Association. (2017). NASW, ASWB, CSWE, & CSWA standards for Technology in Social Work Practice. Author. Patient Protection and Affordable Care Act of 2010, P.L. 111-148, 124 Stat. 119 (March 30, 2010). Rehabilitation Act of 1973, P.L. 93-112, 87 Stat. 355 (September 26, 1973).

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