Contexts/Settings: Private/Independent Practice Settings
Abstract and Keywords
Private independent practice (known historically as private practice) is a growing segment of the social work profession. Social workers entering this context are providing a range of services, including clinical and nonclinical. Major considerations for establishing, maintaining, and marketing a successful and ethical private independent practice will be discussed. Existing tensions and challenges in the social work profession and in the field of social work education will be briefly examined. Future directions for private independent practice of social work will be explored.
Private independent practice had its earliest beginnings with pioneer social workers like Mary Richmond (Barker, 1995; McLaughlin, 2002; Richmond, 1922). Since that time, and especially since the mid-1970s, the number of social workers entering private independent practice has grown. The earlier private practice of social work primarily focused on clinical work, especially psychotherapy. The contemporary landscape of private independent practice reflects a myriad of services, both clinical and nonclinical, depending on individual state rules and regulations. Clinical work may include such services as counseling and psychotherapy to individuals, couples, families, and groups, and clinical supervision of social workers for licensing, community, and corporate interventions. Nonclinical work may encompass program development and evaluation, conflict resolution, mediation, training, and education. Traditionally, private independent practitioners have offered their services in a private office setting. Many now contract with agencies, as well as clients, for the delivery of services.
Private/independent practice tends to attract social workers who desire salaries higher than those of their agency counterparts as well as greater independence and flexibility in their work hours, choice of clients, and approaches to working with clients. Motivation is considered to be a crucial attribute for successful practice (Barker, 1992).
The actual number of social workers in private independent practice is unknown. The Center for Health Workforce Studies and the NASW Center for Workforce Studies (2006) presented findings on a 2004 survey of ∼10,000 licensed social workers. Of those surveyed, 17.5% identified private practice as their work setting. The largest percentage of these private practice social workers, nearly 54%, were aged 65 and older. In comparison to other social service settings, private practitioners had the highest salaries (Center for Workforce Studies, 2006; Whitaker, Weismiller, & Clark, 2006).
In a NASW Practice Research Network 2004 study of a representative sample of 2,000 members, it was found that 23% were in private practice only and 18% were in organizational and private practice settings. Similar to the earlier-mentioned study, respondents in private practice reported higher salaries than did those social workers in organizational settings. On comparing the 2004 study with an earlier 2002 study, it was found that the number of private practitioners had increased 3% (National Association of Social Workers [NASW], 2005a). From these studies, it would appear that private independent practitioners represent a viable and growing sector of the social work profession. Further evidence of this developing interest is reflected in the creation and growth of the private practice specialty section within the National Association of Social Workers (NASW), which is currently the largest section within the association (M. Coleman, personal communication, March 27, 2007).
Prior to engaging in private independent practice, social workers must meet requirements as set by their respective state social work laws. State laws vary in terms of regulations and definitions for private independent practice (Association of Social Work Boards, 2005). Beyond state requirements, social workers may pursue additional clinical credentials and professional development through the NASW, the American Board of Examiners in Clinical Social Work, and the Association of Clinical Social Work.
Private independent practice is essentially a business requiring knowledge and skill in developing and marketing services as well as managing an office and expenses (Barker, 1995). Expenses may include office rental, telephone, telephone answering or voicemail services, pagers, cell phones, office supplies, health insurance, self-employment taxes, and malpractice insurance. Rather than pursuing a solo practice where they maintain sole responsibility, some social workers prefer sharing responsibilities through group practice. It is essential to have established relationships with professionals such as a lawyer, certified public accountant, and experienced social workers, who can provide periodic consultation. Knowledge and skill for addressing and resolving ethical and legal dilemmas, and reducing malpractice risks are key considerations (Houston-Vega, Nuehring, & Daguio, 1997; NASW, 2005b).
Although it is believed that social workers engaging in their own practice fare better physically and psychologically than do social workers in organizational settings, there may be stress related to managing a business, generating referrals, and avoiding ethical, legal, and malpractice risks (Jayaratne, Davis-Sacks, & Chess, 1991).
The tensions and challenges surrounding the private independent practice of social work are alive and well and actually have been in existence since Mary Richmond's first reference to individual case work (Brown & Barker, 1995; Jayaratne et al., 1991; McLaughlin, 2002; Richmond, 1922). Social workers engaged in independent work continue to be criticized for having abandoned the mission of social work (Specht & Courtney, 1994). Many private practitioners would argue that they are committed to social work values, promote social justice, and advocate on behalf of clients and communities. These controversial debates exist in the social work profession and in the field of social work education (Brown & Barker, 1995; Gibelman, 1999; Jayaratne et al., 1991; McLaughlin, 2002; Strom & Gingerich, 1993). Given the reality that many graduate social work students plan on working independently, it creates a critical challenge, obligation, and opportunity for social work educators to accept some responsibility for including course content on private independent practice in the curriculum.
A second notable challenge relates to the diverse terms and definitions used by state social work boards for the legal regulation of private independent practice. With the already existing misperceptions of social work, the lack of consensus on terms, definitions, and regulations only contributes to greater confusion for the profession and the public (Association of Social Work Boards, 2005).
The social work profession is expected to experience a continued growth in the number of social workers in private independent practice (Bureau of Labor Statistics, 2006; Gibelman, 1999). Future directions will most likely include the following: greater recognition of the contributions of private independent practice in the social work profession; research efforts to specifically identify the numbers and profiles of private independent practitioners around the country; development of additional resource materials for educating social workers about establishing and maintaining successful and ethical practices as well as guidelines for closing and retiring from practice; and increased attention to and development of courses with private independent practice content within graduate social work programs.
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