By: Jeann Linsley
Winter 1998, Vol. 5, No. 1
Advanced Clinical Training: Beyond the Master's Degree in Social Work
by Jeann Linsley
For MSWs seeking training beyond their master' degree, the choices are almost limitless-and potentially overwhelming. Workshops, seminars, certificates, and degrees are available in numerous clinical treatment methods, among them Self-Psychology, Object Relations, Adlerian psychology, long-term therapy, short-term cognitive behavioral therapy, family and couples therapy, hypnotherapy, sociotherapy, biofeedback, psychodrama, art therapy, and even sports therapy.
Chad Breckenridge, MSW, BCD, of Minnesota, says MSW graduates are increasingly seeking out post-graduate clinical training.
“We’re in a field where roughly 80 percent of the graduates are saying they want to go into clinical practice,” and feel they need training beyond the MSW to be competent, says Breckenridge. Breckenridge, who has been in practice for several years in a hospital psychiatry unit in St. Paul, MN, is now a student at the Institute for Clinical Social Work in Chicago, a free-standing university that offers a Ph.D. in clinical social work. Unlike many traditional Ph.D. programs, the ICSW program offers both the research focus and the practical clinical training many MSWs are seeking, says ICSW president Thomas Kenemore. “We focus very significantly on clinical practice,” says Kenemore. And while there are specific courses on cognitive-behavioral therapy, the curriculum is more psychodynamically based, he says.
The Ph.D. Option
The ICSW' Ph.D. track is a rigorous, 4-year program that involves classroom work, clinical work, and supervision by seasoned professionals, case presentations, research papers, and a dissertation.
Enrollees must have had a certain number of hours of supervision in a work environment, so the students in this track have had a couple years of agency or private practice experience.
Students who are not ready for the rigors of the Ph.D. can enroll in the Student At Large program, which is available to new MSWs without work experience. This program involves more lecture and classroom work, and is offered on Tuesday and Thursday evenings. Coursework in the Student At Large program can count toward the Ph.D. if the student decides to go on to that program.
Sandra Kryder, MSW, BCD, is a recent graduate of ICSW. Kryder, who is director of the Carnegie-Mellon University Counseling Center, says she chose a Ph.D. program over a clinical certificate program partly because the Ph.D. opens doors to administrative positions. Having a Ph.D. also can prevent the headaches of insurance companies refusing to reimburse a provider because of lack of credentials, she says, noting that the MSW isn’t always honored by insurance providers.
“The downside (of the ICSW program) is that if you don’t have a strong personal support system and network, it might be very difficult to go through,” says Kryder, who completed the program-commuting to Chicago every other week-while at the same time holding down her private practice and maintaining family commitments at home. “I have kids, so my husband filled in the gaps,” she says.
Shorter-term certificate programs in clinical social work or psychotherapy-offered by many colleges and private institutes-are another way for MSWs to obtain advanced clinical training. The University of Minnesota School of Social Work, for example, offers a certificate in Advanced Clinical Studies, a year-long program in which classes are offered on alternating Saturdays so that working graduates are able to participate. The Smith College School for Social Work offers two advanced clinical certificate programs as part of its continuing education program-one focusing on practice with individuals and the other on clinical practice with families.
Like the ICSW Ph.D. program, the Smith College program is designed for applicants who have had two or more years of clinical experience. But others-including new MSW graduates-are considered on a limited basis.
Coursework is completed during two consecutive summers and a nine-month practicum involving work with clients under approved supervision that is organized by the student in his or her own community and approved by the School.
The first track (practice with individuals) includes courses in classical psychoanalytic theory, Self-Psychology, the English and British Schools of Object Relations, and short-term treatment, as well as two intensive case seminars focused on integrating theory and practice.
The Institute Experience
In New York City, there are dozens of private institutes offering post-graduate clinical training. There are so many institutes in New York that there is a guidebook available in New York bookstores containing a complete list. The programs range from long-term programs that can take eight years or more to complete, to shorter-term programs lasting a year or so. Some programs require commitments of several days a week, and others are designed to accommodate full-time working professionals who only have time in the evenings.
There are specific institutes focusing on particular modalities including Self-Psychology, Cognitive Behavioral Therapy, and Ericksonian Hypnosis. Other institutes combine different psychotherapeutic modalities. And there are programs in hypnotherapy, sports therapy, art therapy, and a modality called sociotherapy.
In California, the Los Angeles Institute and Society for Psychoanalytic Studies offers both a Ph.D. and a certificate in psychoanalysis.
Certificate programs that involve somewhat less time and commitment are also available. Graduates who are interested in couples and relationship therapy might consider a program such as the Imago Relationship Therapy program, which involves a series of workshops and trainings in 12 eight-hour days-a total of 96 hours-which can be completed in about 3 months.
The Imago school of thought incorporates fundamentals from British Object Relations theory as well as other psychoanalytic methods, according to Sunny Shulkin, LCSW, a trainer for the Philadelphia Center for Imago Relationship Therapy.
Imago students are required to take a relationship workshop themselves with a significant other prior to starting their own training, says Shulkin.
“We do a nice blend of helping the therapists grow themselves...they must take the role of therapist and the role of partner,” says Shulkin. “Working with couples is one of the more difficult challenges facing a clinician. It can feel like a war zone. And there' an excitement for the clinician as they grow more competent in this difficult area.”
New MSWs can take courses in the Imago program, but the clinical track leading to certification as an Imago Relationship therapist is open only to licensed MSWs who have had 300 hours of supervision and who have had some couples work in their agency or practice, says Shulkin. Imago trainings are conducted in 20 U.S. cities including Philadelphia, PA; Pasadena, CA; Austin, TX; Orlando, FL (the center' headquarters); Chicago, IL; and New York. The trainings also are conducted in other countries, Shulkin says.
Workshops, Seminars, and Such
Beyond Ph.D. programs, institute trainings, and other forms of clinical training, are workshops, seminars, and continuing education courses. Each of these can be a valuable first step for new MSWs who aren’t quite certain about making a commitment to a post-graduate program.
“If you don’t have the money or the time to do a full, intense program, do workshops,” says Kenemore. “The worst thing you can do is to attach to a particular point of view and become isolated.”
You Gotta Shop Around
Seasoned clinicians advise students considering a post-graduate program to first obtain some work experience, as many institutes and programs require such experience, along with supervision.
“It' very important for a new MSW to gain some experience and it' very important to be engaged in some good supervision, to keep that learning experience going,” says Sandra Kryder.
Kenemore advises students simply to shop around. “You should very intensely shop, and make sure there' a good emotional fit,” he says. “There must be some compatibility between what you want and what they offer.”
Many institutes conduct open houses and workshops that students can attend to get a feel for the program, the faculty, and the prospective students who might attend.
Students seeking psychoanalytic institute training should be aware that some programs require trainees to be in therapy themselves, sometimes several times a week. The Chicago ICSW and the Smith College post-graduate program encourage students to be in therapy but don’t mandate it. Many of the New York institutes are more insistent about self-awareness and personal therapy, and most require it.
Financial aid is another consideration in picking a post-graduate program. Students should inquire about loans and grants available to them, perhaps even investigating the size of the school' endowment fund.
Evaluating the quality of the program might be a little more challenging, says Kenemore.
“It' the Wild West out there. It' hard to evaluate programs, especially if you’re a beginning practitioner,” he says. At the very least, they should be accredited, he points out.
Mary Hall, MSW, director of the Smith College social work continuing education program, advises students to contact staff, faculty, and students in the programs they’re considering.
“It' really a matter of talking to people who have firsthand experience with it. Go to workshops. Talk to students,” says Hall. “A lot of people just do it by reputation and what they’ve heard about the program.”
The choice of a program may be limited by the constraints of the prospective student' present work environment, says Hall, noting that the concept of “educational leave” for clinical training is almost unheard of nowadays, as a result of agency budget cutting.
Breckenridge says the demand of clinical training beyond the MSW has led some master' level social work programs to consider adding a third year “specialist” clinical credential.
“What I’m hearing is that the master' curriculum is really not meeting the practice needs of people leaving school with that degree,” he says. “Graduates are saying they’re not feeling like they’re getting the training they need.”
Kenemore says that more new institutes should be developing in the future. “They’re trying to start one in Washington, DC...our hope is that this will be [a trend],” he says.
Breckenridge believes students should aim ultimately for a post-graduate program that has a psychodynamic focus.
“People are seeing the weaknesses of the brief models of therapy that are supported by the insurance industry,” he says. “I really think people need a psychodynamic foundation to make any sense out of something like cognitive-behavioral therapy. We’ve almost taken an anti-intellectual position by producing a lot of young clinicians who are very negative about psychoanalysis. But I believe we have to keep it.”
Is It Worth It?
Breckenridge and Kryder both say their post-graduate clinical training deepened their practice and professional lives and was well worth the challenge.
“You follow [some cases] for a minimum of two years [in the ICSW program] and most of the cases are seen twice a week. So you really learn how to do in-depth work,” says Kryder, who adds that the professional consultation available in the program is invaluable.
Breckenridge says he was drawn to an intensive academic post-graduate clinical program as a means of infusing himself with new clinical knowledge.
“My practice is already benefiting,” says Breckenridge. “It' feeling like my practice is...more alive.”
“I think that wherever you are, there is no better long-term investment than in more clinical training and practice,” says Hall.
Jeann Linsley is a social worker and free-lance writer in New York City. She writes frequently for THE NEW SOCIAL WORKER.