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Spotlight on Walden // Apr 08, 2019

The Case for More Independent Social Workers

Dr. Justa SmithPort Clinton, Ohio, is a city of approximately 6,000 residents that sits along the shore of Lake Erie. It is a tight-knit community whose population swells during summer vacation months. As with many small rural areas, Port Clinton has been hit hard by the opioid epidemic. According to the Centers for Disease Control and Prevention (CDC), rates of drug overdose deaths are rising in rural areas, surpassing rates in urban areas.

“We need to understand why this is happening so that our work with states and communities can help stop illicit drug use and overdose deaths in America," said CDC Director Dr. Brenda Fitzgerald in a press release.

Dr. Justa Smith, a Walden University Doctor of Social Work (DSW) graduate and director of operations at C.H.O.I.C.E.S. Behavioral Health Care, believes one factor is because of a lack of resources, programs, and community activities for healthy engagement. She says there’s not much to do in Port Clinton other than a bowling alley and bars. Though some court-sponsored programs have opened for children, there are no recreation or youth centers where adolescents can play and grow safely. Put-in-Bay, one of the closest choices for entertainment, is outside of town and only accessible by ferry. The village is on South Bass Island and serves as a tourist attraction mainly for adults interested in drinking, dining, and shopping.

“We see substance abuse issues with children and adults,” says Dr. Smith.

Relating to the experiences of her patients, Dr. Smith grew up with an alcoholic father who was abusive toward her mother. Dr. Smith moved to Ohio with her mother and sister, while her dad remained in Nevada and continued to abuse alcohol. He now has alcoholic dementia and lives in a nursing home.

“My life experience has definitely played a major role in my career choice,” says Dr. Smith, who has battled anxiety and depression throughout her life and worked with social workers remotely to ensure her dad was receiving the right care. “I’m better situated to work with people who have similar symptoms and experiences because I can relate to them and, most importantly, help them.”

The agency Dr. Smith works for provides mental health and chemical dependency treatment through intensive outpatient services and opioid maintenance treatment. Due to the pervasive access to and use of opioids, the agency also opened a Suboxone clinic. Dr. Smith was drawn to C.H.O.I.C.E.S. Behavioral Health Care because case managers and counselors offer community services that include home visits if people don’t have access to transportation or refuse to leave their house.

“Since everyone knows everyone, it can be intimidating to get treatment,” says Dr. Smith. “The ability to meet people where they are until they get comfortable to leave their home for treatment is essential. It’s so valuable to have licensed independent social workers in areas that don’t have an existing agency or one nearby, so they can provide services in communities where the need is.”

Dr. Smith is a licensed independent social worker with a supervision designation (LISW-S), which means she can offer supervision and sign-offs. As director of operations at the agency, she meets with patients and oversees operations, including supervising all staff and signing off on all patient-related documents. Having an LISW-S credential is important, she says, because one day she wants to have her own agency. However, her journey to earn her LISW-S revealed a potential drought in the pipeline of credentialed social workers who offer supervising and training services.

Through her Walden doctoral research, “Shortage of Licensed Independent Social Workers With the Training Supervision Designation,” Dr. Smith found several barriers licensed social workers named as reasons not to pursue this credential, including age, their employers not requiring it, being unaware of its value, and it not being a personal or a familial priority. Not having this credential can make it difficult for social workers to strike out on their own. It also can impact health centers if they don’t have enough staff who can sign off on patient documents.

According to Dr. Smith, licensed independent social workers with a supervision designation are in high demand. In her experience, they can charge $175 an hour for the Ohio requirement of 150 supervised hours for social workers pursuing an LISW-S. When Dr. Smith was pursuing her credential, the most affordable supervisor she could find was an hour away from her home. She says the supervision cost plus gas can easily add up to a house and car payment each month, which is a lot for social workers who are underpaid.

“I was lucky to find someone who knew a supervisor who offers a pay-it-forward agreement,” says Dr. Smith. “That meant in order for me to receive free supervisory services, I had to offer the same to other licensed social workers once I earned my LISW-S.”

Every Friday for two hours, Dr. Smith and her fellow supervisees discussed ethical issues, staffing, symptoms, diagnosis, and treatments. The supervision sessions offered the social workers a great way to network with each other while receiving guidance, reviewing laws and rules, and discussing changes in the “Diagnostic and Statistical Manual of Mental Disorders (DSM–5).”

“People would ask me why I was pursuing my doctorate because I didn’t need it for a job and I already obtained the highest licensures,” says Dr. Smith. “I knew I always wanted to be a doctor of some kind and have a greater influence in my field. Social work is one of the best careers because it’s flexible and you can apply it in so many ways. It’s rewarding for me to be able to provide this service to others.”