This month I was invited to present on Supervision at the Association of Social Work Board (ASWB) North America Social Work Board Regulators Conference in Nevada. The theme of the conference was on how to increase Social Work Competency (from what I understand this is a current theme in many of the health care professions). Many questions got raised; Does requiring X number of continuing education credits really define competency? How about supervision? Does X number of hours of supervision equate to competency? Of course not because we all know that many people attend poorly developed continuing education workshops and/or just go as “seat warmers”. In addition, there are many substandard supervisors, so counting hours is not enough. We also asked whose responsibility is it to insure competency to protect the public, which is the main purpose of regulation. Legislators? Regulators? Organizations/Employers? Supervisors? The individual Social Worker? While there were more questions than answers, and nothing is a guarantee fix, in my presentation on Supervision Issues I talked about the need for evidence-based clinical supervision, (which is early in its development, see Robert Reiser and Derek Milne’s work). There also needs to be quality measures for continuing education, (heck, everything one buys now has consumer ratings at least).
What does this have to do with BPD Awareness month and DBT Certification? Well, my passion for quality treatment for, and protection of consumers spans both arenas. As a Qualified Supervisor in Florida (one who is deemed qualified to supervise masters level therapists towards licensure) and the teacher of the course that is required to become a Qualified Supervisor, and as a Linehan Board Certified DBT Clinician, I take this role as a gatekeeper and supervisor seriously. At the conference, I used the DBT-LBC certification process as an example of excellence in assessing competency, and the DBT Consultation team as an example of quality supervision. In addition, the fact that in DBT we measure progress (which only 20% of therapists do formally) is another indicator of quality since we know that clinical outcomes are improved when therapists formally measure progress.
Any high stakes exam or certification process is going to have naysayers. ASWB is the organization tasked with the job of creating the Social Work licensing exam and developed the ACE Continuing education certification program. Their standards are high, again for good reason….to protect the public. You wouldn’t imagine the complaints I’ve heard from those who challenge the test because the applicant failed. “I failed the test because it is the test’s fault”? Yet, because it is valid, reliable and legally defensible exam those complaints hold no water. The same is true for the DBT Certification Process. While there are other “Certificate” Programs, the educated consumer really needs to understand the difference between a “Certificate” and “Certification”. (Click HERE for a thorough explanation). Also, the educated DBT therapist looking to be certified needs to look at who developed the Certification Process? Marsha Linehan, the treatment developer was centrally involved from beginning to end in creating the DBT-LBC Certification process. Is it challenging? Is it expensive? Yes but in order to be valid, reliable and legally defensible it IS more costly than a “Certificate” that is primarily a self-attestation that you check off and voila…..you have your Certificate. How would you feel if your cardio-thoracic surgeon got his Board Certification from a self-attestation process? As a close colleague and friend said, there are lots of people out there looking for a shortcut, or the easy way and there is no easy way to become an expert DBT therapist or Social Worker.
So, for all our sake…..consumers, family, clinicians please educate yourselves on what it takes to be a qualified, excellent therapist. Look for whether they are doing or teaching evidence-based strategies and interventions and measuring progress with outcome measures. Does Certification require one to demonstrate the ability to do the treatment with fidelity to the model through a rigorous application process, test, and the submission of written work and videotapes which are coded by experts?
For more information on DBT-LBC Certification, and a list of Certified Clinicians, go to dbt-lbc.org. Thanks for listening. Nancy Gordon, LCSW