What is a Social Worker?

If you have been following the Mental Health Mama Facebook page, you’ll have been recently inundated with my cheerful posts about National Social Work Month, and Social Work Week. March 1st to 8th marks the one week a year we should take time to recognize the contributions and the overall profession of Social Work (although one week a year seems hardly fair).

Which would be all well and good, if anyone actually knew what a social worker really did.

Let me paint for you a picture.

I’m at a party, drink in hand, vaguely listening to the background noise of the last decade’s best soft-pop hits. It’s not really my scene: this is a group of my friend’s acquaintances, and I’m the tag along. I don’t belong to this particular crowd in any real way aside from association and that desperate urge to still DO something on a Saturday night even if I’d prefer a movie and a housecoat over flat beer and Justin Bieber. I’m trying to blend seamlessly into the beige wall with my all-too-beige personality, when I’m pulled into the conversation around me by that most inane of ice-breakers.

“So what do you do?”

I’m cringing before the conversation has even begun.

“Oh, I’m a social worker.”

The odds are high I’ll get one of two reactions. The first is that I’ll receive a blank stare, and a vague sort of hum of recognition, but there will be a slight pleating of my companion’s eyebrows as if the person is trying quite hard to come up with the definition for the term, failing and not wanting to admit it.

Or they’ll think I work in Child Protection.

“Like CAS? You work with kids?” they’ll ask, not seeming overall happy with that prospect. ‘Baby snatcher’ may be the first automatic thought that comes up for them.

I’ll laugh politely (why do we do that?) and waggle my hand back and forth in a gesture that screams ‘Not in the least bit but I’m trying to be kind and pretend your answer is close’.

“Well, not really – I mean a lot of social workers can be in child protection, but not all of us. I’m a counselor,” I’ll explain, awkward smile in place, hand sweaty with condensation that smells like Bud Light.

“Like… a school counselor?” More confusion. My smile is less awkward and more pained by now.

“No. Like a therapist. I’m a therapist.”

“Oh!” They exclaim, clearly shocked. “I didn’t know you did that.”

I’m stuck trying to parse out if they meant that as in they didn’t think I myself was offering therapy, or if they were using the ‘Royal You’.

While I’m weakly laughing my way through a response, someone else leans into the conversation and the crowd suddenly goes from hesitant to excited.

“Wow! I bet THAT’S got to be a hard job, listening to people’s problems all day!”

Here, I have to bite my lip, because a flame always lights in my chest at the reducing what I do, and what my clients do, as just ‘listening to people’s problems’. Therapy is never just listening and nodding; it’s never just someone complaining. These are people bravely confronting their worst moments, trusting in a total stranger, and I’m holding that space reverently in my hands and trying my hardest to offer them hope.

“Yea, it can be tough,” I deflect, but grin a bit. “But it’s also very rewarding.”

“Man, I could NEVER do that job,” someone will pipe in, eyes rolling exaggeratedly. “I once knew this guy-“

And here it just devolves into a group sharing session around various mental illnesses people have been collecting anecdotes about for most of their lives – and I go back to quietly trying to be absorbed into the crown modeling to avoid any further awkward chat.

This experience is awkward to me for two reasons. I’m very passionate about my work, but I have a bit of an all-or-nothing personality when it comes to my interests. Meaning when I like something, I like it a lot, and I devote a significant amount of time learning and researching everything about it. As a general rule I try to avoid overwhelming others with my enthusiasm for certain topics. No one wants to be verbally assaulted by my nearly manic obsession with neuroscience and the evolution of hemispheric dominance theory. I am a mental health literature fan girl. So I make an effort not to go too deep into my reflections on the work I do, otherwise the dam may open and I’ll be getting eerily intense about recent adjustments to the DSM-V.

The other reason I find this experience awkward is due to how little the general public seems to understand the profession of Social Work, what we do and how we differ from other mental health professionals. It’s a trying task to feel as though you need to give a definition of your career every time you state your role. Or having to dispel a few myths at the same time. 

So what better way to end this Social Work Week than with a bit of a history lesson and education into this profession I proudly support. 

Social Work has been around more officially since the 19th Century, although it likely has a stronger root system that drifts back into the 17th Century as well. Social work as we know it had its humble beginnings in individual support, social administration and social reform. If you want a good history lesson, look into the Charity Organization Society, spearheaded by Helen Bosanquet. You could consider her the grandmother of all clinical social work, but she was really just the start of the profession responding to the needs of the most vulnerable with personal casework and support, and this approach was fine-tuned through the Great Depression and beyond. It essentially started with the need to find solutions mentally, socially and financially for those struggling the most, and charitable organizations began to flourish and spread throughout the world as the needs of this population only grew. Financial supports, personal care, and even institutionalization began to be seen as first line defenses and from this, Social Work began to bloom and was only fully realized further into the 1930’s when changing times required a more disciplined approach to the work we do. 

Social work is a practice-based profession and an academic discipline that promotes social change and development, social cohesion, and the empowerment and liberation of people. Principles of social justice, human rights, collective responsibility and respect for diversities are central to social work.  Underpinned by theories of social work, social sciences, humanities and indigenous knowledge, social work engages people and structures to address life challenges and enhance wellbeing. 
International Federation of Social Worker

Not that you need to learn how to read a Wikipedia page, as I’m sure you can find all this information yourself, but it’s important to note how social work has evolved from such a time that almost all those employed in this profession used to exclusively work within one sector: charity and the treatment of the poor. But as our work expanded, the parameters of our roles did too. We began to see poverty as a social issue, as a determinant of health, noticing the connections of wellness and access and inter-generational impacts. Social work went beyond charity, to the desire to see mass change, to fighting and advocating for reform and macro-level shifts in policy. Social workers began to need a knowledge in medicine, science, law, psychology and sociology. We needed to understand the law-makers and educate ourselves in not just the front line work, but in drafting bills and presenting change for society as a whole. Our vision expanded to seeing the importance of not just justice systems, but family systems, the role of community and inclusion on how others coped with their lives. What someone ate, where they slept, who they spoke to, the laws surrounding them, when they were born, the chemicals in their blood and the resources available to them were all contributing to people’s overall functioning, and social workers needed to keep up in order to serve our clients best.

This expansion of our field of knowledge and expertise is perhaps the reason it is so hard to pin down exactly what a social worker does; because we tend to do it all! 

Where can you find Social Workers?

Social workers can be found in hospitals, private clinics, medical practices, schools, day programs, social action organizations, addictions treatment facilities, government offices, Family Health Teams, and children’s service agencies. To name a few. 

Some of use work in policy, focused on social reform and advocacy, rarely working face to face with clients but making changes to the laws and statutes that influence them. Others use resource linking as their primary skill, working with clients of many backgrounds to support their transition and system navigation; we could be assisting someone manage the paperwork for financial assistance, making vocational assessments to support their employment, or acting as a liaison for new-comers and those struggling with community connection. Or we could be working hands-on with our clients, offering face to face counseling, psycho-education, case work or personal support. 

We can work in teams with other social workers, or as part of a multidisciplinary team. At a Women’s House offering crisis support to victims of domestic violence, as part of a private Memory Clinic team assisting with  lifestyle changes and education on the progression of dementia, as Family Support Workers for a youth program for those with disabilities offering home visits to address behavioural change. We might have our own private practice, charging a fee for couple’s counseling, or family mediation. Or be part of a not-for-profit, facilitating a group for those struggling with addictions. 

Some of us work with kids, using sand-trays and Play-Doh, and playing endless rounds of Uno all in order to build that rapport so an 11 year old feels safe in telling us what’s happening at home. Or we could work with seniors in a retirement home, helping to encourage the benefits of a day-program for stimulation and social activity.

Are you getting the hint yet? 

We are everywhere, and there is no singular way to practice social work aside from abiding by the intrinsic values we hold most dear: we strive to always respect the dignity and inherent worth of every individual, to support diversity, to do no harm to those who cross our path, and to uphold the values of social justice and human rights. 

It is our job to see beyond the person in front of us, to see everything that makes up their unique experience, and always strive to support their overall well being. 

What kind of education does a Social Worker have?

Many of use begin with a Bachelors of Social Work or an associated degree (like psychology, or sociology) and can move forward to a Masters or even a Doctorate. Many don’t stop there – they seek out additional training, or certifications in specific areas of interest like certain forms of therapy, or specializations such as family therapy, or art therapy. You’ll often see many social workers with a few letters at the end of their name, denoting their education level as well as the term RSW (Registered Social Worker). 

Yes, that’s right. We must pay to use this term and are subsequently listed with our regulatory college so clients can easily see our status as a practitioner. Here in Ontario, we must be registered with the Ontario College of Social Workers and Social Service Workers (OCSWSSW) and they receive a lovely cheque from me once a year for the right to add that title to my business cards. 

Why be registered? It’s for your protection. The college acts as advocate for proper ethics and will enact disciplinary action if needed. If you ever feel as though someone claiming to be a social worker is somehow abusing this title, or committing something ethically wrong or against our code of conduct, you have the right and the ability to report them. They could be suspended from practicing social work, or fined. You can cross reference our registration numbers, find out any past charges against us, and make the most informed choice for your own care.

All I get is a little card for my wallet and a lighter bank account. But you get the piece of mind knowing that your counselor is fulfilling all their obligations to ensure you have the right to an informed and safe choice.

How is a Social Worker different from a Psychologist, or a Psychiatrist?

I get this question an awful lot, especially as my particular role is individual therapy. 

I sit with people with a clipboard in hand, listen to their stories and offer my insight and suggestions. I’m a leather chaise couch and a pipe away from the classic mental image we have when we think of a therapist. But many people seem to associate that role with Psychiatry. 

So here’s the best way to explain it:

A Psychiatrist is a medical doctor, typically trained specifically in the diagnosis and treatment of mental health disorders. Think Frasier Crane. These are the folks you need a doctor’s referral to see, who will give you a full diagnosis and likely medication. You might return to them a few times a year – months in between – to adjust prescriptions, but your follow up is not likely going to involve a deep discussion of how you’re feeling and what new changes have happened in your life. Although some can and do offer therapeutic treatment, most are too swamped with lengthy waitlists to be able to see patients consistently, and they typically refer out to the community resources – although they may give a good suggestion of the type of therapy they think will be most helpful. 

They’re also covered through OHIP, so you won’t see a bill for their services in Ontario at least.

A Psychologist is not a medical doctor, but has a Masters and most often a PhD in Psychology. They can still diagnose the same as a Psychiatrist, but they lack the medical degree in order to prescribe medication. Robin Williams’ character in Good Will Hunting was a psychologist. This is your classic impression when people think of a therapist – trained to look at the way thoughts and behaviours influence a person’s well being, psychologists will offer in-depth interpretations of your past and current coping, and help you to manage your feelings and even process things you’ve struggled with most of your life. They will work with you on making a treatment plan and follow up more often than a psychiatrist because talk therapy is all part of the role. But this may cost you. You will either need to use your benefits or pay out of pocket to see most psychologists. 

Registered Social Workers can’t prescribe medication, nor can we make a diagnosis. But what we lack in those capacities we can make up for in offering therapy at a lower, or sometimes no cost, while still addressing thoughts, feelings and behaviours. We will often take assessments from psychiatrist or psychologists into consideration when making treatment plans, and might even confer with your psychiatrist and family doctor about your medications (if you sign consent). 

And just to be confusing, there’s also Psychotherapists, who like a social worker cannot prescribe medication or make a diagnosis, but are registered with the College of Psychotherapists of Ontario instead of the OCSWSSW. They typically have a Masters’ or equivalent degree in counselling or psychotherapy and offer treatment for fee to those who need it. 

Confused yet? I hope not. Relax. It’s not so bad. Most of the time, if you are needing support, asking anyone in a mental health role can direct you where you need to go. Starting at your family physician’s office, or even a quick Google search for counseling in your area will likely give you an idea of some of your options.

At its core, social work is about you. We are a band of professionals in a variety of different roles, but you and your wellness are always our first priority. We are here to advocate for you on the larger world stage, or even just in the same room with you. We aim to give you the tools you need to survive and thrive, to see yourself and others in a different light and reach your best potential. 

Social Work Week isn’t just about raising awareness for this profession, or even thanking those who do this work – although that goes without saying. It’s also about reminding you that there is an entire generation of social workers who have been training their whole career to help, and we are here for you in any role you find us in. I hope that you can take the time to do your own research and know that we are here for you, and ready and willing to do the work, just as we have been doing for decades. 

So thank you to the social workers in my own life, and all the ones who have inspired me to choose this profession, and to stay with it. And hopefully you have a social worker or two in your life who have been there when you’ve needed them too.

Happy Social Work Week.

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