October 28, 2025 • 37 mins
When your license is your livelihood, clarity is everything. We sit down with Darrel Spinks, Executive Director of the Texas Behavioral Health Executive Council (BHEC), to demystify what social workers in Texas can do at each level and how to avoid the traps that put good practitioners at risk. Instead of a rigid ladder, Darrel shares the “bullseye” view of licensure: LBSWs at the core with focused case management and assessments, LMSWs expanding to higher complexity, and LCSWs adding full clinical services. That shift in mindset helps you explain your role, protect your scope, and deliver care with confidence.
We get candid about the most common complaints and why they happen. Independent practice recognition, supervision, and advertising are frequent sources of confusion, especially for LMSWs delivering clinical services under contract. The most preventable violation, practicing without active authority, still leads the pack, ahead of missed renewals and assumptions about pending applications. Darrel explains how these lapses can undermine employers and clients, and he offers practical habits that keep your status clean: verify your license, align your duties with your scope, use precise titles, and document supervision. We also cover familiar hazards like boundary issues, standard-of-care gaps, and shaky ESA letters that skip required assessments.
Ethics shape the profession, but Texas rules govern your practice. We contrast the NASW Code of Ethics with state statutes and board rules, highlight key differences that matter for confidentiality and duty limits, and point you to tools that make compliance easier: a searchable rulebook, proposed rule trackers, and BHEC’s Leadership Listening Hour for direct Q&A. We touch on hot-button topics like licensing exams, workforce equity, and criminal history bars under Chapter 108, and explain where boards can act and where change requires lawmakers. The takeaway is practical and empowering: solve the client’s problem in front of you, stay current on the rules, ask questions early, and carry malpractice coverage that includes administrative defense.
If this conversation helped sharpen your practice, follow the show, share it with a colleague, and leave a review so more Texas social workers can find it! Got a question you want us to put to BHEC leadership next time? Send it our way.
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Visit the resources mentioned in this episode!
BHEC PDF Rulebooks:
https://bhec.texas.gov/statues-and-rules/
Proposed Rule Changes open for public comment:
https://bhec.texas.gov/proposed-rule-changes-and-the-rulemaking-process/proposed-rule-changes-open-for-public-comment/
Texas Social Worker FAQ's:
https://bhec.texas.gov/texas-state-board-of-social-worker-examiners/sw-faqs/
Leadership Listening Hour with BHEC:
https://bhec.texas.gov/agency-news/#:~:text=Upcoming%20Leadership%20Listening%20Hour%20Webinar
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Get more information, details and resources on Know Your Regulator - https://www.belolaw.com/know-your-regulator
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_03 (00:00):
This podcast is for educational purposes only, does
not constitute legal advice, anddoes not create an
attorney-client relationship.
If you need legal assistanceabout a legal problem, contact
an attorney.
SPEAKER_00 (00:12):
Welcome back to Know Your Regulator, the podcast that
inspires you to engage.
I'm your host, Simone Murfrey.
In today's episode, we'reputting a spotlight on one of
the most vital roles in thebehavioral health ecosystem:
licensed social workers inTexas.
Joining me is a returning guest.
We've got Daryl Spinks,Executive Director for the
Behavioral Health ExecutiveCouncil, better known as BHEC.
(00:36):
We're going to be diving intowhat social workers can and
can't do under their license,unpack some of the ethical lines
that they've got to navigate,and we're going to talk through
some of the real worldchallenges that they're facing
today.
So whether you're a seasonedsocial worker or you are new to
the profession, this episode isjust for you.
Well, let's kick things off thescope of practice.
(00:57):
Daryl, for social workers inTexas, especially for those at
different licensure levels, Iknow there's a few different
types, and correct me if I'mwrong on any of these.
We've got the LBSW, which is thebachelor's in social work, the
LMSW, which is the master's insocial work, and then the LCSW,
the licensed clinical socialworker.
(01:18):
So for each of these differentlevels of licensure, what does
the law actually allow them todo?
SPEAKER_04 (01:25):
Social work is one of those professions.
How all the mental healthprofessions, there's just a
significant amount of overlapbetween all of them.
So for example, an LCSW can doeverything that an LBSW and an
(01:49):
MSW can do.
And one of the things I learnedearly on coming on as the ED for
BHEC was social work does notview their licensure in a
hierarchical category.
In other words, I think probablymost people would think of it as
LBSW, move up to MSW, then youmove up to clinical social work.
They don't view it that way.
The better way to view it kindof from the social worker
(02:11):
perspective is it like abullseye.
So you're the LBSW, you're inthe middle, you kind of have the
most confined or restrictedscope.
And then you move outward,concentric rings outwards, until
you get to the LCSW with thegreatest scope of practice.
So what does the LBSW do?
Mainly case management, casemanagement and assessments.
(02:36):
And they they will do somethings like locating resources,
negotiating, and advocating forthe clients, helping folks
navigate very complex,bureaucratic systems, community
organization, teaching, somesome professional development,
that kind of thing.
The real distinction betweenlike the LBSW scope and the MSW
(02:57):
scope is the complexity and thelevel at which you operate on
each one of those tasks.
So, you know, you might beoperating in much less complex
or much more simple systems asan LBSW, whereas an MSW can
handle a much more difficultproblem or issue that the client
poses or presents.
So that's where the scopedifferences really come into
play.
It's more of a um, it's more ofa competency towards complexity,
(03:21):
is kind of the way I look at itwhen you're trying to
distinguish the scopes betweenLBSW and MSW.
Now, clinical folks, like I say,they can do everything the LBSW
and MSW can do, but they theycan do they can deliver the
traditional clinical servicesthat you would think of that a
psychologist or a counselor oran MFT can do as well.
(03:41):
So they they they are kind of uhwhat would you say, a
renaissance man?
They can kind of do it all.
SPEAKER_00 (03:48):
Gotcha, yeah.
Jack of all traits, right?
SPEAKER_04 (03:50):
Yeah, Jack of all traits.
SPEAKER_00 (03:51):
It's like they are the master of all of them as
well.
They are, yeah.
SPEAKER_04 (03:54):
Yeah, um they're they're very good at it.
So uh they they have to theyhave to be able to know quite a
bit.
And I will say that that exam isprobably it's regarded as one of
the more difficult exams out ofall the exams that we
administer, is that LCSW exam?
Yeah, it's a it's a tough one,but it has to be.
SPEAKER_00 (04:11):
So yeah, we'll talk about that competency for that
you know complexity for sure.
And I love that you outlined itum as a bullseye because yes, I
mean, even coming into here, Iwas under the impression that
it's sort of a um a hierarchy,and that's so um I can see it
now, the way that you'vedisplayed it.
(04:31):
So good to know that it's reallyjust the um that you're able to
handle more complex problems oror the complexities of the same
situations.
So really interesting.
SPEAKER_04 (04:44):
They're also one of the only profess well, they are
the only profession we have thatthat has a bachelor's level
licensure.
But they're also unique in thatum the LBSWs can actually have
independent practice authorityand can be supervisors.
They can achieve both of thosethings at the bachelor's level,
which is very unique to socialwork.
(05:04):
Uh that doesn't exist in any ofthe other professions.
SPEAKER_00 (05:07):
Well, that's great.
I mean, those those are allthings that really encourage and
and further the profession andhelp um, you know, peers
interact and be able to do dotheir best.
So that's awesome.
When it comes to scope, there'syou know, got to be some types
of common misunderstandings orsome oversteps.
Can you talk to us about whatthose most common
(05:27):
misunderstandings are and andwhether or not they're
intentional or not?
I would like to believe thatsocial workers, you know, have
got um best ethics in mind, bestmorals in mind, but um, you
know, are these intentional,unintentional mistakes or are
some social workers knowinglycrossing the line?
SPEAKER_04 (05:46):
Yeah, um, of course, you know, all the professions
have some have some bad actorsjust inherently in them.
And then some but 90, you know,I would say the vast majority of
disciplinary orders we enteredare, you know, just one time.
They're not going to be frequentflyers.
We'll never see them again.
They kind of learned theirlesson, they've shaped up,
they've shipped out, they'rethey're off and they're doing
(06:07):
the right thing now from thatpoint forward.
SPEAKER_02 (06:10):
That's good.
SPEAKER_04 (06:10):
Um and on the whole, just the professions that we
regulate, including social work,are very well behaved.
Um, particular that isparticularly true for LBSWs and
MSWs, in that one of the thingsthat kind of helps benefit them
to avoid missteps and problemsis that they tend to work in uh
interdisciplinary teams orenvironments that have just
(06:31):
natural checks and balances tomake sure that nothing bad or
you know or nefarious or justmistakes are made.
We see most of the problems, thedisciplinary problems on the
clinical side, the clinicalpractitioners, because they're
they're working on theone-on-one kind of on one-on-one
with the patient or the client.
And it's it's occurring withinkind of the veil or the cone of
silence and secrecy that it thatattaches to any kind of
(06:52):
therapeutic relationship.
Out of the problems we do seefor LBSWs and MSWs, it tends to
be things like um confusioneither from colleagues or from
the public about whether theyare practicing independently.
Um and I, you know, I will Iwill tell you, if if you read
the rules, you would be like,yeah, that is that is not that's
(07:14):
about as clear as mud uh intrying to understand, you know,
when can a LBSW practiceindependent?
What is considered independentpractice?
Is it independent practice ifyou're working from home, uh yet
your employer is say universitymethodist system, hospital
system?
You know, is that can it can geta little tricky there?
And so we do see some confusionfrom the public and from
(07:38):
colleagues who will report uhanother colleague for practicing
independently without IPR, theindependent practice
recognition.
With, you know, they'll reportan LBSW for practicing without
the IPR.
And then of course we conductthe investigation, come to find
out, no, they're really notpracticing independently.
They haven't hung out a shingle,they're doing everything right.
(07:58):
They probably should have been alittle bit more clear on how
they uh on the outgoingpaperwork or anything, all the
public-facing paperwork or maybesome advertising uh should have
been a little bit more clear,but they they technically didn't
violate the rules, and theycertainly didn't intend to.
So we we you most of those endup being dismissed.
Um, we also see you know some uhsome advertising issues there
(08:22):
around that.
Where it gets a little moreserious is when you start seeing
claims or complaints come in ofLBSWs or MSWs performing
clinical services without uhwell, obviously they can't
because they're not an LCSW, butLMSWs could as long as they are
practicing under a supervisioncontract uh where they are
(08:44):
trying to accrue the necessaryhours to become an LCSW, then an
LMSW actually can provideclinical services as long as
they're under supervision.
But we we see some there wherefolks are like, eh, you kind of
sound like you're providingclinical services.
Um, and that's going to beoutside your scope as an LBSW or
an MSW.
Those can be a little trickybecause uh just somebody from
(09:07):
the outside looking in, it couldvery well look like a scope
problem when in fact then maybethey are operating under a
supervision contract.
You just from the outsidelooking in, you don't know it.
And the only way to figure thatout is is you file a complaint
and all of a sudden now it'sinvoked the machinery of
government, and everybody'severybody gets mad at one
(09:28):
another for obvious reasons.
And I can't even say it's youknow, I wouldn't be mad either.
But that's something that wehave to deal with.
It doesn't happen very oftenbecause one of the things that's
that's pretty unique about thisprofession is I think it gets
drilled in their heads uh intheir training programs that
look, when you guys see aproblem with a colleague, you
(09:49):
need to go talk to thatcolleague and visit with them
and find out for yourself whatis going on.
In other words, go to theprimary source first before you
start lobbing accusations.
SPEAKER_02 (09:59):
Yeah.
SPEAKER_04 (10:00):
Um, and and that is something I do try to encourage
all licensees, even just outsideof the social work as well.
Make sure you go talk to yourcolleague or whoever it is that
you think there may be aviolation.
Now, obviously, if they'resaying I'm sleep, you know,
sleeping with a patient orsomething, you don't talk to
them about that.
Just file the complaint, we'lltake it from there.
But for this other stuff,sometimes it's better to figure
(10:20):
out what's actually going onbefore you start lobbing
grenades.
I'll tell you though, thebiggest problem we have uh from
social work, and it's it's moreprevalent in social work than it
is the other professions, andthat is practicing without an
active license or jumping thegun on licensure and practicing.
And I don't know why that is.
I can't figure out why thisparticular profession seems to
(10:43):
be worse about forgetting torenew or check that they have an
active license or jumping thegun on licensure and just going
ahead and starting startdelivering social work services
before we've actually issued youthe license that says you're
authorized to do so.
SPEAKER_00 (10:59):
Yeah, not a good way to start your career.
SPEAKER_04 (11:01):
It's not.
You get off on a bad foot onyour career or you you you
stumble in the middle of it.
Now, you know, is it a deathpenalty?
No.
Uh, but you still you don't wantthat that ding on your record.
SPEAKER_02 (11:14):
Right.
SPEAKER_04 (11:14):
Um and it's a silly thing to avoid.
I mean, it's it's a silly thingto get hung up on.
It ought to be, as aprofessional, it ought to be
something you check before youand you know for sure.
SPEAKER_02 (11:24):
Right.
SPEAKER_04 (11:25):
Uh before you start, you know, pulling the trigger on
services.
So what you know, kind of myadvice to folks there is is hey,
you're a professional, payattention.
Uh, make sure that your licenseis good to go, that it's active,
uh, and you're in good standingbefore you start delivering
services.
What and that's true whetheryou're a newbie and you've
applied for initial licensure,or whether you have just renewed
(11:48):
your license or you think you'verenewed your license, check our
system.
It's free, it's easy.
Punch in your license number oryour name, and it will tell you
if you're good to go.
And then you know.
So, uh, because that thing thatthing updates automatically.
Uh, so it's there's no notreally any lag there.
There's really no excuse forthat.
SPEAKER_00 (12:08):
So very solid advice.
Yeah, no, it's I mean, well, itsounds like generally social
workers are really well behaved,you know.
It's like generally that they uhyou're not having a huge
problem, um, and that theproblems that you are or that
they are experiencing are notnefarious, they're not um, you
(12:28):
know, with malice.
It's simply, you know, maybejust not understanding the rules
and regulations or what'sexpected or what's coming next,
or um, like you said, that yourlicense expired last week and
you've got to go renew it.
And you've you've been providingservices for the past week to
patients with an inactivelicense.
Yeah.
SPEAKER_04 (12:48):
Exactly.
And I mean, you know, one of thethings I I don't think people
think about, I learned this fromwatching, I learned it, I
learned what I'm about to sayfrom watching uh folks in the
school psychology arena learn itkind of the hard way and the
consequences that befell them intheir districts.
One of the things you got tothink about is it's not just
(13:08):
about you and and me or theagency, whenever you practice
without a license or withoutauthority, whoever your employer
is, whoever was relying uponwhatever services that you
rendered without legal authorityto do so, you have now
jeopardized or underminedeverything that they then built
on top of your opinions or thework that you did.
It may completely invalidateeverything uh that they have
(13:31):
done in reliance upon whateverwork you did.
And so, and a lot of what socialworkers do is foundational.
I mean, you know, they they arehelping people with services to
repair problems or verydifficult times in their lives,
or they're, you know, counselingthem through very difficult
times.
All of this stuff isfoundational work.
And if you got cracks or you youthat foundation crumbles,
(13:53):
everything on top of it, youknow, is now jeopardized.
So that's why I say it's reallycritical that you understand the
status of your license beforeyou you haul off and start you
know giving advice andcounseling and providing
education and all the servicesthat you do as a social worker.
Just make sure you're good togo.
SPEAKER_00 (14:10):
Absolutely.
And you mentioned you don't knowwhy you're seeing that uptick.
You know, ethics are at the coreof social workers.
I wonder if they're feeling apull, a calling, you know, to go
ahead and start the professionor go and help.
I know that there's so manypeople who um service these
vulnerable populations that umjust want to help, you know.
(14:35):
I unfortunately um it's notalways that black and white.
You can't, like you said, justgo ahead and start practicing
without a license.
What are some maybe of the mostcommon ethical pitfalls that you
see that are landing somelicensees in trouble?
SPEAKER_04 (14:52):
Well, I you know, you you touched on something
there that it's it's a personalI have a personal theory on why
I think people probably we seemore practicing without
authorization.
I'll just call it that for kindof a broad generalization.
Any if you spend any time aroundsocial workers, you will hear
them use the phrase, well, ourethical code says this, or our
(15:13):
ethical code demands this.
And they they you know, theyrefer to it heavily and often.
And that's because it's it's oneof the it's one of the core
things that they are taught fromuh in their training programs.
They are not taught from youknow the Texas rules or
regulations and statutes.
They're you know, there will besome, but it's certainly not the
(15:35):
the um the ethical guidepoststhey use to kind of shape their
views of the profession and thedelivery of services within the
training program.
That that's what they're usingthose ethical codes for.
And those are not statepromulgated.
That's not something the stategovernment, the federal
government, or anybodypromulgates.
It comes from like the NationalAssociation of Social Workers,
the NASW ethical code.
(15:57):
And so part of the problem withthat is um while it's good in
that it instills kind of theguidepost for what's expected
for practice within theprofession, um, where it where
it kind of I think falls shortand where the training programs
fall short a bit here and causethis kind of a problem is they
don't really talk to you aboutthe practical implications of
(16:18):
this is all great, but this isnot actually what gives you the
authority to practice in Texas,Rhode Island, Maryland,
wherever.
It's actually that state licensethat does it.
That is what gives you authorityto practice in Texas.
And it is also those stateregulations, you know, for which
you need to comply and staywithin, because our regulations
may differ from those nationalassociation standards or ethical
(16:42):
codes.
This is just what I think afterwatching this stuff for five or
six years now.
I think they get it and they'relike, okay, I'm ready to go.
I know what I have to do andwhat I need to do, and I know
what needs to be done.
And they get so excited, is likejust like you said, they get so
excited to help folks, they kindof forget to check the most
basic things about do I have mylicense?
Um, what are the confidentialityrequirements for Texas?
(17:05):
Are they different fromCalifornia where I was trained
in the CSWE program?
Because they are different.
Uh there are some differencesthere.
California is a Terasoft state.
We are not.
That can get you in big, bigtrouble if you don't know that
difference.
Um and it that it would notreally just us, that the the
California legislature and theTexas legislature view those
(17:26):
things differently, and theyhave placed in they've put in
place very different statutesgoverning that.
So um it's just you gotta knowthose things, and you're not
going to know that if you onlylearn from or operate from the
ethical code.
So that's my theory on it, isthey are trained so heavily on
it, they kind of forget to focuson oh, I need the license, and
(17:47):
when these regulations alsogovern are actually the primary
governing uh codes of governancethat I need to follow.
And so I think they just kind ofget out over their skis on that
sometimes, and it it leads tothese problems that we're seeing
here with you know practicingwithout authority.
Now, as far as kind of thenature of like what are some
(18:07):
ethical uh violations or issuesthat we see.
Um, you know, I I looked thethis morning before we got on
here, I kind of pulled back,went back through a couple of
board meetings or councilmeetings in the past just to
see.
Fourteen out of 15 of the onesfrom our meeting last week or
week before last were practicingwithout authority.
(18:29):
Either you didn't have alicense.
So the other one was somebodyhad issued an uh emotional
support animal letter uh withoutconducting enough um evaluations
and assessments.
They just kind of just kind ofshot from the hip and issued the
letter.
You can't do that on that kindof stuff.
And then, you know, I went backa few more meetings, and a lot
(18:51):
of the stuff there is likeboundary issues.
Um and this is where social workreally kind of mirrors or
parallels the other professions.
They're not any worse, they'renot any better.
They they're just just likeeverybody else.
Um, they suffer from the samehuman fallacies as everybody
else, you know, not recognizingor enforcing boundaries between
clients uh and themselves.
(19:13):
Just to answer your questioninitially, what you asked me was
you know, standard of care isthe biggest, uh, the biggest
area of complaints that wereceive against social workers.
Um, the unprofessional conduct,and that would include like
boundary type issues, uh, that'sgoing to be our second biggest.
And then the sexual misconductis is another another area, but
(19:35):
then also just the theunlicensed activity is is
problematic as well.
So those are the big four insocial work.
Three of those are shared by theother professions as well, the
standard of care andprofessional conduct um and um
dual relationships.
SPEAKER_00 (19:52):
Yeah, I was gonna say we talked about it in our
last episode, the you know,boundaries, right?
And I think your piece of advicewas just don't, just don't even
engage in in that initial umseparate conversation, separate
from what you and your clienthave, that's your you know,
system that you have for yourbusiness, your client record
(20:14):
system.
Um, yeah, I think it's it's bigamongst all of the licensed
professions is um oversteppingthose boundaries and either
entering into some sort ofsexual misconduct, or you've got
this relationship with um apatient or a client.
And um, yeah, those just can soeasily be avoided.
(20:35):
It's such a bummer to see thatthey continue to exist and and
continue to spike up in number.
SPEAKER_04 (20:42):
Yeah.
It is the proverbial slipperyslope, um, which is a nasty
pool.
It's got a nasty landing at theend of it.
I'll tell you that.
SPEAKER_00 (20:52):
Yes, sir.
Yeah.
Well, Darrell, as executivedirector, you hear from
licensees, you hear from yourenforcement division at BHEC.
What kind of challenges aretoday's social workers bringing
to your attention?
SPEAKER_04 (21:09):
You know, this is one where it's it's um it's
interesting because we get a lotbecause of the way social
workers are trained, they arethere's a lot of advocacy
drilled into them because partof their part of their function
or their role is to go out andfight for their client, to get
them, you know, whatever kind ofservices or benefits are
available to them.
(21:29):
And they're they're dealing withfolks who really can't fight for
themselves most of the time orsimply don't know how to fight
within a very complex or largesystem.
And so they're kind of yourchampion.
Uh, they are your champion ifyou're that individual.
Um, and so they're they're wiredwith this advocacy mindset.
And so we'll see a lot of themreach out to us, come into
(21:50):
meetings and reach out to us,and and they want to talk about
like more socialjustice-oriented issues.
Unfortunately, a lot of that isbeyond the purview of a
regulatory agency.
Those are those are policydecisions or debates that really
need to be had uh under in thelegislative you know sphere, not
in the boardroom.
Right.
Uh I often tell like boardmembers in our training when I
(22:13):
do new board member training, isthere are a lot of problems in
this world.
And there are not many, though,that are really suited for
resolution in the boardroom.
Uh, most of the the ail theailment of society that you will
have a front row seat to as a asa as a board member are going to
be things that have to becorrected over in the
(22:34):
legislative sphere, not in theregulatory sphere.
Because we operate within a verynarrow set of guideposts that
the legislature gives us.
We are we are a verymission-focused, kind of a one,
you know, one one horse showhere.
SPEAKER_02 (22:47):
Right.
SPEAKER_04 (22:48):
Um, our job is to license mental health providers
and behavioral health providersand regulate them or police
them.
It is not to solve extraneousissues.
You know, they they want toadvocate, want us to take
actions or do things that arewell beyond our ability to do.
What I always like to tellpeople is is I understand that,
(23:09):
I understand where you're comingfrom on that advocacy, but uh
sometimes the best thing you cando rather than focus on the
macro is kind of look at themicro and use your skill set to
fix the problem that your clientis facing.
You can't always, you know,change the world or move heaven
and earth, but sometimes you cankind of fix the problem for that
particular client.
(23:30):
Yeah, you do that, you do thatenough, and in aggregate, you
can change the world.
Uh, but you can't do it reallyfrom a macro perspective as
easily uh through through us,anyways.
Let me back up.
No, there is one area where itinterfaces pretty well with us
where you can kind of do themacro, and that is like
workforce issues.
(23:50):
Um, if you're coming in andyou're saying, look, this
population or you know, thispopulation or this group of
people are being um adversely ordisproportionately impacted in
the licensing process.
And therefore, say there there'snot as many uh blacks or
Hispanics in the profession asthere are whites or Asians.
(24:13):
Well, that is definitelysomething we can look at to see,
well, is it our licensingprocesses um or is it our
licensing standards that we wepromulgate, not anything that's
in statute, but we havepromulgated by rule, is that
causing that disproportionality?
And if that's the case, then weabsolutely can take a look at
that.
And that can have much morewidespread systemic change.
(24:37):
Um, but for the most part, youknow, if you're if you're
arguing over, well, I don't evenknow if there should be an exam.
Well, that's not really anythingwe can answer because that's a
statutory requirement.
Right.
It's like, well, maybe thereshouldn't, but you're gonna have
to go convince, you know, 185members of the legislature to do
away with that, um, and not thenot the social work board or
BHEC.
(24:57):
You know, another area where weum kind of you you kind of get
into uh folks wanting to affectchange, and that is like the
licensing exam itself.
It's died down a little bitrecently, but in in I'd say
within the past 18 months to 24months, there was a lot of
consternation in the professionabout really, I think, beginning
(25:20):
to question that whether therewas a need for a licensing exam
altogether, because when youlook at the exam statistics, uh
there are certain demographicgroups that just do better on
the exam than others.
Uh and so it it becomes youknow, obviously it's it's a
question of well, why?
(25:40):
Uh can anybody explain why thatis?
And if you can't, then you knowwhy why are we keeping something
that has kind of adiscriminatory effect, if you
will.
Now, I don't I don't usediscriminatory in the kind of
the bad sense.
I mean, all licensing isdiscriminatory in it lets
competent folks in and it keepsincompetent folks out.
(26:01):
That's the whole purpose oflicensing.
There are going to be winners,there are going to be losers in
licensing.
That's just the way it is.
If you don't like that, then youneed to do away with licensing.
Uh, because there that's ourjob.
We're we're gonna we're gonnatell some people, you are not
cut out for this, you need to godo something else.
And I'm sorry that that decisioncomes after the fact that you
have gone probably through agraduate training program and
(26:22):
incurred a significant amount ofstudent debt.
That part stinks, I admit, butthat's the way this works.
Um, we don't know if you're cutout for it until you've actually
gone through the training togive you a shot to learn it all,
and then we have to test you.
And if you fail it, then toobad.
Uh but uh we we have a lot of,you know, we have a lot of folks
(26:44):
that that approach us with uhthose types of problems about
challenges of getting into theprofession because of the exam.
They can do everything else,they've passed all their
coursework, they've graduated,they've got the requisite
degrees, taken the jurisprudenceexam.
They've done everything we'veasked of them, except they can't
pass that national licensingexam.
Uh, and then it becomes verydifficult to explain to them
(27:06):
well, it's this one thing that'skeeping you out of the
profession, keeping you fromdoing what you need to do.
And oh, by the way, they canalways point to and go, and you
kind of need me because look atthe significant workforce
shortage that you've got.
And it's like I mean, there's apoint there.
SPEAKER_02 (27:23):
Yeah.
SPEAKER_04 (27:24):
Uh I mean, you can't you can't deny that.
So uh that's an issue.
Uh another example of I thinkwhere people um feel a little
challenged or frustratedsometimes with the ext the
current state of the law, is thelegislature sometimes makes
calls about who can be in aprofession and who cannot be
(27:45):
based upon criminal history.
And social work and psychologyare the only two professions.
Well, I say they're the only twoprofessions regulated by BHEC,
where the legislature has said,as a hardline rule, if you've
got a uh a certain type ofconviction that involves the um
violence or the threat ofviolence, you cannot be a social
(28:08):
worker.
You can't, excuse me, you cannotbe a psychologist.
And there's no there's no getsouts of it, there's no waivers,
no nothing, you know, oh you'vebeen clean for 30 years, so
we'll look the other way.
None of that.
It's just a lifetime ban.
And so that that is that isanother area.
In fact, where there's actuallya lawsuit pending against BHEC
(28:29):
right now over that very issue.
It's chapter 108 of theoccupations code.
Um, we we often refer to them as108 casualties because it's but
for that, you know, theyprobably would have been
qualified for licensure.
SPEAKER_00 (28:44):
Well, and you would think that um, you know, there
are certainly other um otherstate agencies who've got um who
recognize rehabilitation andkind of take that into account
with licensees or applying, youknow, for a license.
Um and you, you know, sometimesI I'd like to think that uh
(29:05):
someone who may have gonethrough something or had a bad
patch in say their teens ortheir early adulthood um may
have worked with a social workerthemselves and been really
inspired or worked with atherapist or a counselor.
Um and uh that is a bummer.
That's uh but also sorry thatyou guys are going through that
lawsuit.
I know that that's not a funtime, you know.
(29:29):
No, no.
Um well kind of on that sametune, how can social workers
protect themselves while they'reserving these very vulnerable
populations?
We've got um, you know, some insome social workers in group
settings, we've got some socialworkers with one on one.
How can they all um all licensesof social workers protect
(29:54):
themselves?
SPEAKER_04 (29:56):
The the very first and the simplest thing to do is
solve the solve the Clientproblem that's in front of you.
In other words, whatever problemis presented to you, help that
client solve their problem orget them out of whatever
situation they're in.
It's kind of hard for anybody tobe mad at you if you're helping
them.
SPEAKER_02 (30:14):
Right.
SPEAKER_04 (30:15):
And so where folks tend to get a little mad is if
they feel like maybe you're amean, if that if they feel like
they're a means to another end,if you're using them as some
sort of an argument or a pretextto make some other more global
uh macro argument for change,help that client, fix their
problem because then they can'tbe mad at you.
Second, stay up to date on therule changes.
(30:37):
I I know we've said I've, youknow, this is now the second
time I visited with y'all.
And I sound like a brokenrecord, I know, but for heaven's
sakes, folks, you got to readthe rules.
It's not enough to know the NASWethical code.
You have got to know the BHEXregulatory rules and your the
social work board rules.
You you just have to.
That's what actually gives youthe right to practice in Texas.
(30:58):
That's what actually governsyou.
If you get in trouble, I am notgoing to quote the NASW ethical
code in the complaint againstyou or prosecute you for
violation of that.
It just will not show upanywhere in the complaint.
You've got to know the rules,and we have tried to make it as
easy as possible.
We have a PDF rule book that youcan download and is searchable.
Uh yeah, you know, you cansearch on the Secretary of
(31:20):
State's administrative code tooif you'd like.
Uh, we tried in the PDF rulebook, you can see what rule
changes were actually made tothe rules up to I think a year
back.
It goes a year back.
In the very front of the book,you'll you'll see what rules
were changed.
And we also have a webpage wherewe we we put up for uh public
comment to solicit publiccomment, any kind of proposed
(31:41):
changes that are currentlypending.
So if you want to see what we'reworking on right now, like the
social work board uh and BHEGjust voted to propose a large
batch of changes to the socialwork rules.
Those will go up on our websitehere pretty soon.
We haven't we haven't gonethrough the regular the review
process with the governor'soffice on them yet, but as soon
as he clears us, we'll post themto the website and you can look
(32:04):
at it and you can see thechanges, strike throughs for
stuff we're pulling out,underlines for additions.
You'll be able to see what we'redoing.
Try to use those tools that wewe put out there for you to keep
track of the rule changes.
I know we I know we tend to do alot of rule changes.
Most of them are not substantivechanges to rules that actually
govern your practice, they'remore changes in process or
(32:26):
procedure within the agency,maybe say to the enforcement
process.
So the vast majority of you willnever even encounter the
enforcement process, thankgoodness.
So those changes really don'taffect y'all all that much.
Uh, but just do what you can tokeep track of that.
And then, you know, we do thingslike the leadership listening
hour, which is where myexecutive team, we go through
(32:48):
and we just hang out for an hourand a half or two hours and
answer any kind of question thatcomes through the door.
Uh, it's a webinar, so you cancome and go as you please.
Um you can ask anything you wantto unless it's a question about
a pending application or acomplaint, but we we answer a
whole host of things.
We have people get on there andum sometimes you're like, wow,
(33:11):
you you haven't read the rulesat all, I can tell.
Um, and then some get on thereand will almost admit a
violation.
We're not taking notes.
I mean, unless you get on thereand just admit that you have
slept with the patient, I'm nottaking notes as to who asked me
what kind of questions.
Um, we're not, you know, tryingto punish you.
I'm actually trying to keep thecar out of the ditch through all
(33:32):
these efforts because it'seasier to keep it out of the
ditch than to pull it out onceyou've driven it off in there.
SPEAKER_02 (33:37):
Less expensive too.
SPEAKER_04 (33:39):
Yes, yes.
And so, you know, we're reallynot, I really try not to be a
bad guy, my team and I.
We really don't want to be thebad guys.
We're trying to help you allout, but you got to use these
tools uh that we're giving you.
And so I can't make you usethem.
I can't make you read, but I'mjust trying to make it as easy
as possible.
And then lastly, uh what I wouldsay, and I know this sounds
(34:01):
strange coming from me, but havemalpractice insurance that that
would provide uh you know legalrepresentation if you do get in
trouble.
It's dirt cheap for you guys.
Um it's it's just a verypractical, simple thing to do.
It's cheap.
And believe me, you will youwill get out on your knees and
thank the heavens above if youever do need it.
(34:24):
Uh, because I'm just telling youright now, people can file a
complaint on you for any reasonor no reason whatsoever.
And it's nice to be able to say,if you've got that kind of
coverage, to be able to say, youknow what, Berlino or or whoever
you choose, yeah, here's all myfiles, here's what happened.
You deal with BHEC, you dealwith the board and deal with
this.
And I'll be honest with you, asthe ED, we tend to like dealing
(34:47):
with the lawyers better than youknow the the respondent licensee
as well, because there's lessemotion, there's less hand
holding, it's just moretransactional in nature for us.
Because we're we're not we'renot out to get you on a
complaint.
Uh, it's just a transact, it'sjust something we have to do.
It's our job.
And so it's it's an unemotionalthing for us.
SPEAKER_02 (35:08):
Yeah.
SPEAKER_04 (35:08):
But it's not for you as the licensee.
I get that.
And so it it just helps ifyou've got that objective kind
of champion on your side who cango, look, let me structure your
response for you.
Let me point B heck to where theevidence is or isn't, and then
I'll negotiate with them and wecan try to work something out.
SPEAKER_02 (35:26):
Yeah.
SPEAKER_04 (35:27):
That's just a much easier and safer way.
And it ought to be lessstressful for you too, rather
than having to deal with usdirectly.
So that's why I say get yourmalpractice insurance, uh,
because it's cheap, or rat holemoney, whatever you want to do.
Uh you know, have a rainy dayfund, whatever your whatever
your pleasure is.
SPEAKER_00 (35:44):
I mean, either it's better to be safe than sorry in
that kind of situation.
The you don't want to be caughtwithout malpractice insurance
and then have to do sometimesthe insurance companies can put
you in contact with a with anattorney.
Sometimes they've got theirin-house attorneys.
Uh it it's uh definitely a goodstart instead of um totally by
(36:06):
yourself at square one.
Daryl, this has been a a greatepisode of super powerful
discussion, tons of takeawaysand insights for social workers
in Texas to um to listen and andknow that maybe there's some
things they need to go back anduh make sure they read the rules
on, or maybe there's some thatare confidently practicing.
(36:27):
They've got a little pep intheir step tomorrow because they
know they're doing the rightthing.
Uh, do you have any final wordsof wisdom for some of our social
workers who are listening?
SPEAKER_04 (36:37):
Y'all are doing good.
Your judgment, obviously, yourjudgment as a whole is good
because y'all are not getting introuble for the most part.
So you're already 90% there.
So pat yourself on the back forthat.
Now, how do we tighten up thatlast 10%?
It's pretty easy.
Check to make sure your licenseis valid, read your rule book
and ask questions.
SPEAKER_02 (36:58):
Yeah.
SPEAKER_04 (36:58):
And, you know, all those things I can I can try to
make the asking questions easy.
I can't make you read, but thatone's on you as a professional.
SPEAKER_00 (37:07):
So solid advice to our listeners.
Remember that your license isyour livelihood, know your
scope, stay grounded in yourethics, and use those tools that
your regulatory agency provides.
For more information, you cancheck out the links in our
description.
If you're ever unsure, reach outand consult a professional like
Mr.
Spinks just mentioned.
(37:28):
Thanks for joining us again onKnow Your Regulator.
And until next time, stayinspired and stay engaged with
your regulatory agency.
Know Your Regulator, the podcastthat inspires you to engage.
This podcast is for educational purposes only, does
not constitute legal advice, anddoes not create an
attorney-client relationship.
If you need legal assistanceabout a legal problem, contact
an attorney.
SPEAKER_00 (00:12):
Welcome back to Know Your Regulator, the podcast that
inspires you to engage.
I'm your host, Simone Murfrey.
In today's episode, we'reputting a spotlight on one of
the most vital roles in thebehavioral health ecosystem:
licensed social workers inTexas.
Joining me is a returning guest.
We've got Daryl Spinks,Executive Director for the
Behavioral Health ExecutiveCouncil, better known as BHEC.
(00:36):
We're going to be diving intowhat social workers can and
can't do under their license,unpack some of the ethical lines
that they've got to navigate,and we're going to talk through
some of the real worldchallenges that they're facing
today.
So whether you're a seasonedsocial worker or you are new to
the profession, this episode isjust for you.
Well, let's kick things off thescope of practice.
(00:57):
Daryl, for social workers inTexas, especially for those at
different licensure levels, Iknow there's a few different
types, and correct me if I'mwrong on any of these.
We've got the LBSW, which is thebachelor's in social work, the
LMSW, which is the master's insocial work, and then the LCSW,
the licensed clinical socialworker.
(01:18):
So for each of these differentlevels of licensure, what does
the law actually allow them todo?
SPEAKER_04 (01:25):
Social work is one of those professions.
How all the mental healthprofessions, there's just a
significant amount of overlapbetween all of them.
So for example, an LCSW can doeverything that an LBSW and an
(01:49):
MSW can do.
And one of the things I learnedearly on coming on as the ED for
BHEC was social work does notview their licensure in a
hierarchical category.
In other words, I think probablymost people would think of it as
LBSW, move up to MSW, then youmove up to clinical social work.
They don't view it that way.
The better way to view it kindof from the social worker
(02:11):
perspective is it like abullseye.
So you're the LBSW, you're inthe middle, you kind of have the
most confined or restrictedscope.
And then you move outward,concentric rings outwards, until
you get to the LCSW with thegreatest scope of practice.
So what does the LBSW do?
Mainly case management, casemanagement and assessments.
(02:36):
And they they will do somethings like locating resources,
negotiating, and advocating forthe clients, helping folks
navigate very complex,bureaucratic systems, community
organization, teaching, somesome professional development,
that kind of thing.
The real distinction betweenlike the LBSW scope and the MSW
(02:57):
scope is the complexity and thelevel at which you operate on
each one of those tasks.
So, you know, you might beoperating in much less complex
or much more simple systems asan LBSW, whereas an MSW can
handle a much more difficultproblem or issue that the client
poses or presents.
So that's where the scopedifferences really come into
play.
It's more of a um, it's more ofa competency towards complexity,
(03:21):
is kind of the way I look at itwhen you're trying to
distinguish the scopes betweenLBSW and MSW.
Now, clinical folks, like I say,they can do everything the LBSW
and MSW can do, but they theycan do they can deliver the
traditional clinical servicesthat you would think of that a
psychologist or a counselor oran MFT can do as well.
(03:41):
So they they they are kind of uhwhat would you say, a
renaissance man?
They can kind of do it all.
SPEAKER_00 (03:48):
Gotcha, yeah.
Jack of all traits, right?
SPEAKER_04 (03:50):
Yeah, Jack of all traits.
SPEAKER_00 (03:51):
It's like they are the master of all of them as
well.
They are, yeah.
SPEAKER_04 (03:54):
Yeah, um they're they're very good at it.
So uh they they have to theyhave to be able to know quite a
bit.
And I will say that that exam isprobably it's regarded as one of
the more difficult exams out ofall the exams that we
administer, is that LCSW exam?
Yeah, it's a it's a tough one,but it has to be.
SPEAKER_00 (04:11):
So yeah, we'll talk about that competency for that
you know complexity for sure.
And I love that you outlined itum as a bullseye because yes, I
mean, even coming into here, Iwas under the impression that
it's sort of a um a hierarchy,and that's so um I can see it
now, the way that you'vedisplayed it.
(04:31):
So good to know that it's reallyjust the um that you're able to
handle more complex problems oror the complexities of the same
situations.
So really interesting.
SPEAKER_04 (04:44):
They're also one of the only profess well, they are
the only profession we have thatthat has a bachelor's level
licensure.
But they're also unique in thatum the LBSWs can actually have
independent practice authorityand can be supervisors.
They can achieve both of thosethings at the bachelor's level,
which is very unique to socialwork.
(05:04):
Uh that doesn't exist in any ofthe other professions.
SPEAKER_00 (05:07):
Well, that's great.
I mean, those those are allthings that really encourage and
and further the profession andhelp um, you know, peers
interact and be able to do dotheir best.
So that's awesome.
When it comes to scope, there'syou know, got to be some types
of common misunderstandings orsome oversteps.
Can you talk to us about whatthose most common
(05:27):
misunderstandings are and andwhether or not they're
intentional or not?
I would like to believe thatsocial workers, you know, have
got um best ethics in mind, bestmorals in mind, but um, you
know, are these intentional,unintentional mistakes or are
some social workers knowinglycrossing the line?
SPEAKER_04 (05:46):
Yeah, um, of course, you know, all the professions
have some have some bad actorsjust inherently in them.
And then some but 90, you know,I would say the vast majority of
disciplinary orders we enteredare, you know, just one time.
They're not going to be frequentflyers.
We'll never see them again.
They kind of learned theirlesson, they've shaped up,
they've shipped out, they'rethey're off and they're doing
(06:07):
the right thing now from thatpoint forward.
SPEAKER_02 (06:10):
That's good.
SPEAKER_04 (06:10):
Um and on the whole, just the professions that we
regulate, including social work,are very well behaved.
Um, particular that isparticularly true for LBSWs and
MSWs, in that one of the thingsthat kind of helps benefit them
to avoid missteps and problemsis that they tend to work in uh
interdisciplinary teams orenvironments that have just
(06:31):
natural checks and balances tomake sure that nothing bad or
you know or nefarious or justmistakes are made.
We see most of the problems, thedisciplinary problems on the
clinical side, the clinicalpractitioners, because they're
they're working on theone-on-one kind of on one-on-one
with the patient or the client.
And it's it's occurring withinkind of the veil or the cone of
silence and secrecy that it thatattaches to any kind of
(06:52):
therapeutic relationship.
Out of the problems we do seefor LBSWs and MSWs, it tends to
be things like um confusioneither from colleagues or from
the public about whether theyare practicing independently.
Um and I, you know, I will Iwill tell you, if if you read
the rules, you would be like,yeah, that is that is not that's
(07:14):
about as clear as mud uh intrying to understand, you know,
when can a LBSW practiceindependent?
What is considered independentpractice?
Is it independent practice ifyou're working from home, uh yet
your employer is say universitymethodist system, hospital
system?
You know, is that can it can geta little tricky there?
And so we do see some confusionfrom the public and from
(07:38):
colleagues who will report uhanother colleague for practicing
independently without IPR, theindependent practice
recognition.
With, you know, they'll reportan LBSW for practicing without
the IPR.
And then of course we conductthe investigation, come to find
out, no, they're really notpracticing independently.
They haven't hung out a shingle,they're doing everything right.
(07:58):
They probably should have been alittle bit more clear on how
they uh on the outgoingpaperwork or anything, all the
public-facing paperwork or maybesome advertising uh should have
been a little bit more clear,but they they technically didn't
violate the rules, and theycertainly didn't intend to.
So we we you most of those endup being dismissed.
Um, we also see you know some uhsome advertising issues there
(08:22):
around that.
Where it gets a little moreserious is when you start seeing
claims or complaints come in ofLBSWs or MSWs performing
clinical services without uhwell, obviously they can't
because they're not an LCSW, butLMSWs could as long as they are
practicing under a supervisioncontract uh where they are
(08:44):
trying to accrue the necessaryhours to become an LCSW, then an
LMSW actually can provideclinical services as long as
they're under supervision.
But we we see some there wherefolks are like, eh, you kind of
sound like you're providingclinical services.
Um, and that's going to beoutside your scope as an LBSW or
an MSW.
Those can be a little trickybecause uh just somebody from
(09:07):
the outside looking in, it couldvery well look like a scope
problem when in fact then maybethey are operating under a
supervision contract.
You just from the outsidelooking in, you don't know it.
And the only way to figure thatout is is you file a complaint
and all of a sudden now it'sinvoked the machinery of
government, and everybody'severybody gets mad at one
(09:28):
another for obvious reasons.
And I can't even say it's youknow, I wouldn't be mad either.
But that's something that wehave to deal with.
It doesn't happen very oftenbecause one of the things that's
that's pretty unique about thisprofession is I think it gets
drilled in their heads uh intheir training programs that
look, when you guys see aproblem with a colleague, you
(09:49):
need to go talk to thatcolleague and visit with them
and find out for yourself whatis going on.
In other words, go to theprimary source first before you
start lobbing accusations.
SPEAKER_02 (09:59):
Yeah.
SPEAKER_04 (10:00):
Um, and and that is something I do try to encourage
all licensees, even just outsideof the social work as well.
Make sure you go talk to yourcolleague or whoever it is that
you think there may be aviolation.
Now, obviously, if they'resaying I'm sleep, you know,
sleeping with a patient orsomething, you don't talk to
them about that.
Just file the complaint, we'lltake it from there.
But for this other stuff,sometimes it's better to figure
(10:20):
out what's actually going onbefore you start lobbing
grenades.
I'll tell you though, thebiggest problem we have uh from
social work, and it's it's moreprevalent in social work than it
is the other professions, andthat is practicing without an
active license or jumping thegun on licensure and practicing.
And I don't know why that is.
I can't figure out why thisparticular profession seems to
(10:43):
be worse about forgetting torenew or check that they have an
active license or jumping thegun on licensure and just going
ahead and starting startdelivering social work services
before we've actually issued youthe license that says you're
authorized to do so.
SPEAKER_00 (10:59):
Yeah, not a good way to start your career.
SPEAKER_04 (11:01):
It's not.
You get off on a bad foot onyour career or you you you
stumble in the middle of it.
Now, you know, is it a deathpenalty?
No.
Uh, but you still you don't wantthat that ding on your record.
SPEAKER_02 (11:14):
Right.
SPEAKER_04 (11:14):
Um and it's a silly thing to avoid.
I mean, it's it's a silly thingto get hung up on.
It ought to be, as aprofessional, it ought to be
something you check before youand you know for sure.
SPEAKER_02 (11:24):
Right.
SPEAKER_04 (11:25):
Uh before you start, you know, pulling the trigger on
services.
So what you know, kind of myadvice to folks there is is hey,
you're a professional, payattention.
Uh, make sure that your licenseis good to go, that it's active,
uh, and you're in good standingbefore you start delivering
services.
What and that's true whetheryou're a newbie and you've
applied for initial licensure,or whether you have just renewed
(11:48):
your license or you think you'verenewed your license, check our
system.
It's free, it's easy.
Punch in your license number oryour name, and it will tell you
if you're good to go.
And then you know.
So, uh, because that thing thatthing updates automatically.
Uh, so it's there's no notreally any lag there.
There's really no excuse forthat.
SPEAKER_00 (12:08):
So very solid advice.
Yeah, no, it's I mean, well, itsounds like generally social
workers are really well behaved,you know.
It's like generally that they uhyou're not having a huge
problem, um, and that theproblems that you are or that
they are experiencing are notnefarious, they're not um, you
(12:28):
know, with malice.
It's simply, you know, maybejust not understanding the rules
and regulations or what'sexpected or what's coming next,
or um, like you said, that yourlicense expired last week and
you've got to go renew it.
And you've you've been providingservices for the past week to
patients with an inactivelicense.
Yeah.
SPEAKER_04 (12:48):
Exactly.
And I mean, you know, one of thethings I I don't think people
think about, I learned this fromwatching, I learned it, I
learned what I'm about to sayfrom watching uh folks in the
school psychology arena learn itkind of the hard way and the
consequences that befell them intheir districts.
One of the things you got tothink about is it's not just
(13:08):
about you and and me or theagency, whenever you practice
without a license or withoutauthority, whoever your employer
is, whoever was relying uponwhatever services that you
rendered without legal authorityto do so, you have now
jeopardized or underminedeverything that they then built
on top of your opinions or thework that you did.
It may completely invalidateeverything uh that they have
(13:31):
done in reliance upon whateverwork you did.
And so, and a lot of what socialworkers do is foundational.
I mean, you know, they they arehelping people with services to
repair problems or verydifficult times in their lives,
or they're, you know, counselingthem through very difficult
times.
All of this stuff isfoundational work.
And if you got cracks or you youthat foundation crumbles,
(13:53):
everything on top of it, youknow, is now jeopardized.
So that's why I say it's reallycritical that you understand the
status of your license beforeyou you haul off and start you
know giving advice andcounseling and providing
education and all the servicesthat you do as a social worker.
Just make sure you're good togo.
SPEAKER_00 (14:10):
Absolutely.
And you mentioned you don't knowwhy you're seeing that uptick.
You know, ethics are at the coreof social workers.
I wonder if they're feeling apull, a calling, you know, to go
ahead and start the professionor go and help.
I know that there's so manypeople who um service these
vulnerable populations that umjust want to help, you know.
(14:35):
I unfortunately um it's notalways that black and white.
You can't, like you said, justgo ahead and start practicing
without a license.
What are some maybe of the mostcommon ethical pitfalls that you
see that are landing somelicensees in trouble?
SPEAKER_04 (14:52):
Well, I you know, you you touched on something
there that it's it's a personalI have a personal theory on why
I think people probably we seemore practicing without
authorization.
I'll just call it that for kindof a broad generalization.
Any if you spend any time aroundsocial workers, you will hear
them use the phrase, well, ourethical code says this, or our
(15:13):
ethical code demands this.
And they they you know, theyrefer to it heavily and often.
And that's because it's it's oneof the it's one of the core
things that they are taught fromuh in their training programs.
They are not taught from youknow the Texas rules or
regulations and statutes.
They're you know, there will besome, but it's certainly not the
(15:35):
the um the ethical guidepoststhey use to kind of shape their
views of the profession and thedelivery of services within the
training program.
That that's what they're usingthose ethical codes for.
And those are not statepromulgated.
That's not something the stategovernment, the federal
government, or anybodypromulgates.
It comes from like the NationalAssociation of Social Workers,
the NASW ethical code.
(15:57):
And so part of the problem withthat is um while it's good in
that it instills kind of theguidepost for what's expected
for practice within theprofession, um, where it where
it kind of I think falls shortand where the training programs
fall short a bit here and causethis kind of a problem is they
don't really talk to you aboutthe practical implications of
(16:18):
this is all great, but this isnot actually what gives you the
authority to practice in Texas,Rhode Island, Maryland,
wherever.
It's actually that state licensethat does it.
That is what gives you authorityto practice in Texas.
And it is also those stateregulations, you know, for which
you need to comply and staywithin, because our regulations
may differ from those nationalassociation standards or ethical
(16:42):
codes.
This is just what I think afterwatching this stuff for five or
six years now.
I think they get it and they'relike, okay, I'm ready to go.
I know what I have to do andwhat I need to do, and I know
what needs to be done.
And they get so excited, is likejust like you said, they get so
excited to help folks, they kindof forget to check the most
basic things about do I have mylicense?
Um, what are the confidentialityrequirements for Texas?
(17:05):
Are they different fromCalifornia where I was trained
in the CSWE program?
Because they are different.
Uh there are some differencesthere.
California is a Terasoft state.
We are not.
That can get you in big, bigtrouble if you don't know that
difference.
Um and it that it would notreally just us, that the the
California legislature and theTexas legislature view those
(17:26):
things differently, and theyhave placed in they've put in
place very different statutesgoverning that.
So um it's just you gotta knowthose things, and you're not
going to know that if you onlylearn from or operate from the
ethical code.
So that's my theory on it, isthey are trained so heavily on
it, they kind of forget to focuson oh, I need the license, and
(17:47):
when these regulations alsogovern are actually the primary
governing uh codes of governancethat I need to follow.
And so I think they just kind ofget out over their skis on that
sometimes, and it it leads tothese problems that we're seeing
here with you know practicingwithout authority.
Now, as far as kind of thenature of like what are some
(18:07):
ethical uh violations or issuesthat we see.
Um, you know, I I looked thethis morning before we got on
here, I kind of pulled back,went back through a couple of
board meetings or councilmeetings in the past just to
see.
Fourteen out of 15 of the onesfrom our meeting last week or
week before last were practicingwithout authority.
(18:29):
Either you didn't have alicense.
So the other one was somebodyhad issued an uh emotional
support animal letter uh withoutconducting enough um evaluations
and assessments.
They just kind of just kind ofshot from the hip and issued the
letter.
You can't do that on that kindof stuff.
And then, you know, I went backa few more meetings, and a lot
(18:51):
of the stuff there is likeboundary issues.
Um and this is where social workreally kind of mirrors or
parallels the other professions.
They're not any worse, they'renot any better.
They they're just just likeeverybody else.
Um, they suffer from the samehuman fallacies as everybody
else, you know, not recognizingor enforcing boundaries between
clients uh and themselves.
(19:13):
Just to answer your questioninitially, what you asked me was
you know, standard of care isthe biggest, uh, the biggest
area of complaints that wereceive against social workers.
Um, the unprofessional conduct,and that would include like
boundary type issues, uh, that'sgoing to be our second biggest.
And then the sexual misconductis is another another area, but
(19:35):
then also just the theunlicensed activity is is
problematic as well.
So those are the big four insocial work.
Three of those are shared by theother professions as well, the
standard of care andprofessional conduct um and um
dual relationships.
SPEAKER_00 (19:52):
Yeah, I was gonna say we talked about it in our
last episode, the you know,boundaries, right?
And I think your piece of advicewas just don't, just don't even
engage in in that initial umseparate conversation, separate
from what you and your clienthave, that's your you know,
system that you have for yourbusiness, your client record
(20:14):
system.
Um, yeah, I think it's it's bigamongst all of the licensed
professions is um oversteppingthose boundaries and either
entering into some sort ofsexual misconduct, or you've got
this relationship with um apatient or a client.
And um, yeah, those just can soeasily be avoided.
(20:35):
It's such a bummer to see thatthey continue to exist and and
continue to spike up in number.
SPEAKER_04 (20:42):
Yeah.
It is the proverbial slipperyslope, um, which is a nasty
pool.
It's got a nasty landing at theend of it.
I'll tell you that.
SPEAKER_00 (20:52):
Yes, sir.
Yeah.
Well, Darrell, as executivedirector, you hear from
licensees, you hear from yourenforcement division at BHEC.
What kind of challenges aretoday's social workers bringing
to your attention?
SPEAKER_04 (21:09):
You know, this is one where it's it's um it's
interesting because we get a lotbecause of the way social
workers are trained, they arethere's a lot of advocacy
drilled into them because partof their part of their function
or their role is to go out andfight for their client, to get
them, you know, whatever kind ofservices or benefits are
available to them.
(21:29):
And they're they're dealing withfolks who really can't fight for
themselves most of the time orsimply don't know how to fight
within a very complex or largesystem.
And so they're kind of yourchampion.
Uh, they are your champion ifyou're that individual.
Um, and so they're they're wiredwith this advocacy mindset.
And so we'll see a lot of themreach out to us, come into
(21:50):
meetings and reach out to us,and and they want to talk about
like more socialjustice-oriented issues.
Unfortunately, a lot of that isbeyond the purview of a
regulatory agency.
Those are those are policydecisions or debates that really
need to be had uh under in thelegislative you know sphere, not
in the boardroom.
Right.
Uh I often tell like boardmembers in our training when I
(22:13):
do new board member training, isthere are a lot of problems in
this world.
And there are not many, though,that are really suited for
resolution in the boardroom.
Uh, most of the the ail theailment of society that you will
have a front row seat to as a asa as a board member are going to
be things that have to becorrected over in the
(22:34):
legislative sphere, not in theregulatory sphere.
Because we operate within a verynarrow set of guideposts that
the legislature gives us.
We are we are a verymission-focused, kind of a one,
you know, one one horse showhere.
SPEAKER_02 (22:47):
Right.
SPEAKER_04 (22:48):
Um, our job is to license mental health providers
and behavioral health providersand regulate them or police
them.
It is not to solve extraneousissues.
You know, they they want toadvocate, want us to take
actions or do things that arewell beyond our ability to do.
What I always like to tellpeople is is I understand that,
(23:09):
I understand where you're comingfrom on that advocacy, but uh
sometimes the best thing you cando rather than focus on the
macro is kind of look at themicro and use your skill set to
fix the problem that your clientis facing.
You can't always, you know,change the world or move heaven
and earth, but sometimes you cankind of fix the problem for that
particular client.
(23:30):
Yeah, you do that, you do thatenough, and in aggregate, you
can change the world.
Uh, but you can't do it reallyfrom a macro perspective as
easily uh through through us,anyways.
Let me back up.
No, there is one area where itinterfaces pretty well with us
where you can kind of do themacro, and that is like
workforce issues.
(23:50):
Um, if you're coming in andyou're saying, look, this
population or you know, thispopulation or this group of
people are being um adversely ordisproportionately impacted in
the licensing process.
And therefore, say there there'snot as many uh blacks or
Hispanics in the profession asthere are whites or Asians.
(24:13):
Well, that is definitelysomething we can look at to see,
well, is it our licensingprocesses um or is it our
licensing standards that we wepromulgate, not anything that's
in statute, but we havepromulgated by rule, is that
causing that disproportionality?
And if that's the case, then weabsolutely can take a look at
that.
And that can have much morewidespread systemic change.
(24:37):
Um, but for the most part, youknow, if you're if you're
arguing over, well, I don't evenknow if there should be an exam.
Well, that's not really anythingwe can answer because that's a
statutory requirement.
Right.
It's like, well, maybe thereshouldn't, but you're gonna have
to go convince, you know, 185members of the legislature to do
away with that, um, and not thenot the social work board or
BHEC.
(24:57):
You know, another area where weum kind of you you kind of get
into uh folks wanting to affectchange, and that is like the
licensing exam itself.
It's died down a little bitrecently, but in in I'd say
within the past 18 months to 24months, there was a lot of
consternation in the professionabout really, I think, beginning
(25:20):
to question that whether therewas a need for a licensing exam
altogether, because when youlook at the exam statistics, uh
there are certain demographicgroups that just do better on
the exam than others.
Uh and so it it becomes youknow, obviously it's it's a
question of well, why?
(25:40):
Uh can anybody explain why thatis?
And if you can't, then you knowwhy why are we keeping something
that has kind of adiscriminatory effect, if you
will.
Now, I don't I don't usediscriminatory in the kind of
the bad sense.
I mean, all licensing isdiscriminatory in it lets
competent folks in and it keepsincompetent folks out.
(26:01):
That's the whole purpose oflicensing.
There are going to be winners,there are going to be losers in
licensing.
That's just the way it is.
If you don't like that, then youneed to do away with licensing.
Uh, because there that's ourjob.
We're we're gonna we're gonnatell some people, you are not
cut out for this, you need to godo something else.
And I'm sorry that that decisioncomes after the fact that you
have gone probably through agraduate training program and
(26:22):
incurred a significant amount ofstudent debt.
That part stinks, I admit, butthat's the way this works.
Um, we don't know if you're cutout for it until you've actually
gone through the training togive you a shot to learn it all,
and then we have to test you.
And if you fail it, then toobad.
Uh but uh we we have a lot of,you know, we have a lot of folks
(26:44):
that that approach us with uhthose types of problems about
challenges of getting into theprofession because of the exam.
They can do everything else,they've passed all their
coursework, they've graduated,they've got the requisite
degrees, taken the jurisprudenceexam.
They've done everything we'veasked of them, except they can't
pass that national licensingexam.
Uh, and then it becomes verydifficult to explain to them
(27:06):
well, it's this one thing that'skeeping you out of the
profession, keeping you fromdoing what you need to do.
And oh, by the way, they canalways point to and go, and you
kind of need me because look atthe significant workforce
shortage that you've got.
And it's like I mean, there's apoint there.
SPEAKER_02 (27:23):
Yeah.
SPEAKER_04 (27:24):
Uh I mean, you can't you can't deny that.
So uh that's an issue.
Uh another example of I thinkwhere people um feel a little
challenged or frustratedsometimes with the ext the
current state of the law, is thelegislature sometimes makes
calls about who can be in aprofession and who cannot be
(27:45):
based upon criminal history.
And social work and psychologyare the only two professions.
Well, I say they're the only twoprofessions regulated by BHEC,
where the legislature has said,as a hardline rule, if you've
got a uh a certain type ofconviction that involves the um
violence or the threat ofviolence, you cannot be a social
(28:08):
worker.
You can't, excuse me, you cannotbe a psychologist.
And there's no there's no getsouts of it, there's no waivers,
no nothing, you know, oh you'vebeen clean for 30 years, so
we'll look the other way.
None of that.
It's just a lifetime ban.
And so that that is that isanother area.
In fact, where there's actuallya lawsuit pending against BHEC
(28:29):
right now over that very issue.
It's chapter 108 of theoccupations code.
Um, we we often refer to them as108 casualties because it's but
for that, you know, theyprobably would have been
qualified for licensure.
SPEAKER_00 (28:44):
Well, and you would think that um, you know, there
are certainly other um otherstate agencies who've got um who
recognize rehabilitation andkind of take that into account
with licensees or applying, youknow, for a license.
Um and you, you know, sometimesI I'd like to think that uh
(29:05):
someone who may have gonethrough something or had a bad
patch in say their teens ortheir early adulthood um may
have worked with a social workerthemselves and been really
inspired or worked with atherapist or a counselor.
Um and uh that is a bummer.
That's uh but also sorry thatyou guys are going through that
lawsuit.
I know that that's not a funtime, you know.
(29:29):
No, no.
Um well kind of on that sametune, how can social workers
protect themselves while they'reserving these very vulnerable
populations?
We've got um, you know, some insome social workers in group
settings, we've got some socialworkers with one on one.
How can they all um all licensesof social workers protect
(29:54):
themselves?
SPEAKER_04 (29:56):
The the very first and the simplest thing to do is
solve the solve the Clientproblem that's in front of you.
In other words, whatever problemis presented to you, help that
client solve their problem orget them out of whatever
situation they're in.
It's kind of hard for anybody tobe mad at you if you're helping
them.
SPEAKER_02 (30:14):
Right.
SPEAKER_04 (30:15):
And so where folks tend to get a little mad is if
they feel like maybe you're amean, if that if they feel like
they're a means to another end,if you're using them as some
sort of an argument or a pretextto make some other more global
uh macro argument for change,help that client, fix their
problem because then they can'tbe mad at you.
Second, stay up to date on therule changes.
(30:37):
I I know we've said I've, youknow, this is now the second
time I visited with y'all.
And I sound like a brokenrecord, I know, but for heaven's
sakes, folks, you got to readthe rules.
It's not enough to know the NASWethical code.
You have got to know the BHEXregulatory rules and your the
social work board rules.
You you just have to.
That's what actually gives youthe right to practice in Texas.
(30:58):
That's what actually governsyou.
If you get in trouble, I am notgoing to quote the NASW ethical
code in the complaint againstyou or prosecute you for
violation of that.
It just will not show upanywhere in the complaint.
You've got to know the rules,and we have tried to make it as
easy as possible.
We have a PDF rule book that youcan download and is searchable.
Uh yeah, you know, you cansearch on the Secretary of
(31:20):
State's administrative code tooif you'd like.
Uh, we tried in the PDF rulebook, you can see what rule
changes were actually made tothe rules up to I think a year
back.
It goes a year back.
In the very front of the book,you'll you'll see what rules
were changed.
And we also have a webpage wherewe we we put up for uh public
comment to solicit publiccomment, any kind of proposed
(31:41):
changes that are currentlypending.
So if you want to see what we'reworking on right now, like the
social work board uh and BHEGjust voted to propose a large
batch of changes to the socialwork rules.
Those will go up on our websitehere pretty soon.
We haven't we haven't gonethrough the regular the review
process with the governor'soffice on them yet, but as soon
as he clears us, we'll post themto the website and you can look
(32:04):
at it and you can see thechanges, strike throughs for
stuff we're pulling out,underlines for additions.
You'll be able to see what we'redoing.
Try to use those tools that wewe put out there for you to keep
track of the rule changes.
I know we I know we tend to do alot of rule changes.
Most of them are not substantivechanges to rules that actually
govern your practice, they'remore changes in process or
(32:26):
procedure within the agency,maybe say to the enforcement
process.
So the vast majority of you willnever even encounter the
enforcement process, thankgoodness.
So those changes really don'taffect y'all all that much.
Uh, but just do what you can tokeep track of that.
And then, you know, we do thingslike the leadership listening
hour, which is where myexecutive team, we go through
(32:48):
and we just hang out for an hourand a half or two hours and
answer any kind of question thatcomes through the door.
Uh, it's a webinar, so you cancome and go as you please.
Um you can ask anything you wantto unless it's a question about
a pending application or acomplaint, but we we answer a
whole host of things.
We have people get on there andum sometimes you're like, wow,
(33:11):
you you haven't read the rulesat all, I can tell.
Um, and then some get on thereand will almost admit a
violation.
We're not taking notes.
I mean, unless you get on thereand just admit that you have
slept with the patient, I'm nottaking notes as to who asked me
what kind of questions.
Um, we're not, you know, tryingto punish you.
I'm actually trying to keep thecar out of the ditch through all
(33:32):
these efforts because it'seasier to keep it out of the
ditch than to pull it out onceyou've driven it off in there.
SPEAKER_02 (33:37):
Less expensive too.
SPEAKER_04 (33:39):
Yes, yes.
And so, you know, we're reallynot, I really try not to be a
bad guy, my team and I.
We really don't want to be thebad guys.
We're trying to help you allout, but you got to use these
tools uh that we're giving you.
And so I can't make you usethem.
I can't make you read, but I'mjust trying to make it as easy
as possible.
And then lastly, uh what I wouldsay, and I know this sounds
(34:01):
strange coming from me, but havemalpractice insurance that that
would provide uh you know legalrepresentation if you do get in
trouble.
It's dirt cheap for you guys.
Um it's it's just a verypractical, simple thing to do.
It's cheap.
And believe me, you will youwill get out on your knees and
thank the heavens above if youever do need it.
(34:24):
Uh, because I'm just telling youright now, people can file a
complaint on you for any reasonor no reason whatsoever.
And it's nice to be able to say,if you've got that kind of
coverage, to be able to say, youknow what, Berlino or or whoever
you choose, yeah, here's all myfiles, here's what happened.
You deal with BHEC, you dealwith the board and deal with
this.
And I'll be honest with you, asthe ED, we tend to like dealing
(34:47):
with the lawyers better than youknow the the respondent licensee
as well, because there's lessemotion, there's less hand
holding, it's just moretransactional in nature for us.
Because we're we're not we'renot out to get you on a
complaint.
Uh, it's just a transact, it'sjust something we have to do.
It's our job.
And so it's it's an unemotionalthing for us.
SPEAKER_02 (35:08):
Yeah.
SPEAKER_04 (35:08):
But it's not for you as the licensee.
I get that.
And so it it just helps ifyou've got that objective kind
of champion on your side who cango, look, let me structure your
response for you.
Let me point B heck to where theevidence is or isn't, and then
I'll negotiate with them and wecan try to work something out.
SPEAKER_02 (35:26):
Yeah.
SPEAKER_04 (35:27):
That's just a much easier and safer way.
And it ought to be lessstressful for you too, rather
than having to deal with usdirectly.
So that's why I say get yourmalpractice insurance, uh,
because it's cheap, or rat holemoney, whatever you want to do.
Uh you know, have a rainy dayfund, whatever your whatever
your pleasure is.
SPEAKER_00 (35:44):
I mean, either it's better to be safe than sorry in
that kind of situation.
The you don't want to be caughtwithout malpractice insurance
and then have to do sometimesthe insurance companies can put
you in contact with a with anattorney.
Sometimes they've got theirin-house attorneys.
Uh it it's uh definitely a goodstart instead of um totally by
(36:06):
yourself at square one.
Daryl, this has been a a greatepisode of super powerful
discussion, tons of takeawaysand insights for social workers
in Texas to um to listen and andknow that maybe there's some
things they need to go back anduh make sure they read the rules
on, or maybe there's some thatare confidently practicing.
(36:27):
They've got a little pep intheir step tomorrow because they
know they're doing the rightthing.
Uh, do you have any final wordsof wisdom for some of our social
workers who are listening?
SPEAKER_04 (36:37):
Y'all are doing good.
Your judgment, obviously, yourjudgment as a whole is good
because y'all are not getting introuble for the most part.
So you're already 90% there.
So pat yourself on the back forthat.
Now, how do we tighten up thatlast 10%?
It's pretty easy.
Check to make sure your licenseis valid, read your rule book
and ask questions.
SPEAKER_02 (36:58):
Yeah.
SPEAKER_04 (36:58):
And, you know, all those things I can I can try to
make the asking questions easy.
I can't make you read, but thatone's on you as a professional.
SPEAKER_00 (37:07):
So solid advice to our listeners.
Remember that your license isyour livelihood, know your
scope, stay grounded in yourethics, and use those tools that
your regulatory agency provides.
For more information, you cancheck out the links in our
description.
If you're ever unsure, reach outand consult a professional like
Mr.
Spinks just mentioned.
(37:28):
Thanks for joining us again onKnow Your Regulator.
And until next time, stayinspired and stay engaged with
your regulatory agency.
Know Your Regulator, the podcastthat inspires you to engage.
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