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Recasting Licensing in Social Work: Something More for Professionalism Erlene Grise-Owens, Larry W. Owens, and Justin Jay Miller

ABSTRACT Abraham Flexner contended that “something more than a degree or claim” is needed to make a profession. He further asserted that the definitions of a profession require recasting over time. This article critically considers recast- ing licensing as something more for social work. Analysis of past and present discourse on licensing in social work revealed three overarching themes: (a) advocacy and rationale for licensing, (b) scrutiny and critique of licensing, and (c) the disconnect and dissonance between professional licensing and social work education. Moving forward, we suggest recasting social work’s professional paradigm in the common framework of compe- tency, with licensing part of the continuum of professionalization. This recasting can promote critical congruence between social work education and ongoing professional competency.

ARTICLE HISTORY Accepted: March 2016

Flexner’s (1915/2001) pivotal speech reverberates through the decades. The impact and intent of that speech has been analyzed critically by some, argued against by some, and accepted implicitly by others (Baylis, 2004; Glaser, 2001; Holosko & Leslie, 2001; Johnson, 1999, 2008; Morris, 2008; Wong, 2001). Somewhat ironically, given the impact of this speech, even Flexner questioned whether he had the “competency” (p. 152) to assess social work. Later, he stated that the definitions of a profession will require “recasting from time to time” (p. 153).

Yet, Flexner (1915/2001) asserted that “to make a profession in a genuine sense, something more [emphasis added] than a mere claim or an academic degree is needed” (p. 153). In many professions, in part, licensing, regulation, and credentialing are cast as the primary means for achieving this something more. The terms, credentialing, licensing, regulation, and certification are used somewhat interchange- ably, and the distinctions among them are delineated elsewhere (e.g., Crane et al., 2010; Iverson, 1987; Miller, Deck, Grise-Owens, & Borders, 2015; Miller, Grise-Owens, & Escobar-Ratliff, 2015; Randall & DeAngelis, 2008) For simplicity, we use licensing as a general term, in this article.

Hardcastle (1977) declared regulation or licensing “a major contemporary movement in social work’s efforts to attain recognition as a full profession” (p. 14). However, this licensing as something more has been a dynamic tension in social work (e.g., Bibus, 2007; Boutté-Queen, 2003). Members of many professions, such as medicine or law, seem to largely accept licensing as an unquestioned aspect of their professional identity and practice reality (e.g., Goldsmith, 1931; Thyer, 2011). In contrast, social work tends to debate the efficacy and effects of licensing (e.g., Hardcastle, 1977; Liles, 2007; Marson, 2006; Miller, Deck, Grise-Owens, & Borders, 2015; Miller, Grise-Owens, & Escobar- Ratliff, 2015; Seidl, 2000; Thyer, 2000). Bibus (2007) described licensing in social work as a topic of “discourse, debate, and some controversy for at least 75 years” (p. 2).

This article briefly considers where social work has been and analyzes where it stands today in terms of professional licensing. The article synthesizes three prominent themes in the present discourse on licensing in social work: advocacy and rationale for licensing, scrutiny and critique of licensing, and the disconnect and dissonance between professional licensure and professional

CONTACT Larry W. Owens [email protected] Western Kentucky University, Department of Social Work, 1906 College Heights Blvd., #11039, Bowling Green, KY 42101-1039. © 2016 Council on Social Work Education

JOURNAL OF SOCIAL WORK EDUCATION 2016, VOL. 52, NO. S1, S126–S133 http://dx.doi.org/10.1080/10437797.2016.1174641

preparation, that is, social work education. Then the article critically considers implications and directions for licensing as social work moves into the future. We suggest recasting social work’s professional paradigm to more fully use the common framework of competency.

Themes in the discourse regarding social work licensing

This article does not replicate other articles that document the history of social work licensing and describe the details of licensing levels and criteria (e.g., Bibus & Boutté-Queen, 2011; Boutté-Queen, 2003; Dyeson, 2004; Hardcastle, 1977; Iverson, 1987; Miller, Deck, Grise-Owens, & Borders, 2015;Miller, Grise-Owens, & Escobar-Ratliff, 2015; Randall & DeAngelis, 2008). Rather, this article synthesizes major themes in the discourse on licensing to provide a context for moving forward critically and constructively.

Some early discussion about licensing debated its value (e.g., Gandy & Raymond, 1979). However, early proponents, such as Goldsmith (1931) strongly described licensing as “important and desir- able” (p. 560). Goldsmith noted that social work could learn from the evolution of other professions (such as teaching and nursing) and their adopting regulation on their path to professionalism. In the early 1970s, the National Association of Social Workers (NASW, 1974) issued a policy statement promoting regulation of social work, that is, licensing.

In social work today, licensing has become a “fixture” (Boutté-Queen, 2003, p. 166). Currently in the United States, every state has professional social work licensing in place, and countries such as Great Britain, Australia, and Canada also regulate the practice of social work (Association of Social Work Boards [ASWB], 2014; Randall & DeAngelis, 2008). Licensing is administered at the state level in the United States. The vast majority of the states work with the ASWB, which develops and administers licensing examinations.

Even with the ubiquity of licensing, the literature on licensing and social work remains relatively sparse. Bibus and Boutté-Queen (2011) concluded, “there are fewer published articles than expected” (p. 11). Likewise, these authors and others (e.g., Black & Whelley, 1999; Donaldson, Hill, Ferguson, Fogel, & Erickson, 2014) specifically noted a paucity of research on licensing related to social work education. In this article, we consider what has been written (and not) along with discussions in professional forums, conferences for example (Escobar-Ratliff, Miller, & Grise-Owens, 2014). In the following sections we consider three overarching themes in the past and present discourse about licensing.

Advocacy and rationale for licensing

Regulating the profession is viewed by some in social work as a basic professional obligation for all social workers. Thus, proponents usually frame licensing as a necessary commitment and indicator of professionalism (Colby & Dziegielewski, 2004). Defining professional parameters and practices, protecting the general public and providing accountability for consumers, developing and enhancing the profession, and gatekeeping for the profession are common reasons given for the need for and purpose of licensing (e.g., Deitz & Thompson, 2004; NASW, 1975; Randall & DeAngelis, 2008) As noted previously, professional bodies such as the NASW (2005) promote professional licensing as a means of ensuring professional standards.

Some studies examined the impact of licensing on practice, including protecting the public. For example, Boland-Prom (2009) examined sanctions levied by licensing boards and found that licensees were most often cited for substandard practice, dual relationships, and crimes. Boland- Prom found that licensing boards responded with letters of reprimand or revocation of the licenses. Bern-Klug and Sabri (2012) found that social service directors in their study reported that licensed social workers needed less on-the-job training about elder abuse than their non- licensed counterparts.

Others documented the positive impact of licensing on the status of practitioners. For example, Baines (2004) noted that licensing “restored some of the worker’s sense that their knowledge and skills

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were valuable” (p. 17) Baines further reported that licensing “improved social respect [which con- tributed to] an increased sense of control over their work and stature in the larger community” (p. 17).

Boutté-Queen (2003) explored barriers to obtaining social work licensing in Texas, such as the perceived cost. Other studies have identified cost as a barrier (Cavazos, 2001; Floyd & Rhodes, 2011). This perceived cost may be related to perceived benefit (Escobar-Ratliff, Miller, & Grise-Owens, 2014). As Boutté-Queen (2003) asserted, “If the profession is to decrease the perception of barriers to licensure attainment, efforts to educate the general public, those who oversee social service agencies, and those seeking a social work education about the benefits of licensure must continue.” (p. 148) Boutté-Queen emphasized the need to educate prospective employers on the value of social work licensing. And she advocated for social work education to lead in this educational endeavor.

Scrutiny and critique of licensing

Although some tout the benefits of licensing as an obligation and essential element of professional social work, others critique and scrutinize licensing. For example, some authors have drawn attention to possible biases (e.g., race, gender) in the licensing examination content and licensing credentialing expectations (Boutté-Queen, 2003; Garcia, 1990; Iverson, 1987). Significant scrutiny is related to the efficacy of licensing. For example, Hardcastle (1977) harshly criticized licensing, primarily because of vague standards and rampant exemptions. Hardcastle declared that “weak legal regulations” make it worse, rather than better (p. 19).

Others report preliminary findings that question the impact and efficacy of licensing. For example, in a study of BSW-level social workers in Texas, Cavazos (2001) found no correlation between being licensed and higher salary or greater employment. Swagler and Harris (1977) reported similar findings in an economic analysis of the benefits of licensing.

A few studies look at factors affecting exam scores and related effectiveness of the exam. Albright and Thyer (2010) highlighted flaws in the licensing preparation examinations. Johnson and Huff (1987) further questioned the effectiveness of the exam. Thyer (2011) looked at the licensed clinical social worker pass rates in Florida and considered the relationship between the Council on Social Work Education’s (CSWE) accreditation standards and the ASWB’s task analysis. Thyer noted the lack of “formal investigations on the extent to which these two driving forces governing the profession overlap, supplement, or contradict each other. Such analyses are long overdue” (p. 300).

Some research further critiqued the licensing exam and ASWB. For example, Albright and Thyer’s (2010) study concluded that the ASWB clinical examination did not offer a valid assessment of practice. Other works have noted similar concerns (Randall & Thyer, 1994; Thyer, 2011). In contrast, Marson, DeAngelis, and Mittal’s (2010) research found that the social work licensing examinations (at all levels) were “valid, reliable, and defensible” (p. 98).

Licensing has been scrutinized by some formicro bias. For example,Donaldson et al. (2014) critiqued the “hegemony of clinical social work” (p. 59) and argued for a social work licensing level related to macro practice. Donaldson et al. noted that Michigan, Missouri, and Oklahoma are the only states with such a designation. They asserted that social work needs to revisit the issue ofmacro-practice licensing and, indeed, the idea of inclusive licensing. Citing the deleterious effects of this lack of an encompassing professional licensure structure, Donaldson et al. concluded, “Not having this conversation is no longer an option” (2014, p. 60).

Disconnect and dissonance between licensing and social work education

Another key theme in the discourse is the disconnect and dissonance between licensing as a professional credential and social work education as the preparatory process for the profession. This dissonance is seen most prominently in the debate in social work education on whether faculty should be licensed. Similarly, a disconnect is seen in the relative lack of attention developers of social work education curricula give to licensing requirements.

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Whether social work faculty should be licensed is a key topic in the discourse (e.g., Liles, 2007; Marks & Knox, 2009; Marson, 2006; Seidl, 2000). The CSWE (2001) issued an opinion statement that social work faculty do not need to be licensed. The ASWB (2010) conducted a comprehensive study of licensing; the demographic report noted a significantly low number of licensed individuals whose primary setting is in academia. Boutté-Queen (2003) noted that many faculty “work actively to see that licensure does not become an additional requirement of faculty for a number of reasons” (p. 148), which include (a) direct practice services are not part of the job function; (b) burden of the faculty role in scholarship, teaching, and service precludes licensing requirements; (c) barriers regarding eligibility for licensing from state to state; and (d) accountability to the university and accreditation bodies supersedes licensing accountability.

However, proponents argue that these reasons fall short, particularly in the context of broader practice expectations. These proponents believe that social work educators should possess this practice credential (e.g., ASWB, 2012; Marson, 2006; Thyer, 2000). Reasons for licensing include (a) an ethical obligation to practice in an area of competence, (b) credibility in the social work profession at large and in interprofes- sional contexts, and (c) adequate practice preparation for instructional roles. Modeling professionalism for students is another argument for social work educators to be licensed (e.g., Thyer, 2000). This discrepancy of faculty promoting licensing while being unlicensed creates dissonance.

Research findings indicate that students value licensing as a professional credential and see licensing as a means for professional advancement, marketing, credibility, and competence (e.g., Bibus & Boutté-Queen, 2011; Miller, Deck, Grise-Owens, & Borders, 2015; Miller, Grise-Owens, & Escobar-Ratliff, 2015). Cherry, Rothman, and Skolnik (1989) reported that students perceive the licensing exam as “important to the profession and significant to their future” (p. 268). However, Cherry et al. found that faculty are unfamiliar with the licensing examination content and do not take the examination into account in curriculum development or classroom teaching. Cherry et al. concluded that “although recognized as a growing phenomenon … it [licensing] has had only minimal impact on schools of teaching” (p. 273). More recent surveys of students have echoed similar findings (Miller, Deck, Grise-Owens, & Borders, 2015; Miller, Grise-Owens, & Escobar- Ratliff, 2015).

Social work education has largely neglected licensing as a matter of concern (Bibus & Boutté- Queen, 2011; Black & Whelley, 1999; Donaldson et al., 2014; Miller, Deck, Grise-Owens, & Borders, 2015; Miller, Grise-Owens, & Escobar-Ratliff, 2015). Thyer (2011) characterized social work educa- tion’s attitude toward licensing as “ambivalence” (p. 297). This ambivalence contributes to a relative lack of attention to licensing, which in turn creates a disconnect between social work education and professional practice.

This disconnect is even more evident as evolving accreditation standards call for more accountability. Increasingly, administrators of schools of social work are expected to consider licensing factors (e.g., number of test takers, pass rates, and so forth) as gauges of programmatic outcomes and effectiveness (Thyer, 2011). For example, as part of a volunteer benchmarking service, the CSWE asks schools to provide data related to licensing pass rates (deGuzman, 2009). The growing tendency to use licensing factors in assessing social work educational programs is consistent with other professional disciplines (e.g., nursing, law). Universities and their related constituents expect this consistent programmatic evaluation from professional programs (Miller, Deck, Grise-Owens, & Borders, 2015; Miller, Grise- Owens, & Ratliff, 2015; Thyer, 2011).

Given the increasing reality of licensing in professional social work, educational program adminis- trators need to consider more preparatory initiatives to support successful licensing (Escobar-Ratliff, Miller, & Grise-Owens, 2014). The ASWB (2013) has created a Path to Licensure Initiative to form partnerships with CSWE-accredited schools of social work to customize initiatives to “meet their own teaching needs,” (para. 5) as applied to professional regulation or licensing. According to the ASWB, the primary aim of this initiative is to help students make the transition to professional practice. Preparing students for professional licensing as part of a social work curriculum could contribute to addressing the disconnect between their studies and their professional practice realities (Escobar-Ratliff, Miller, & Grise-Owens, 2014; Thyer, 2011).

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Recommendations and future directions

Having considered three primary themes in the current social work discourse regarding licensing, where do we go from here? The following section offers three recommendations for social work licensing: continued critical attention and balanced research, engaged interprofessional interchanges, and improved linkages between social work education and licensing. These recommendations promote a recasting of social work professionalization, using the congruent framework of competency throughout educational preparation and ongoing regulation.

Continued critical attention and balanced research priorities

Licensing is a normative aspect of social work practice. The current challenge and opportunity is to ensure improved quality and effectiveness of this normative element. Certainly, continued critique is needed to achieve this aim. For example, continued scrutiny of and research regarding the licensing examination content, process, and parameters are necessary (e.g., Albright & Thyer, 2010; Biggerstaff, 1994). Furthermore, continual assessment of biases in the licensing process and exam- ination needs to be pursued (e.g., Boutté-Queen, 2003; Garcia, 1990; Iverson, 1987).

Likewise, as the discourse has revealed, continued critique is needed about which social work roles should require licensing and what (if any) exemptions should apply (Boutté-Queen, 2003; Hardcastle, 1977; Marson, 2006; Seidl, 2000; Thyer, 2000). Similarly, more research is needed on the impact of licensing on professional status, performance, andmarketability in all arenas of social work (e.g., Donaldson et al., 2014). And, most notably, sustained research should examine the effectiveness of licensing in meeting its basic aims, such as protecting the public and ensuring there are competent professionals in the field (Bibus & Boutté-Queen, 2011; Thyer, 2011).

Social work education must lead the way in contributing research on licensing. In particular, social work education needs to implement licensing preparation initiatives and evaluate their effectiveness. This area of research complements the growing need for accountability measures that mirror other disciplines and document ongoing professionalization (Escobar-Ratliff, Miller, & Grise-Owens, 2014; Marson, 2006; Thyer, 2000)

Engaged interprofessional interchanges

As noted at the beginning of this article, many other disciplines accept licensing more as a reality of professional practice. Markedly, other disciplines seem to give more attention to preparing students for passing their professional examinations. Social work education programs may benefit from these interprofessional comparisons.

For example, Chambers (2004) promoted a portfolio approach to preparing for dental licensing. Trujillos (2007) discussed methods for updating the attorney licensing process, highlighted strategies to improve bar passage, and delineated steps for law school administrators to take in their curricula to better prepare students for the bar examination. Similarly, Lauchner, Newman, and Britt (2008) described the use of computerized programs to prepare nursing students for the licensing examination. Jeffreys (2007) tracked the progress of nursing students toward licensing; factors that correlated with success in passing the examination included a higher grade point average and fewer course withdrawals.

Another area for increased interchange is interprofessional and interdisciplinary practice models for education (Interprofessional Education Collaborative, 2014). Developments in interprofessional education inform social work education’s emphasis on competencies. The Interprofessional Education Collaborative Expert Panel (2011) developed a set of core interprofessional competencies. A congruent focus on competencies translates across disciplines. These interprofessional compar- isons have an impact on social work education; likewise, social work needs more research that includes a social work perspective in these collaboratives (Kilgore-Bowing, 2014). Notably, a competency framework is congruent with professional regulation and licensing.

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Improved linkages between social work education and licensing

Although the scholarship on licensing and social work is relatively limited, the literature (and gaps therein) consistently identifies the need for more attention to the relationship between social work education and licensing (Bibus & Boutté-Queen, 2011; Black & Whelley, 1999; Boutté-Queen, 2003; Cherry et al., 1989; Donaldson et al., 2014; Miller, Deck, Grise-Owens, & Borders, 2015; Miller, Grise-Owens, & Escobar-Ratliff, 2015). Flexner’s (1915/2001) key criticism of social work was the “lack of specificity” (p. 162) in social work training and practice. This criticism has continued to challenge social work, such as the consistent development of curricula and the efficacy of licensing. Boutté-Queen (2003) noted social work’s “lack of vision” (p. 148) in clearly defining social work practice as a deterrent in valuing and promulgating licensing as a professional credential. Likewise, Hardcastle (1977) critiqued licensing and social work education, lamenting, “If those associated with social work are unable or unwilling to define more precisely the basic competence, knowledge, and skills of the profession, the assumption that they can test and differentiate these appears dubious” (p. 19).

As Flexner (1915/2001) noted, the definitions of professions will require “recasting from time to time” (p. 153). Social work education has recast the professional training framework. The CSWE (2015) moved toward a competency-based approach to curricula, a new approach that provided a particular opportunity to cast regulation and licensing of the profession in a new, expansive light. This competency framework recasts social work’s vision as a profession with more specifics, that is, competencies. This recasting means that social work programs are revamping curricula to reframe outcomes as evidence of professional competence rather than measurements of content delivered.

This competency approach is congruent with interprofessional practice as well as professional practice regulation’s emphasis on competence. Social work education’s primary function is to strengthen the profession of social work (CSWE, 2015). Therefore, social work education programs and curricula play a pivotal role in determining the conceptualization and construction of our profession. Part of that role could include conceptualizing and constructing curricula and programs that prepare graduates for professional licensing. This preparation should not involve a stunted approach of teaching to the test. Rather this preparation should underscore congruency between social work education and practice expectations. For example, as noted earlier, programs could integrate licensing preparation initiatives. Likewise, social work education could promote improved efficacy of the licensing examination and ongoing continuing education requirements.

In this article, we implicitly ask the following questions: What is lost in the historical conceptualization of licensing? What can be gained by a more comprehensive construction of licensing as the something more for social work? With increased attention to relevance, account- ability, and competency in the context of globalization and interprofessionalism, those of us in social work must fully claim our professional identity. Social work education must recast licen- sing as part of the continuum of professionalization. Social work education can lead in the development of a constructive paradigm for promoting congruence between professional pre- paration and ongoing professional competency.

Notes on contributors

Erlene Grise-Owens is Professor at Spalding University. Larry W. Owens is Associate Professor at Western Kentucky University. Justin Jay Miller is Assistant Professor at University of Kentucky.

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