New93 role standards, now public
MedTality
Role standards

Behavioral health

Clinical social worker

What a licensed clinical social worker must be able to do in independent practice: assess, diagnose and treat with the person's social context in view, manage risk, keep an honest record, and act on ethical problems, drawn from the clinical licensing examination US and Canadian social work boards use for independent clinical licensure.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
4
Sources
3
Version
1

Built from Association of Social Work Boards, National Association of Social Workers. Reviewed by clinicians, last on .

01What the role is measured on#

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

  • Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
  • Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
  • Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
  • Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
  • Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

02What a ready hire does#

What a competent clinical social worker does on day one, dimension by dimension.

Clinical skills

  • Conducts a biopsychosocial assessment with a mental status examination, separates a mental disorder from the effects of social conditions, substances and medical illness, and reaches a DSM-5-TR diagnosis where one is warranted.
  • Delivers a psychotherapy with evidence for the client's problem, adapted to their circumstances, and measures whether it is working.

Workflow and tools

  • Keeps accurate, timely records of every service actually provided, including assessment, risk reasoning and plan, bills only what was done, and corrects records openly.
  • Identifies the concrete resources a client needs and is eligible for, and connects them, checking that the connection actually happened.

Patient communication

  • Engages every client as someone who may have experienced trauma, including trauma from systems, gives them choice and control, and avoids retraumatising them.
  • Finds out what the client wants from services in their own terms and builds the goals from that, rather than from the referrer's agenda.

Compliance and safety

  • Asks directly about suicide, assesses ideation, intent, plan, preparation, means, history, protective factors and the social stressors driving the risk, and acts with a safety plan, means restriction and the right level of care.
  • Screens for intimate partner violence, elder abuse and exploitation in private, assesses danger, and safety plans with the person without taking over their decisions.

Role knowledge

  • Reports suspected child, elder or dependent adult abuse and neglect promptly as the law requires, and handles duty-to-protect situations under their jurisdiction's law.
  • Recognises an ethical problem in their own practice, a colleague's or their agency's, consults, and acts through the right channel until clients are protected.

03Safety red lines#

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

  • Diagnoses and treats a mental disorder in a client whose presentation has an evident possible medical or substance cause - new confusion or memory loss, symptoms after a stroke or head injury, heavy substance use or withdrawal - without referring for medical evaluation.

    A delirium, a stroke complication or a withdrawal syndrome treated as depression or anxiety goes untreated, and some of these are fatal.

  • Lets a client with current suicidal intent, a plan, preparation or access to lethal means leave without a safety plan, means restriction and an arranged next step, or relies on a no-harm contract or the client's promise instead of assessing.

    The hours after a disclosure are when a person with a plan and a means is most at risk, and a promise protects nobody.

  • Would backdate or alter a note, document a service that did not happen, record or bill a service as longer or different from what was provided, or change a record after a request or subpoena to hide what happened.

    A false record misleads every clinician and reviewer after them, and billing for services not provided is healthcare fraud.

  • Takes no action, or agrees to keep quiet, on learning that a colleague is in a sexual, romantic or exploitative relationship with a client or is practising while impaired in a way that puts clients at risk.

    Clients go on being harmed by someone they were told to trust, and the social worker who knew becomes part of the harm.

04Outside the role#

Knowing where the role stops is part of the standard. Going past it is not extra credit.

  • Does not practise independent clinical social work, including diagnosis and psychotherapy without supervision, before holding the clinical licence; titles, supervision requirements and scope differ by US state and Canadian province.Practises under the required clinical supervision until licensed, and within the law of the jurisdiction where the client is located.
  • Does not prescribe, or advise clients to start, stop or change medication.Refers to or coordinates with the prescriber and reports side effects or non-adherence and its reasons.
  • Does not investigate suspected abuse or act as the child or adult protective services investigator.Reports reasonable suspicion to the responsible agency and continues the clinical role.
  • Does not administer or interpret psychological tests beyond their training and their jurisdiction's scope.Uses screening instruments within their competence and refers to a psychologist for psychological testing.

05How it is assessed#

  • A spoken assessment

    An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

  • Five dimensions

    Each answer is read against the expectations above and rated on the same four-level scale.

  • The 70 bar

    Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

  • Safety first

    Crossing one of the safety red lines holds a pass back, however strong the rest was.

The four levels

  1. Not yet
  2. Developing
  3. Proficient
  4. Exemplary
How a verdict is made

06Sources and review#

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 1, last reviewed .

Cited as sources. Not an endorsement by the organizations named.

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