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In the 1920s charity organizations and societies changed their mission and role from charity administration to mental health oriented family and individual counseling, re-naming themselves family service agencies (Austin, 1984). This transition had a profound effect on the growth of social practice in mental health and was further fueled by the replacement of many charity agencies by Federal assistance to low-income families through the AFDC program. This greatly diminished the involvement of social work practice in poverty, serving to further direct practice to mental health issues. Approach to Treating Mental Health Problems

The core of social work practice in acute mental health settings is individual and group practice and involves psychological counseling or psychotherapy. The psychotherapeutic practice includes ego-psychology, behavioral, cognitive, and ecological theoretical frameworks. While using these approaches, social work practice is usually based on a medical model that includes diagnosis, treatment (intervention) and the notion of cure as an outcome (Austin, 1984).

In contrast to psychology, social work has generally enjoyed cordial relations with psychiatry – the dominant mental health profession (Grob, 1991). During World War II, psychiatric social workers were afforded the opportunity to do psychiatric assessments - a function they continued to perform after the war in psychiatric hospitals and, increasingly, in outpatient settings as the locus of mental health care shifted to the community. Because psychiatry and social work viewed each other largely as complementary to (rather than substitutable for) each other, demand and opportunity for psychiatrically trained social workers has increased steadily with the growth of mental health care and services. In addition to assessment (including diagnosis) and individual and group treatment, social workers are potentially well-suited to address issues involving families and other social and community services that are central to community-based mental health care.

The relations between psychiatry and social work have remained cordial, even as social workers have achieved a greater role as direct service providers. Perhaps this is because social work does not contest the medical sovereignty of psychiatry in delivering mental health care. In contrast, both nursing and psychology are increasingly pressing for the right to prescribe psychotropic medications. There is a potential and sometimes realized conflict between social work and psychology. This conflict arises primarily in the areas of the right of direct practice and direct reimbursement for services. In larger, organized work settings such as community mental health centers, psychologists and social workers tend to work relatively harmoniously with each


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