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other. Social workers and counselors may also compete with each other in the area of providing supportive services. Current Structure of the Profession

The National Association of Social Work (NASW) is the governing professional Association and the Council on Social Work Education accredits educational programs in social work. In 1998 the NASW surveyed its membership about the perceived need and interest for additional certification and training. "To help NASW members in today's competitive workplace" the NASW has established a national certification program creating specialty certification in three areas": case management, ATOD (alcohol, tobacco, and other drugs), and school social work (NASW, no date).

As of 2000, the Council on Social Work Education accredited 421 BSW programs and 139 MSW programs. There were 71 doctoral programs for Ph.D.s in social work (Bureau of Labor Statistics, 2002). Acute mental health treatment has been the major focus of graduate education for direct practice in social work since the 1950s. Approximately 85 percent of students entering social work programs expect to practice in mental health. Number and Types of Social Workers

Licensed clinical social workers (LCSWs) are a component of mental health delivery systems and generally have received master's level training in programs teaching family dynamics, psychotherapy, cultural milieu, and crisis intervention (Ivey et al., 1998). Estimates of the number of clinically trained social workers in mental health vary, but generally show a lower bound of around 84,000 (active) and a upper bound of 94,000 - 100,000 (active and inactive) (Ivey et al., 1998; BLS, 2002). Licensure, Scope of Practice, and Reimbursement

All states and the District of Columbia have licensing, certification, or registration requirements. While standards vary, communication skills and training in cultural diversity are increasingly being emphasized. The NASW offers voluntary certification and (as described above) is offering its membership increased options for specialty certification to enhance competitive position (employment and reimbursement) in the market place.

The Bachelor's degree is the most common and minimum requirement to qualify for a job as a social worker in mental health. However, the master's or doctoral level clinical social work degree is generally (almost always) required for independent practice and reimbursement by Medicare, Medicaid, and most private payers. Medicare pays licensed clinical social workers seventy-five percent of a physician's fee and allows for direct billing.

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