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Exploring Social Work Continuing Education
By Brian Carnahan; Sally Dunlap, MSW; and Dana White, MSW, LCSW
October 2016

The Ohio Counselor, Social Worker and Marriage & Family Therapist (CSWMFT) board has recently been exploring social work continuing education (CE). An advisory committee was established to help the board better understand CE needs. As part of that effort, a survey was sent to more than 25,000 licensed social workers in Ohio in the summer of 2015. One reminder was sent that generated additional responses; 3,637 social workers responded to the survey. Their responses indicated the following:

• 56% were licensed social workers (LSW), 31% licensed independent social workers with a supervisor designation (LISW-S), and 11% LISWs. The remaining respondents, around 2%, were social work assistants (SWA);
• 86% of respondents identified as female;
• 69% of respondents have at least an MSW;
• 75% work full time;
• 34% of the respondents have been licensed 21 years or more, while 20% have been licensed one to five years;
• 78% are working in a setting utilizing social work skills, with the top five workplaces including health systems/hospitals, government, community mental health, social services, and private practice; and
• more than 40% work in a clinical setting, 20% work in a supervisory capacity, while the remaining 40% were in a nonclinical setting or selected "not applicable"; 22% of respondents indicated they were not working in a setting using social work skills.

The survey contained a series of questions about the type and quality of CE social workers take, as well as questions about preferences. The survey revealed the following:

• nearly 50% of the respondents take up to five more hours of CE than required and nearly 20% take 10 or more hours than required;
• about 55% of respondents are required to take up to 10 hours of CE that cannot be counted toward license renewal;
• more than 80% of respondents indicated it was very important that CEs they take be approved by the licensure board for credit;
• course preference was divided, with: 41% instructor led, 22% online/web based, 7% self-study, and 30% no preference;
• the quality of training is thought to be better when it is in person (59%), compared with no opinion (33%) and distance learning (7%);
• more than 90% of respondents indicated they could find the CEs they need to remain effective as a social worker;
• nearly 80% of respondents thought the training they had taken was somewhat or mostly rewarding;
• 45% of respondents said it was easy to find affordable CE in their community, while nearly 35% said it was only occasionally easy and the remaining 20% said it was not easy;
• nearly 59% of respondents said their employer sponsors CE programs; and
• more than 65% of respondents said they pay for most of the CE programs they take. About 40% of social workers report their employer pays for some or all of their CEs.

The survey contained questions about CE trends. In other words, what training do social workers currently need or think they will need in the near future? The following were some of the top categories of CE identified by respondents:

• technology/social media in practice settings;
• health care/wellness/Medicaid;
• alcohol and drug addiction;
• DSM-5;
• gender/sexuality issues;
• aging;
• evidence-based practices;
• trauma;
• macro practice (social justice/administrative); and
• family/children-related issues.

Open-Ended Responses

Among comments from survey respondents, several topics and issues arose as more prominent than others. Accessibility and affordability, in a variety of forms, continue to be critical issues in improving social worker CE. The direct cost of CE is a limiting factor that often constrains social workers to choose the least expensive CE unit (CEU) options over more relevant and valuable trainings. Other less obvious costs, such as using paid or sometimes unpaid leave for training, transportation, and childcare are also considerable barriers. It can be difficult to commit to fulfilling CE obligations if the costs and barriers are too high. This set of issues is particularly important when taking into account the typically low compensation of social workers.

The accessibility and cost of online trainings also factor into social workers' CEU options. As one respondent commented: "I enjoy the in-person seminar opportunities but am not often able to attend due to my current job and personal responsibilities, so I enjoy the convenience of distance learning trainings because of that reason." In-person trainings are preferred where quality is concerned, but online training is a significant source of CE hours because of the convenience and lower cost.

Survey comments also noted a lack of employer support that can further burden social workers' access to CE. Employers often offer strong encouragement to take CE but do not always provide the needed support to complete it. More support from employers, e.g., by providing time off and financial assistance, is evident from the comments. Many survey respondents recognized that there must be a balance between meeting agency and client goals while at the same time growing professionally.

Other factors connected to CE accessibility include both reciprocity and online training options. Respondents clearly desire more reciprocity between other professions' CE options. As social work grows even more integrated into a variety of practice settings (as noted above where medical settings are prominent), social workers are increasingly working in multidisciplinary settings and are interacting with other professions. They cannot always access the training available to these colleagues. While some of the training provided for other disciplines may not be appropriate for social workers, this does highlight a challenge in increasing accessibility for social workers in these multidisciplinary settings.

Cost, in a variety of forms, is a critical issue. Certainly the direct costs of CE is important, but other less obvious costs, such as using paid leave for training, or giving up a day's pay altogether to take training are important, as are other costs such as those for transportation or childcare. It can be difficult to commit to fulfilling CE obligations if the costs are prohibitive. This set of issues is particularly important when one takes into account the average compensation of social workers.

While respondents stated an interest in a variety of topics, there was a notably strong desire for more education around medical issues as increasing numbers of social workers find themselves employed in medical facilities. Responses suggested a demand to better understand the medical environment, but this shift toward addressing medical issues also highlights the need for more training on navigating the medical insurance bureaucracy, particularly through the Affordable Care Act and Medicaid. At the same time, this trend toward medical social work practice highlights a need for future areas of discussion regarding the scope of practice for social workers, particularly during a time in which health care providers are increasingly expected to provide effective services using fewer resources.

Concerning CE hour requirements, respondents expressed that a wide spectrum of employers provide CE opportunities. There is encouragement to take CE and recognition of its value, but not always the substantive support to complete CE. More support from employers, for example, by providing time off and financial assistance, is needed, as is evident from the comments. Responding social workers recognize that there must be a balance between meeting agency and client goals while at the same time growing professionally.

There is no "perfect" number for CEs. In considering this issue, it is worth noting that 70% of respondents exceed the board-mandated CE requirements. Some licensees view 30 hours every two years (the Ohio requirement) as a burden, while others think it is too few hours. This perspective could simply be due to personal opinions on CE, but further exploration is needed to determine whether these perspectives are also related to the quality, convenience, and cost of CEUs taken.

Discussion and Next Steps

The Social Work Continuing Education survey has pointed to a number of next steps or topics to explore. Some of these are clearly the responsibility of the CSWMFT board to address, while others are more appropriate for educators and others to address. Potential future steps that should be explored include the following:

• Continue to encourage and support research that examines the link between CE and effective and ethical practice. Such research can be helpful in determining the appropriate amount and type of CE that should be required.

• Explore how the needs expressed in the survey impact CE approval by the licensure board. Are topics that the respondents identified being offered by program providers? If not, why not? How can we ensure that providers are getting and acting on feedback from social workers? How can the board best address the fact that 55% of respondents are required to take CE that cannot be used toward license renewal?

• Encourage or require providers to survey social workers, focusing questions on quality and how the training is delivered, as well as questions about what motivated the social worker to take the course.

• Foster policies at the licensing board that set high standards for the quality of CE. These expectations set by the licensing board should only be seen as a baseline standard. Providers should seek to exceed any standards the board establishes regarding content and presenter qualifications.

• Research how CE needs align with existing definitions of the scope of practice. Some topics of interest push the boundaries of social work practice. It is important to consider how the long-term impact of expanding scope of practice addressed by CE. These changes should be addressed both within academia and in the field.

• Build partnerships that can address problems such as better access in underserved communities, more quality online instruction, and employer support.

This survey helps to better understand the current and future CE and training needs of social workers in Ohio. Given the diversity of the social work profession in Ohio, the lessons and questions that can be drawn from this survey can also inform the administration of CE in other jurisdictions.