The Clinician Vol. 41, No. 2, 2010 Fall

president’s message 
By Jonathan Morgenstern
The planning 
for the Society’s 
Annual Membership 
Meeting program 
this year is a model 
for the importance 
of infrastructure 
to the accom­
plishment of our 
Society’s stated 
purposes.
A committee had been selected by the 
State Board to plan our entire annual mem­
bership meeting – subject, topics, program, 
setting and promotion. When the initial (and 
hastily advertised) program proposal was 
reviewed and revised, challenges were made 
both from within and outside the committee 
to the established process. Ultimately, the 
original infrastructure was upheld and the 
result was an excellent program which fea­
tured presentations by Dr. David Hamilton, 
Executive Secretary, State Board for Social 
Work, and our own Michael Koetting (who 
chaired the planning committee which also 
included Beth Pagano and Dore Shepherd) 
and Dr. David Philips (Society Past President 
and former Society Ethics Committee Chair, 
currently serving on the Society’s By-Laws 
IN THIS ISSUE
 4 Federal Parity Law
 7 Cultivating Referrals
 13  Letter to State Education Dept. 
CONTINUED ON PAGE 3
CONTINUED ON NEXT PAGE
Jonathan Morgenstern, 
MSW, LCSW
LEGISLATIVE COMMITTEE REPORT:
State Finalizes Social Work 
Licensing Regulations
Formal comments were submitted to the 
State Education Department by NYSSCSW 
By Marsha Wineburgh, DSW, Chair
A Notice of Proposed Rule Making (a change in regulations) was published in the State 
Register on June 30, 2010. In response to this notice, formal comments were submitted 
to the State Education Department on behalf of the Clinical Society objecting to, in particu­
lar, the change in regulations with regard to supervision requirements for the LCSW. Our 
comments focused primarily on the inadequacy of group supervision as an acceptable clinical 
supervisory experience for LMSWs mastering diagnosis, treatment and treatment planning 
for the mentally ill. Unfortunately, the proposed amendments were revised and continued 
without our suggested changes by the Board of Regents at the June 2010 meeting. The revised 
regulations were published in the State Register on September 29, 2010 and may be adopted 
as permanent regulations by the Board of Regents at the November 2010 meeting.
The following material is from the “Summary” of proposed amendments to the social 
work licensing regulations prepared by the State Education Department.
LCSW Experience Requirements
Section 7704(2) of the Education Law requires an applicant seeking licensure as an LCSW to 
complete three years of full-time supervised post-graduate clinical social work experience 
The 41st Annual Education 
Conference in May featured 
outstanding keynote 
presentations by (photo left)
Catherine Lewis and 
Crayton E. Rowe, Jr. 
see page 8.
Photo: Sandra Indig
CONFERENCE REPORT: Contemporary Approaches to the Treatment of Trauma
TH E N EWSLETTE R OF TH E N EW YORK STATE SOCI ETY FOR CLI N ICAL SOCIAL WORK, I NC.
FALL 2010 | VOL. 41, NO. 2
2   The Clinician
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NEW YORK
STATE
SOCIETY
FOR
CLINICAL
SOCIAL
WORK,
INC.
President’s Message
State Board Members 2010
STATE EXECUTIVE COMMITTEE
President  
Jonathan Morgenstern  MjonathanM@aol.com
Past President  
Hillel Bodek  bodekmsw@verizon.net
First Vice President  
Marsha Wineburgh  mwineburgh@aol.com
Second Vice President  
Shannon Boyle  shannonboyle@hotmail.com
Treasurer  
Helen Hinckley Krackow hhkrackow@aol.com
Board Secretary  
Elizabeth Ojakian  e08@nyu.edu
CHAPTER PRESIDENTS
Brooklyn  
Carol Kamine-Brown  c.kbrown@cohme.org
Manhattan (Met)  
Ariane Sylva  drsylva@drsylva.com
Mid Hudson  
Rosemary Cohen  rosemarycohen@gmail.com
Nassau  
Lorraine Fitzgerald  cfgoodgnef@mac.com
Queens  
Fred Sacklow  freds99@aol.com
Rockland  
Dore Shepherd  doreshep@yahoo.com
Staten Island  
Mary FitzPatrick  fitzrodal@aol.com
Suffolk  
Sandra Jo Lane  sjsunshine@aol.com
Westchester  
Martin Lowery  mlowery@maryknoll.org
MEMBERS-AT-LARGE
Manhattan (Met)  
Fred Mazor  fredm25@aol.com
Mid Hudson  
Roberta Faulk  srfaulke@juno.com
Rockland  
Beth Pagano  bethpagano678@msn.com 
Westchester  
Sheldon Blitstein  sabhidhammab@optonline.net
COMMITTEE CHAIRS
Annual Education Conference  
Susan Klett  suzannneklett@aol.com
Creativity and Transformation  
Sandra Indig  psych4art@hotmail.com
By-Laws  
Beth Pagano  bethpagano678@msn.com
Chapter Development 
Helen Hinckley Krackow  hhkrackow@aol.com
Disaster Preparedness  
Fred Mazor  fredm25@aol.com
Ethics  
Hillel Bodek  bodekmsw@verizon.net
Forensic Social Work  
Hillel Bodek  bodekmsw@verizon.net
Independent Practice  
Sheila Peck  sheila2688@aol.com 
Leadership  
Beth Pagano  bethpagano678@msn.com
Legislative Affairs  
Marsha Wineburgh  mwineburgh@aol.com
Membership  
Shannon Boyle  shannonboyle@hotmail.com
Mentorship  
Helen Hinckley Krackow  hhkrackow@aol.com
Newsletter  
Helen Hinckley Krackow  hhkrackow@aol.com
Nominations and Elections  
Beth Pagano  bethpagano678@msn.com
Palliative Care  
Hillel Bodek  bodekmsw@verizon.net
Strategic Planning  
Judy Crosley  crosleyj@yahoo.com
Vendorship and Managed Care Helen Hoffman  helenhoffman@verizon.net
Listserv  
Robert Berger  rsb111@columbia.edu
CONTINUED FROM PAGE 1
Revision Committee). All graciously offered to present on 
short notice.
The purposes of our Society include strengthening profes­
sional identity, building professional networks, promoting 
professional expertise and advocating for clinical social 
work. The infrastructure to accomplish these goals includes 
members who volunteer to make up the state and chapter 
boards to provide administration and support; members 
who volunteer on state and chapter committees to provide 
specific goal-related work; and administrative supports now 
provided by Sheila Guston and Total Management Solutions, 
who had made all of the meeting’s setting arrangements. 
Mitzi Mirkin, former Society Consulting Administrative 
Assistant who retired earlier this year, was honored for 
her many years of service to the Society. 
Volunteerism is the life blood of the Society – everyone 
volunteers on top of everything else they already do – and 
this represents both our greatest strength through commit­
ment, and also our greatest limitation.
Our infrastructure also includes our by-laws, which are 
currently undergoing updating and revision by a commit­
tee chaired by Beth Pagano, and our policies and proce­
dures, which were recently compiled into 11 manuals by 
the Strategic Planning Committee, chaired by Judy Crosley. 
These anchor and guide all our work on behalf of the Society. 
Volunteers do not have to struggle with how to do things – 
our manuals pretty much spell everything out clearly, and 
make it easier to transition from one leader to the next. 
It is this infrastructure that supports all that we wish to 
accomplish. I have spent the last three years of my presi­
dency strengthening this infrastructure through transparent 
and collaborative communication and leadership. Our future 
requires nothing less.
Vision for the future
My vision for the remainder of my presidency includes fur­
ther clarification of our identity as a society of clinical social 
workers. Are we a society of private practitioners only, or do 
we include clinical social workers in all work settings (e.g., 
agencies, clinics and hospitals)? If we choose to be more 
inclusive, we should consider offering services of relevance 
and value, including broader educational offerings and peer 
supervision – and we will need to engage in outreach. Some 
chapters are already planning for this. 
We should be more involved in the process of establish­
ing more clarity regarding distinctions currently being made 
between “clinical social work” and “psychotherapy,” since 
this is causing much division within the social work field. 
CONTINUED ON PAGE 15
Published twice yearly by the
New York State Society for Clinical Social Work, Inc.
243 Fifth Avenue, Suite 324, New York, NY 10016
Website: www.ClinicalSW.org / Tel: 1-800-288-4279
Ivy Miller, Newsletter Editor
301 East 45 Street, Apt. 8d, New York, NY 10017
E-Mail: IvyMiller@hotmail.com / Tel: 917-620-3460
Helen Hinckley Krackow, Newsletter Chair
Ad Deadlines: January 15 and September 15
Fall 2010    3
in diagnosis, psychotherapy and assessment-based treatment plan­
ning, or its part-time equivalent obtained over a period of not more 
than six years. The law does not require the applicant to complete 
any other social work experience, although the practice of licensed 
clinical social work includes other activities, including case man­
agement, advocacy, and testing. Such activities are not acceptable 
toward completion of the experience requirement under the current 
law. The new regulations adopted in June require an applicant to 
complete 2,000 client contact hours in diagnosis, psychotherapy, and 
assessment-based treatment planning over a period of not less than 
36 months and not more than 72 months under a qualified supervi­
sor. While this is a 30 percent reduction from the current require­
ment for 2,880 client contact hours over the same period of time, it 
is still among the highest requirements for clinical hours in the U.S., 
and the Department believes 2,000 client contact hours provides 
sufficient experience to ensure client protection once the applicant 
is licensed. 
Section 74.3 of the Commissioner’s regulations was also amend­
ed to clarify the experience requirements for licensure as an LCSW 
in New York. The amendments require an applicant for licensure 
to complete the required experience as an LMSW or permit holder 
in New York, except in certain limited circumstances. For experi­
ence completed in another jurisdiction, the experience must be 
obtained after the applicant completes his or her master’s degree. 
The amendment requires the applicant to complete the experience 
in an acceptable setting under a qualified supervisor, as defined in 
section 74.6 of the Commissioner’s regulations. The amendment 
also requires the supervisor to maintain records of the applicant’s 
client contact hours and supervision and to submit verification of 
the client contact hours and supervision on forms prescribed by the 
Commissioner. 
The regulations also add a new section 74.9 to allow the 
Department to endorse for practice in New York the license of 
an LCSW licensed in another jurisdiction. The applicant would 
have to have at least 10 years of licensed practice during the 15 
years immediately preceding the application for licensure in New 
York. In addition, the applicant must demonstrate: licensure as 
an LCSW on the basis of a master’s degree in social work from an 
acceptable school, post-degree supervised clinical experience, 
and the passage of a clinical examination in social work acceptable 
to the Department. The applicant must also be of good moral 
character, complete coursework in the identification and reporting 
of suspected child abuse, and submit the application for licensure 
and fee established in law and regulation. 
Section 74.4 of the Commissioner’s regulations was also 
amended to clarify that limited permit applicants must be of good 
moral character and that the permit may only be issued for work 
in an authorized setting under a qualified supervisor. In addition, 
the amendment strengthens the requirement that the supervisor 
is responsible for the services provided by the permit holder and 
limits a licensee to supervising no more than five permit holders at 
any one time. Since the permit holder is only authorized to practice 
under supervision, this restriction is appropriate for public protec­
tion and consistent with the requirements in other professions. An 
LMSW or LCSW permit holder who is practicing clinical social work 
under supervision must be under general supervision as defined in 
the proposed amendment.
“R” Requirements 
Experience for the insurance privilege, “R,” must be obtained after 
licensure as an LCSW over a period of not less than three years. 
In addition, the applicant must have no less than 400 client contact 
hours in any one year in order to qualify for the privilege. In order to 
clarify the process of meeting the requirements in Insurance Law, 
the amendment also defined an acceptable setting for the practice 
of licensed clinical social work and required an LCSW to submit for 
approval by the State Board for Social Work a plan for appropriate 
supervision. The amendment also defined acceptable supervision 
for the privilege as two or more hours per month of individual or 
group consultation or enrollment in a program in psychotherapy 
offered by an institution of higher education or by a psychotherapy 
institute chartered by the Board of Regents. This amendment 
also eliminated peer supervision, which is not authorized by the 
Insurance Law, and clarifies the pathway to the insurance privilege. 
Certain individuals who started their experience for the insur­
ance privilege prior to January 1, 2011, may submit experience 
obtained prior to licensure as an LCSW toward the experience 
requirements for the insurance privilege. 
Supervision requirements for the LCSW
The amendments to section 74.6 of the Regulations of the 
Commissioner of Education establish the supervision requirements 
for a licensed master social worker providing clinical social work 
services. An LMSW who has submitted an application for licensure 
as an LCSW must maintain registration as a LMSW in New York and 
may practice only under supervision until licensed as an LCSW. The 
amendments clarify what constitutes an acceptable setting for the 
practice of clinical social work and require the supervisor to provide 
at least 100 hours of individual or group supervision to the LMSW, 
distributed appropriately over a period of at least 36 months. The 
LMSW would also be able to submit a plan for supervised experi­
ence toward licensure as an LCSW, for review and approval by the 
State Board for Social Work. By obtaining such approval prior to 
starting a position, an applicant would be able to avoid working for 
three years in a position which cannot be accepted toward meeting 
Legislative Committee Report 
CONTINUED FROM PAGE 1 
FOR COMPLETE TEXT OF LETTER TO STATE EDUCATION 
DEPARTMENT ON BEHALF OF SOCIETY SEE PAGE 13.
CONTINUED ON PAGE 16
4   The Clinician
Vendorship and Managed Care Committee 
By Helen T. Hoffman, LCSW, Chair
T
he purpose of the Vendorship and Managed Care Committee is 
to gather and disseminate information, to provide support to 
individual members on insurance issues, and to consider how 
the Society might act to influence external forces affecting the financial 
health of clinical social workers.
The committee, which consists of 13 members drawn from the vari­
ous chapters of the Society, meets six to eight times a year by telecon­
ference and in person, and shares information by E-mail. In the last six 
months the committee has focused on the following areas:
• Responding to the Oxford/UBH transition with a letter to UBH and 
support for members
• Following the roll-out of the Federal Parity Bill (MHPAEA) as it is 
interpreted by the insurance industry
• Attempting to understand how the Affordable Care Act will affect 
patients and providers
• Learning about the realities and possibilities for advocacy from 
speakers on antitrust and the Clinical Social Work Guild
• Participation in planning for a pilot on depression care by New York 
Business Group on Health
The Committee recently archived its bulletins of the last two years on 
the Society website. You are invited to visit http://clinicalsw.org/com­
mittee_vendorship.asp
Committee members who may be contacted for information or support 
on insurance issues: 
CHAPTER/NAME	
E-MAIL	
OFFICE PHONE
metropolitan
Helen Hoffman	
helenhoffman@verizon.net 	
212-873-3052 
Ruth Washton	
rwashton@verizon.net	
917-584-7783 
Virginia Lehman*	
LehmanV117@aol.com	
212-674-2984
Mary Freeman**	
bullpen@mindspring.com	
212-348-0004
Judy Adelson	
judyadelson@rcn.com	
212-222-4486
Henni Fisher	
info@hennifisher.com	
718-646-7001
queens
Shirley Sillekens	
ssillekens@aol.om	
718-527-7742
northeast
Doris Tomer	
tomerd@juno.com 	
518-271-1862
westchester 
Linda Plastrik	
LPtunedin@aol.com 	
914-631-6342
rockland 
Lorraine Schorr	
lorrainesara@aol.com	
845-354-5040
nassau
Susan Kahn	
shkahn@verizon.net 	
516-482-1269
staten island
Colleen Downs	
eve114@aol.com 	
718-816-0712
Observations on the New Federal 
Parity Law    By Ruth Washton, LCSW
Optum Health presented a webinar on August 4, 2010 concern­
ing implications and implementation for providers of the new 
Federal Mental Health Parity Law, which went into effect July 1, 
2010. Although I was unable to attend, I did receive a summary, 
which you may access at http://go.optumhealth.com/optum­
health/presentations/080410_nyforum.pdf
As I find the content of this summary for the most part inscru­
table, I would like to share my own current understanding of par­
ity based on a reading of the law in the Federal Register, as well 
as conversations with the health care representative in Senator 
Gillibrand’s office (a social worker by training) and a UBH Care 
Advocate who impressed me as having informed herself as much 
as possible to date about the new law. I do not make any claim 
to being an authority on this subject, but only wish to share my 
thoughts and observations on this important topic.
The interpretation of the Federal Parity Law is evolving. While 
it went into effect 7/1/10, it becomes applicable to a particular 
policy only when that policy renews on or after 7/1/10. So most 
policies will not be subject to parity until they renew on January 
1, 2011. It is on that date that the final interpretation of the law 
must be in place. Some of the issues still being grappled with are 
as follows:
• The Federal Parity Law does not define which diagnoses are 
covered. Apparently, it is up to an employer to decide which DSM 
diagnoses to cover. The NY State Empire Plan, which covers NY 
State employees, has decided to cover all DSM diagnoses, but 
a Congressional decision has not yet come down to apply to all 
policies. Therefore, in NY State, Timothy’s Law still applies, and 
right now in New York, only the biologically based diagnoses are 
covered. 
• The New Jersey APA has brought suit against Blue Cross, 
Horizon and Magellan to challenge managed care’s right to 
intrude on patient confidentiality with their telephone clinical 
reviews. We are all aware of the stepped up pace with which 
these reviews are now taking place. APA’s basis for its challenge 
is twofold: the first leg is the breach in confidentiality mandated 
by HIPAA; and the second leg is the mandate for parity between 
medical/surgical review practices and behavior health. In other 
words, if physicians are not called repeatedly to review their 
treatment of patients, then such review of behavior health pro­
viders is not in parity under the law. We will see how this plays 
out in court. 
• To achieve parity between medical/surgical and behavioral 
health benefits, employers may restrict behavioral health ben­
efits by restricting medical/surgical. For example, a maximum 
number of visits to a medical provider may be imposed to achieve 
*Medicare Liason; ** National Health Insurance Observer
CONTINUED ON PAGE 16
Fall 2010    5
Chapter Reports
METROPOLITAN • MID-HUDSON • QUEENS • STATEN ISLAND • SUFFOLK • WESTCHESTER
Metropolitan Chapter
Ariane Sylva, President 
The thriving Met Chapter holds lively planning 
discussions at the second-Friday-of-the-month 
board meetings. Members are welcome to 
attend. Contact our President, Ariane Sylva, 
to ensure your space, in advance at drsylva@
drsylva.com.
Our Met Chapter Announcements Listserv 
has been keeping us all up-to date on the 
various meetings of the 14 Met Chapter 
Committees. Our Interactive Listserv has 
become an online hub for referrals, informa­
tion and resources. Contact Committee Chairs 
Robert S. Berger and Lisa Beth Miller at 
i.m.c.moderators@gmail.com.
The Education Committee held three 
brunches, as usual: the February Brunch, 
“Some Like It Not: Why Couples Stop Engaging 
in Sex with Their Partner,” presented by 
Sari Eckler Cooper; the April Brunch, on 
“Psychotherapeutic Considerations Specific to 
the Treatment of the Older Population,” pre­
sented by Renee Goldman; and recently, anoth­
er wildly successful, informative and moving 
brunch, on October 17, “From Soup to Nuts: 
Effectively Resolving Resistances in Individual 
and Group Eating Disorder Treatment,” led by 
Joanne Gerr. Contact Committee Chair Susan 
Appelman at shrinksga8@aol.com.
The Membership Committee has been 
hosting wonderful receptions (four this year) 
welcoming new, old and potential members. At 
our upcoming Food for Thought event, mem­
bers will be meeting for a delicious dinner at 
Carmine’s Restaurant and a professional pre­
sentation on Tuesday, October 26, at 7:30 p.m. 
Dr. Simon Rego will be presenting “Building 
Your CBT ‘Tool Kit’ for Anxiety Disorders.” 
Contact Committee Chair Richard B. Joelson at 
rbjoelson@aol.com.
The Clinical Ethics Committee is meeting 
on October 22. These meetings are closed 
and confidential, where peers work through 
an ethical dilemma in their practice or that af­
fects their practice. Contact Committee Chair 
Eileen Ain at dreileenain@gmail.com.
The Committee on Psychoanalysis is hold­
ing another rich discussion at the upcoming 
Movie Night presentation of “Two Lovers,” to 
be held on November 19 at 7:00 pm. Contact 
Committee Chair Libby Kessman at libbykess­
man.lcsw@yahoo.com.
Save the date for our upcoming Holiday 
Party: Sunday, December 12, 4:00–7:00 pm. 
A great time is had by all at these events.
Our Spring Gathering, usually held in April, 
will be another great opportunity to meet in 
person and put faces to the names of the many 
colleagues interacting on our Listserv.
Rita Gazarik and Phyllis Mervis are 
planning for our March 26, 2011 Conference: 
“Creating and Sustaining a Clinical Practice 
in the 21st Century.” Anyone interested in co-
leading a workshop about blogs, please contact 
Rita Gazarik at ritagazarik@gmail.com or 
Committee Chair Phyllis Mervis at pmicsw@
aol.com.
Reminder for any colleagues interested in 
the Society: If you join after September 15, you 
will be paying the 2011 membership fee and 
getting the rest of this year at no extra charge. 
We welcome new participants in our wonderful 
society, a vibrant professional community.
To contact the leadership of the Met 
Chapter, go to http://www.clinicalsw.org/
By Lisa Beth Miller, LCSW, Met Chapter 
Listserv Committee Co-Chair
Mid-Hudson Chapter
Rosemary Cohen, President
In collaboration with NASW Hudson Valley 
Division and the Adelphi University/Hudson 
Valley Graduate School of Social Work, 
the Mid-Hudson Chapter is holding its Fall 
Conference on October 15, with Monica 
McGoldrick: “Context and Connection: Helping 
Clients Transform Their Life Narratives.” 
Twenty years ago, in Poughkeepsie, 
Ms. McGoldrick presented to an overflow­
ing audience a full-day conference on family 
systems theory and therapy, sponsored also 
with the NASW Hudson Valley Division and 
local social work schools and agencies. Since 
that time several social work conferences have 
occurred here in the Hudson Valley through 
this ongoing collaboration.
On November 13, at the Benedictine 
Hospital Conference Room in Kingston, Bonnie 
Kavner Scheer will present her workshop: 
“Please Don’t Treat Alcoholism and Substance 
Use and Abuse, Unless…”
Ms. Scheer has spent her entire social 
work career in community service with the 
Dutchess County Department of Mental 
Hygiene. In the l990’s she was chosen to be 
Social Worker of the Year by the NASW Hudson 
Valley Division. 
On January 22, 2011, at Vassar Brothers 
Medical Center, longtime Society member 
Alan Spivack of the Family Therapy Center 
of Poughkeepsie will offer his workshop: 
“Theraplay: An Attachment Based Family Play 
Therapy.” Rosemary Cohen, President,  
rosemarycohen@gmail.com
Queens Chapter
Fred Sacklow, President
The Queens Chapter had a busy year. We had 
monthly Board meetings and educational 
presentations from October 2009 until June 
2010, meeting at Holliswood Hospital in central 
Queens. Our presentations included the fol­
lowing topics: Emotional Freedom Technique, 
practice building, psychosis, distressed 
marriages, adult ADHD, adult children of 
alcoholics, overeating, boundary crossings and 
dreams. It was a very rich year. 
Our listserv has been active and we are 
planning for upcoming meetings and presenta­
tions. Please keep the following dates avail­
able: 9/19, 10/17, 11/21, 12/19, 1/16/11, 2/13, 3/20, 
4/17, 5/15, 6/12. Educational presentations run 
from 11:30 am until 1:00 pm. 
I also want to announce that Lynne 
O’Donnell, LCSW received a recognition 
award from the Queensboro Council for Social 
Welfare in March for her service to the people 
of Queens and to the social work profession. 
For questions please contact 
Fred Sacklow, President, at Freds99@aol.com.
CONTINUED ON PAGE 17
6   The Clinician
Committee for Creativity & Transformation 
in Clinical Practice
A
lmost by way of welcoming this change of season, we 
will start our Sunday series of presentations/ work­
shops with a new name. We were The Committee 
for Arts and Creativity, and we are now The Committee 
for Creativity & Transformation in Clinical Practice. This 
new name was perceived to be more inclusive. Perhaps as 
a result, we will continue to have a long waiting list of fine 
speakers for the academic calendar year of 2011–12. 
Winter to Spring 2010
The Committee presented three very well received events. 
On February 26, Sema Gurun, LCSW met us at the Morgan 
Library for a walk through the exhibit of one of the largest 
selections of Jane Austen’s letters. The exhibit, “A Woman’s 
Wit: Jane Austen’s Life and Legacy,” was further enhanced by 
the attendance of its curators and their commentary.
“Source Material of the Writer: Reflections on Jane 
Austen,” an enjoyable presentation by Dr. Roberta Shechter, 
DSW, LCSW on March 28, used biographical and literary 
commentaries on Austen and her work to explain the 
Freudian psychodynamics of learning to love found in the 
novel Pride and Prejudice.
On May 16, Bryan C. Hazelton, LCSW, CASAC, BCD presented 
experiential exercises to highlight his workshop, “Embracing 
Empathy Through the Use of Imagination in Treatment.” 
Fall 2010 to Spring 2011
October 10  
Dayle Kramer, LCSW, LP: “Observing and Seeing: The Art 
of Attunement with Yourself and Your Patient” This workshop 
will focus on the similarities between the art of listening, 
observing the patient, and making art. Through the use of 
basic drawing exercises and discussion, participants will 
experience an increased connection to their creative core 
and the similarities of sitting with a patient.
November 14  
Ann Rose Simon, LCSW: “How Can Neuroscience Inform our 
Practice: Reclaiming Creativity and the Self?” This workshop 
will give a brief overview of recent findings in neuroscience 
research which support some of the psychotherapeutic 
concepts that we utilize in our practices. 
January 9
George Hagman, LCSW: “The Artful Brain: Survival 
Through Creativity”
We will explore enhancement of brain functioning and 
the psychological nature of art as well as subjective states 
including survival through creativity. 
March 13 
Paul Giorgianni, LCSW, BCD: “Objects in the 
Psychotherapy Environment”
This workshop will explore the use of displacement and 
projection by both patient and therapist in the service of 
communication. Case examples of the use of objects in the 
therapist’s office will be given. 
April 10   
Helen Hinckley Krackow, LCSW, BCD: “Mirrors of the Soul: 
Evoking the Unconscious Body Image through Hypnosis”
This workshop will demonstrate the use of clinical hypnosis 
and psychodynamic theory in working with clients’ uncon­
scious representations of self. The technique for accessing 
this material will be demonstrated and opportunities to 
participate will be offered to workshop attendees.   
by Sandra Indig, LCSW, ATR-BC, Chair
WHERE AND WHEN: 
Sundays from 11:00 am to 12:30 pm or 1:00 pm. 
150 Fifth Avenue, Suite 900 
(Between 18th and 19th Streets) 
CONTACT: 
Sandra Indig, Chair, for more information: 
212-330-6787
Fall 2010    7
 
By Richard B. Joelson, DSW
T
oo many clinicians in private practice struggle to main­
tain an acceptable number of clients in their practices, 
while others report having more work than they can 
handle. The causal factors for this disparity may have very little 
to do with training, years of experience, skill level, or talent. 
Too often the problem is the absence of effective practice 
promotion or the absence of practice promotion altogether.
There are many who believe that an excellent education, 
proper credentials, a lovely office, and a fine reputation in 
the professional community are—or should be—enough to 
succeed in private practice. Yet, somehow, the phone is not 
ringing and there are way too many open hours. Often, these 
are the very mental health professionals who argue that 
marketing or practice promotion is “unacceptable,” “unpro­
fessional,” or “undignified.” Comments like these frequently 
turn out to be camouflage for “I’m not comfortable market­
ing,” or “I don’t know how to market myself,” or “I don’t want 
my colleagues to think I’m not doing well,” and more.
A consistent referral flow from a variety of referral 
sources is vital to a successful practice and marketing your 
practice is one of the obvious ways to achieve this. I have 
always seen marketing as an acceptable and enjoyable part of 
my professional life. I have also observed the extent to which 
it provides not only opportunities to inform people about my 
work, but it helps people learn something about what mental 
health professionals do, how they do it, and what services are 
available to them as service consumers. It is also an excel­
lent opportunity to help people unsure or unfamiliar with 
the world of mental health services differentiate between 
various providers, so that they may be in a better position to 
make an informed and thoughtful choice.
Marketing to the lay public and to the professional com­
munity certainly involves some different approaches and 
strategies. To the general public, marketing often provides 
an educational opportunity and helps to demystify what it is 
we do. Whenever I am in a position to answer questions from 
prospective clients like, “what exactly is psychotherapy?,” 
“how long does it take?,” should I see a psychiatrist, psychol­
ogist, or a social worker?,” “will people think I’m crazy if I see 
a shrink?,” etc. I feel I am helping people pave the way to get 
the help they might need, as well as promote my own practice 
if I think it is appropriate to do so.
Marketing to the professional community is different in 
many ways, but involves quite similar activities. Here are 
some ideas about how to develop a “marketing mindset” and 
some “tips” for cultivating new referral sources as well as 
making sure that existing sources of referral remain active 
and interested in you and your practice:
1. Try to remember (and get comfortable with) the fact 
that your practice is also your business and needs to be 
handled accordingly.
2. Try to get beyond the idea that your training and 
competence alone should make marketing strategies 
unnecessary for successful independent practice.
3. Beware of “narcissistic pitfalls” in the marketing of your 
practice. Try to make sure that your self-esteem is not at 
the mercy of such things as the number of open hours 
in your practice, ebbs and flows in referral activity, some 
referred clients not working out, etc.
4. Always carry a few business cards with you. Not only is 
it important to have one on you when someone asks, but 
carrying them helps to heighten awareness of marketing 
opportunities.
5. Schedule marketing activity in your professional 
appointment book the way you would schedule a client. 
My recommendation is a minimum of three to five hours 
per week for a practitioner who is seriously interested in 
generating a solid referral base and in generally attending 
to the marketing requirements of a successful practice.
6. Figure out a thoughtful way to inform old and new referral 
sources of changes in your services or in your professional 
life, e.g., a new specialization, training, publications, 
degrees, office relocation, honors, etc. 
7. Accept responsibility for the outcomes of your marketing 
efforts. This will help you identify and change attitudes and 
behaviors that might be interfering with more productive 
marketing activities.
8. Write an article for either a professional or lay publication 
on a topic about which you have expertise and that might 
have marketing value for your practice. If published, send 
copies to both existing and prospective referral sources.  
next issue: The Self-Defeating Private Practitioner: 
Causes & Cures
Private Practice Matters
Tips on Cultivating New Referral Sources
8   The Clinician
New York State Society for Clinical Social Work 41st Annual Education Conference  |  May 8, 2010 
Lives Disrupted:
I
n his presentation, Crayton Rowe examined the concept of trauma 
as it pertains to first-year-of-life experiences, and extended 
one aspect therein, interruptions in one’s basic undifferentiated 
selfobject experience, to explain symptoms of psychopathology in 
adulthood. 
The concept of the “undifferentiated selfobject” is an origi­
nal concept first introduced in 2005 by Rowe, and refers to “the 
fundamental experience of knowing that there will be unknown, 
nonspecific happenings that will occur throughout life that will be 
surprising, challenging, uplifting, and self-enhancing no matter the 
positive or negative nature of our current circumstances.” In that 
the undifferentiated selfobject is an extension of Kohut’s selfobject 
concept, Rowe began his presentation by first describing Kohut’s 
selfobject. He explained that the selfobject is “the experience of 
the functions provided by an object – understanding, attention, and 
so on.” These functions, when present in another, allow us to meet 
our basic needs for “recognition, twinship… and idealization.” 
Rowe, referencing Kohut, explained that the selfobject is defined by 
our experience of “what emanates from an object — not from the 
object itself.” 
Rowe argued that along with this interpersonal experience 
of the selfobject, infants universally first experience the more 
primary phenomena of the undifferentiated selfobject, which does 
not depend on another to exist. He described the undifferentiated 
selfobject as the “fundamental experience of knowing that there 
is more forthcoming to experience.” Ultimately, Rowe believes this 
serves as “the motivating force” throughout life for accomplish­
ments, recognition, the pursuit of satisfying friendships, creativity, 
discovery, and development. 
Illustrations
To illustrate this experience, Rowe first referenced cultural icons 
like Sondheim, and his West Side Story hit “Something’s Coming 
Keynote Presentation by Crayton E. Rowe, Jr., MSW, BCD-P / Review by Charlotte Elkin, LCSW
Extending Kohut’s Concept of Selfobject: The Undifferentiated Selfobject: 
A Case of a Depressed and Potentially Suicidal Woman
Charlotte Elkin, LCSW, has a private practice in Manhattan working with 
adult individuals and couples. She is also in the CUNY doctoral program in 
Social Welfare.
A Theoretically Rich Event	
By Susan A. Klett, LCSW-R, BCD, Chair
At the 41st Annual Conference, the keynote presentations by renowned experts Crayon E. Rowe, Jr., MSW, BCD-P, and Catherine Lewis, 
LCSW, MS, were theoretically rich, creatively reflective and thought-provoking, providing new concepts and approaches in treatment 
for clinicians working with family and individuals impacted by traumatic experiences.
Thirteen distinguished workshop leaders from across a wide theoretical spectrum, Mary Elbow, PhD, LCSW, Ann Rose Simon, LCSW, 
Alice Entin, LCSW Aideen Nunan, LCSW, Edith Laufer, PhD Charlotte Kahn, PhD Hillary Grill, LCSW, Louise Kindley, LCSW, Sally W. 
Clayton, Certified hypnotist, Madelyn Miller, LCSW,CGP, Marc Wayne, LCSW, BCD. Gildo M. Consolini, PhD, LCSW and Tripp Evans, PhD, 
LCSW, addressed optimal ways to understand and treat patients suffering from multiple dimensions of trauma.
An audience exceeding one hundred people contributed to lively discussions. Groups of up to 20 clinicians participated in dynamic 
workshops which addressed the educational needs of social workers from diverse backgrounds and settings. 
I would like to extend many thanks to the gifted members of the Education Committee — Meryl G. Alster, LCSW-R, Kirk Brewster, 
LCSW, Gildo M.Consolini, PhD, LCSW, Charlotte Elkin, LCSW, CEAP, Tripp Evans, PhD, LCSW-R, Gail Grace, LCSW-R and Ashanda S. 
Tarry, LMSW — who gave generously of their time and talents to the success of this extraordinary conference.
I welcome your feedback and encourage you to submit topics for next year’s workshops. I invite you to send in a workshop 
proposal, to share in our community, and to promote your professional growth. You may contact me at suzanneklett@aol.com or by 
mail at 157 East 57th Street, #6D, New York, N.Y. 10022
CALL FOR PROPOSALS FOR 2011 CONFERENCE: PAGE 12
Fall 2010    9
Contemporary Approaches to the Treatment of Trauma
(something good);” Beckett, and the “rewarding” experience 
of waiting despite the outcome in his Waiting for Godot, and 
Dostoevsky’s observation in The Idiot that Columbus’ “highest 
moment of happiness was, perhaps, exactly three days before the 
discovery of the New World… the point is in life, in life alone — 
in discovering it, constantly and eternally, and not at all in the 
discovery itself.” Rowe then went on to share video clips of four 
infants, two of whom were twins filmed together, from the Child 
Study Group of The New York Institute for Psychoanalytic Self 
Psychology. The clips all showed infants at 8 to 9 months, and then 
again at around 13 months of age. Clearly evident in all three clips of 
the 8 to 9-month-olds was the “motivational force” to search for and 
explore that which is new; all four babies enthusiastically reached 
for or moved towards new objects, and pleasurably examined these 
objects from a variety of viewpoints. Even the twins, whom one 
might assume would be more interested in each other, separately 
exhibited this type of exploratory behavior. 
Interestingly, at 13 months, an age by which selfobject experi­
ences have typically evolved, the babies all looked towards their 
caregivers to share their discoveries, walking to offer a ball, toy or 
other object for a more interpersonal experience. With one child, 
the video depicted a mother engaged in a conversation with another 
adult, and her repeated lack of recognition when her son offered 
a ball, instead rolling the ball away with little acknowledgement of 
his discovery. Although subtle, one noticed the child’s enthusiasm 
diminish and his mood shift as he repeatedly tried to interact and 
was brushed away. He slowly began to disengage and Rowe refer­
enced Kohut when he later went on to describe experiences like 
this one, where basic selfobject needs for recognition go unmet, 
repeatedly and drastically over time, and contribute to subsequent 
psychopathology. 
Of further note, however, is Rowe’s belief that in the first year of 
life, interruptions in the experience of the undifferentiated selfob­
ject (e.g., an overprotective or germ-phobic parent who continuously 
curtails a baby’s exploration by jerking away toys, etc.) subsequently 
affect fulfillment of selfobject needs. When an infant’s search behav­
ior is limited, Rowe argued, their need for recognition is “circum­
vented” and the “idealizing and twinship needs that are dependent 
on the child’s feeling recognized will not emerge.” In essence, 
normal development is disrupted and Rowe, citing others, explained 
“the traumatizing effects remain as core negative experiences in 
the unconscious.” Rowe shared that in his analytical practice he 
has observed that disruptions like these are universally present in 
“severely emotionally traumatized adults and children.” 
In discussing treatment, Rowe explained that while severely trau­
matized patients may initially present with “compulsive, suicidal, 
addictive, and attention deficit/hyperactivity behavior,” and tend to 
focus on the “debilitating effects of their symptoms,” of importance 
beyond their complaints is their “continuous preoccupation” with 
“detect[ing] and anticipat[ing] new aspects of their symptoms.” 
From his perspective, that a developmental need to discover (undif­
ferentiated selfobject) moves an infant towards the development of 
selfobject needs, Rowe posited that this “pursuit of thinking,” and 
the resulting worsening of symptoms experienced by these patients, 
is actually the primary issue, and the symptoms themselves second­
ary. In other words, individuals whose fundamental motivating force 
was thwarted early on lack a “template” for motivation, are “fixated 
on core negative experiences,” and hold onto “more negative views 
of themselves and the world.” 
Because expression of early undifferentiated selfobject needs 
have been interrupted, Rowe argues that these individuals are 
pessimistic about new experiences, expecting the reoccurrence 
of the negative, or the repetition of disturbing symptoms, rather 
than relief from them. Thus, in treatment, Rowe believes that 
interventions must focus first on understanding and validating the 
early “trauma,” or the disruptions in patients’ preverbal, first year 
experiences, and next offer space in which patients can once again 
feel free to explore, discover and ultimately resolve unfulfilled 
selfobject needs. With this approach, Rowe argued, patients can 
move beyond their fixations to feel recognition, and in turn, success, 
worthy of contribution, and a need for like-minded friends/partners. 
Rowe contrasted this to other theories focusing on the nature and 
persistence of individuals’ symptoms instead. Significantly, in mak­
ing this purposeful shift, Rowe described his patients as “feel[ing] 
understood, and [their] symptoms subsid[ing].”
Education Conference Committee Members: (l to r, front) Susan Klett, 
Chair, LCSW-R, BCD; Charlotte Elkin, LCSW, CEAP; Gail Grace, LCSW-R (back) 
Gildo Consolini, Ph.D., LCSW; Tripp Evans, Ph.D., LCSW-R; Ashanda S. Tarry, LMSW; 
and Kirk Brewster, LCSW.
Photo: Sandra Indig
CONTINUED ON PAGE 15
10   The Clinician
to a confidentiality bind in assuring Matthew and his father that 
everything shared in individual sessions will remain private unless 
the person agrees to share the information or when safety issues 
emerge which would requires a mandated report. Matthew and his 
father appear committed to improving their relationship; their treat­
ment goal is to strengthen their relationship bond by working toward 
achieving a meaningful connection to each other. 
Lewis’ dedication to the systematic family approach is evident as 
demonstrated in the following sessions whereby she clearly remains 
focused on the family relationship while scrutinizing interpersonal 
dynamics through her precise questions and always exploring 
relational thoughts and feelings when meeting individually with each 
family member.
Matthew’s session
Matthew’s moderately overweight body is slouched in a chair; he lifts 
his angelic face with full, rounded cheeks, and looks directly at Lewis. 
Matthew appears overmedicated; yet, despite his drowsiness, Lewis 
reaches him. She skillfully begins a decision dialogue which leads to 
uncovering the cause of Matthew’s reluctance. We discover that he 
is entrenched in a loyalty bind contributing to relational constraints. 
With sensitivity, attunement and evenly hovering attention, Lewis 
C
atherine Lewis, LCSW, M.S., began her innovative and 
thought provoking keynote presentation by defining Family 
Relational Trauma according to Sheinberg & True (2008) “as 
an event in which a child’s sense of emotional and/or physical safety 
has been ruptured or violated by the behaviors of adult caregivers. 
Such situations include, but are not limited to a bitter divorce, the 
death of a parent, being parented by an alcoholic family member, a 
child witnessing domestic violence, or a child who has experienced 
incest. In these clinical situations, the therapist has to explore the 
relational disruptions that have occurred and the ensuing barriers 
to fostering re-attachments between family members.” 
Lewis engaged the audience by preparing them to enter a live 
session with her (via video) where she illustrated Ackerman’s 
Relational Model by sharing the following key concepts which guided 
her interventions: confidentiality binds, decision dialogue, personal 
agency, recursive process and relational constraints.
An expert in treating families who have experienced trauma, 
Catherine Lewis has served in leadership positions at several New 
York City Social Service Agencies. She is a faculty member of the 
Ackerman Institute for the Family and the Director of Community 
and International Training. She is a current member of Ackerman’s 
Center for Relational Trauma and a past member of the Ackerman 
Foster Care Project. 
Lewis provided a case vignette illustrating a family system 
approach to the treatment of relational trauma. In her case study, 
Matthew, an eleven-year-old African American male, has recently 
been reunited with his biological father after spending two years in 
foster care during which time he has been diagnosed with ADHD, 
bipolar and oppositional defiant disorders. 
We are invited into a session between Matthew and his father. 
The audience observes an impasse; Matthew is reluctant to speak 
to his father who appears sullen, defended and angry. Lewis decides 
(a choice point in therapy) to meet with Matthew alone with the 
permission of both Matthew and his father. She carefully explains 
the family therapeutic process. She creates safety by attending 
New York State Society for Clinical Social Work 41st Annual Education Conference  |  May 8, 2010 
Lives Disrupted:
Workshop Leaders, Neuroscience Group: (l to r, front) 
Edith Laufer, Ph.D.; Aideen Nunan, LCSW (back) Mary Edlow, Ph.D.; 
Ann Rose Simon, LCSW; and Charlotte Kahn, Ph.D.
Susan A. Klett, LCSW-R, BCD, Faculty, Supervisor, Training Analyst and 
Director of Continuing Education at Washington Square Institute, Faculty at 
Postgrad* The Institute of the Postgraduate Psychoanalytic Society, President 
of the Postgraduate Society, Chair of the Education Committee of the 
NYSSCSW. She maintains a private practice in Manhattan.
Keynote Presentation by Catherine Lewis, LCSW, MS / Review by Susan A. Klett, LCSW-R, BCD
Treating Family Relational Trauma
Photo: Sandra Indig
Fall 2010    11
struggles with multiple complex feelings. He was now able to identify 
with his father and understand his intersubject experience.
Matthew joins session with his father
Matthew felt prepared to speak directly with his father, who now 
appeared non-threatening. Lewis mediated, using expanded 
relational information to guide an interaction between them, which 
bridged their former huge communication gap and helped father and 
son to understand their intersubjectivity, fostering empathy. Both 
Matthew’s and his father’s relational constraints were brought into 
a conversation; both were less defended and able to understand and 
respond to each other.
Lewis presented a compelling case vignette of a father and son 
struggling to relate utilizing Ackerman’s Relational Model to heal 
relational trauma. In the paradigm of family therapy, individual work 
is part of a systemic family therapy approach in which separate 
sessions are used to enrich family sessions. Lewis skillfully wove 
concepts of this method throughout her treatment. 
Following her presentation, Lewis openly shared the daunting 
challenges she faced in a lively, thought-provoking and enlightening 
dialogue with the audience.
In keeping with the theme of this year’s conference, Lewis 
successfully provided clinicians with a new effective approach for 
healing and reconnecting families, especially children, with caretak­
ers whose lives and relationships have been disrupted by relational 
trauma.  
Reference: Sheinberg, M. & True, F. (2008). “Treating Family Relational Trauma: 
A Recursive Process Using a Decision Dislogue.” Family Process, 47, (2) pp.173-195. 
Contemporary Approaches to the Treatment of Trauma
Workshop Leaders: (l to r, front) Madelyn Miller, LCSW, CGP; Sally W. Clayton, 
Certified Hypnotist (back) Gildo Consolini, Ph.D., LCSW; Louise Kindley, LCSW; 
Tripp Evans, Ph.D., LCSW-R; and Marc Wayne, LCSW, BCD
gradually deepens exploration of Matthew’s thoughts and feelings. 
At times she labels a feeling with a questioning tone and at other 
times repeats a feeling articulated by Matthew to underscore and 
validate its importance. She attempts to help him connect body, 
emotions and mind by questioning “how does this feel in your body?” 
Through this process, Matthew connects to his fear of angering his 
father, being abandoned, guilt over his attachment to his stepfather, a 
desire to protect his father from hurt feelings and anxiety regarding 
addressing these issues with his father. Lewis stays acutely attuned 
to Matthew; she continues to validate and normalize his competing 
complex feelings. We witness the expansion of Matthew’s awareness 
and his connection to deep-rooted longings as he expresses his 
desire for his father to become friends with his stepfather and, for 
the first time, allows himself to have the hope of keeping both father 
figures in his life. Lewis prepares Matthew to talk to his father as 
part of the decision dialogue by helping him to rehearse, modify and 
edit his articulation of feelings to effectively relate them to his father. 
Matthew’s confidence grows as he experiences a sense of personal 
agency in being clearly included as an equal participant in family 
treatment. However, Matthew appears hesitant; Lewis responds 
and questions whether he would prefer her to speak with his father 
alone, and he agrees. She listens carefully and transmits his message 
to his father while he enters the process by viewing them through a 
two-way mirror. 
Matthew’s father
Lewis enters the room with Matthew’s father. He appears angry 
and defensive. In a patient and non-judgmental stance, Lewis stays 
attuned to his self state, curious about his underlying feelings, his 
personal history, cultural and organizing relational beliefs.
She informs him that Matthew wants her to let him know how 
he perceives their relationship and his hopes for their future. 
His defenses gradually soften; it appears that he can take in this 
information relayed from Matthew in a way that he would not be able 
to if requested by Lewis. He begins to open up as he reveals how 
powerless he has felt dealing with the foster care system and how 
usurped he felt by Matthew’s foster care father, a man caring for 
his son, who limited and rejected his attempts to contact him. This 
important expanded relational information provided opportunities 
for a significant therapeutic intervention.
Lewis meets again with Matthew to discuss his feelings regarding 
her session with his father. This is known as the recursive process. 
Lewis came to understand Matthew’s father’s intersubjective experi­
ence, his shame, fear, anger, a sense of hopelessness and competition 
with the foster parent who has temporarily taken oven his parental 
role contributing to his sense of inadequacy. As she shares this with 
Matthew in an age-appropriate manner, he realized that his father also 
Photo: Sandra Indig
12   The Clinician
Call for Proposals
For Workshops and Panels for the 42nd Annual Conference 
of the New York State Society for Clinical Social Work 
The Multiple Dimensions of Narcissism 
and How to Survive Them 
Date of Conference: May 7, 2011
Joan Lachkar, Ph.D. states, “The narcissist is the ‘entitlement lover,’ the self-proclaimed special child of the universe. Narcissists have excessive 
entitlement fantasies and an exaggerated sense of self, with which they are entirely preoccupied. They believe the world ‘owes them,’ are ob­
sessed with perfectionism, and have an internalized, strongly castrating superego. Narcissists are intoxicated by their own power and are unable 
to use healthy aspects of narcissism because they lack the capacity for empathy and introspection. They strive relentlessly to prove their special­
ness.” [Joan Lachkar, Ph.D. The Narcissistic/Borderline Couple, New Approaches to Marital Therapy, Brunner-Routledge, N.Y. (2004) (p.2)] 
This conference will address various facets of narcissism and optimal treatment approaches. We are looking for proposals for workshops and 
panels from all theoretical orientations as well as all modalities that reflect this theme.
•	The Narcissistic Generation: Twitter/ 
Facebook: Seductive Outlets for 
Exhibitionism and Voyeurism (How this 
affects our patients and their relationships 
in and out of session)
•	Parenting Issues in a Narcissistic Culture
•	Working with the Narcissistic Couple
•	Containing Narcissistic Rage Evoked in 
the Transference
•	Countertransference toward the 
Narcissistic Patient
•	School Social Work: Clinical and political 
issues when consulting with the 
narcissistic parent
•	The Unconscious at Work: Navigating 
politics when dealing with the narcissistic 
supervisor/boss/colleague
•	Attachment: Reaching the narcissistic patient
•	Dealing with Narcissism in Groups
•	Uncovering the Lost Self: Development 
disrupted by the narcissistic parent
•	Narcissism: Developing a secure professional 
identity in the hierarchical mental health 
hospital setting
•	How the Therapist’s own Narcissistic Needs 
Influence the Therapeutic Process
•	Sexting: Narcissism and the adolescent in 
the 21st century
•	Narcissism as a Defense
•	Understanding and Working Effectively 
with the Narcissistic Character Structure 
(malignant narcissism, destructive envy 
and competition, the patient’s desire to 
see the therapist fail)
1) Description: purpose, function, and teaching 
objectives. Include clinical illustrations.
2) A workshop or panel outline describing con­
cepts to be developed.
3) A bibliography.
4) Nine copies of the proposal, one copy of your 
C.V. (and all other identifying information) on 
a separate page. Underline one affiliation that 
you would like listed in the brochure. Private 
practice is not considered an affiliation.
5) On a separate page: A brief paragraph of five 
lines stating purpose of workshop and listing 
five to six aims and objectives.
Mail to: Susan Klett, 157 East 57th Street, Apt. 6D, New York, NY 10022
Workshop Suggestions: 
Proposals should be from three to five typewritten pages, double-spaced, 
and should include the following: 
Deadline for Submission of Proposals: December 15, 2010 
Fall 2010    13
New York State Society for Clinical Social Work
243 Fifth Avenue, Suite 324, New York, NY 10016-8703 
(800) 288-4279
www.nysscsw.org
Tuesday, August 10, 2010
David Hamilton, PhD, LMSW
Executive Secretary, State Board for Social Work 
New York State Education Department
89 Washington Avenue
Albany, New York 12234-1000
Dear Dr. Hamilton,
We are writing on behalf of the New York State Society for Clinical Social Work, Inc. 
to provide comments on and disagreement with certain changes in the Regulations 
of the Commissioner of Education, specifically, §§ 74.3, 74.4, 74.5, 74.6, 74.7 and a 
new regulation, § 74.9. The Notice of Emergency Action relating to these amended 
regulations was posted in the State Register on July 14, 2010 and is expected to be on 
the Regent’s Calendar for September, 2010 for permanent adoption.	  
We have serious concerns about one of the proposed amendments: Section 74.3 
– the manner and effectiveness of clinical group supervision for LCSW licensure,
LCSW Clinical Supervision
Section 74.3 decreased the number of hours of supervised experience LMSWs 
will be required to meet for the LCSW supervised experience requirement from 
28801 supervised client hours of diagnosis, psychotherapy and assessment based-
treatment planning to 2000 hours. However, we have serious concerns about the 
manner (group and/or individual) in which supervision is to occur. In this regard, 
the LMSWs seeking LCSW licensure will have to complete 2,000 client clinical con­
tact hours in diagnosis, psychotherapy, and assessment-based treatment planning 
over a continuous period of not less than 36 months and not more than 72 months 
under a qualified supervisor.
The proposed amendment, regarding the provision of this supervision, 
to section 74.6 provides that “Supervision of the clinical social work services 
provided by the qualified individual2 shall consist of contact between the qualified 
individual and supervisor during which:
(i)	 qualified individual apprises the supervisor of the diagnosis and treatment 
of each client;
(ii)	 qualified individual’s cases are discussed;
(iii)	 the supervisor provides the qualified individual with oversight and guidance 
in diagnosing and treating clients;
(iv)	 the supervisor regularly reviews and evaluates the professional work of the 
qualified individual;
(v)	 the supervisor provides at least one hundred hours of in-person individual 
or group clinical supervision, distributed appropriately over the period 
of the supervised experience.”3 
We do not believe that clinical group supervision meets the supervisory 
needs of newly licensed MSWs who wish to learn the specialty practice of 
psychotherapy nor provides adequate overview by an experienced clinician for the 
consumer-patient. 
Individual supervision is the key to professional development of a health care 
professional. In the training of a mental health professional in the provision of 
psychotherapy services it is particularly essential that the supervisor and the 
supervisee discuss the interactions that the supervisee has with the patient and 
how the process unfolded in the psychotherapeutic relationship. Indeed, one 
of the most important supervisory tools is the treatment process recordings 
(transcripts of the patient-therapist interaction) by the supervisee which are used 
for the following: to facilitate the supervisee’s assessment and diagnosis of the 
patient, to recognize and address the supervisee’s feelings about the patient, to 
explain the rationale behind how, why, and when the supervisee intervened in the 
psychotherapy session, to demonstrate how the supervisee might have intervened 
in more effective ways, and to encourage the supervisee to reflect on his or her 
role in the psychotherapeutic process with different patients.
For inexperienced LMSWs to provide mental health services, it is critical that 
the supervisor and supervisee meet weekly to discuss the supervisee’s cases. 
This is particularly true today, where people do not stay in psychotherapy for 
years, but, rather, stay in treatment on average for three months to a year. In the 
past, when patients stayed in longer-term treatment, there was more time to un­
derstand the patient’s diagnostic needs and plan cogent and meaningful treatment 
interventions. Today, with shorter term treatments, regular discussions between 
the supervisor and supervisee on a weekly basis are a necessity to quickly grasp 
the treatment issues and plan appropriate interventions. 
We need to be cognizant that the LMSWs who are seeking to obtain the LCSW 
are typically recent graduates of MSW programs and may have varying levels of 
didactic mental health training and have had different field placement experiences 
in relation to diagnosis, psychotherapy and assessment-based treatment plan­
ning. Placing such supervisees in group supervision is too general a supervision 
experience and would be inappropriate until they have at least been supervised 
individually. We recommend at least 1000 post-MSW clinical contact hours, and 
down the line they could then be supervised in individual supervision with a mix 
of group supervision. 
We are very concerned that this regulation amendment allows all of the 
supervision to be provided as group supervision. Although we can appreciate 
the monetary benefit of group supervision (fewer supervisors to supervise the 
treatment of a larger number of supervisees’ patients), this does not adequately 
protect the consumer-patient from well-meaning but inexperienced LMSWs. Once 
they have had a significant amount of individual supervision, group supervision 
can be an appropriate method as sharing clinical material with their colleagues 
under the guidance of an experienced supervisor may be educational.
Given the decrease in patient contact hours of the supervisees, from 20 (960 
hours/48 weeks) patients on average per week to 14 (2000 hours/144 weeks) 
patients on average per week and given the fact that most patients no longer 
remain in psychotherapy for more than three months to a year, supervisors now 
have to supervise the treatment of more patients over the course of a year who 
are in short-term psychotherapeutic treatment. Further, appropriate and effective 
supervision requires that each patient’s treatment be supervised by the same in­
dividual. This ensures continuity of treatment for the patient as well as promotes 
a consistent educational experience for the LMSW. 
We suggest the following schedule for supervision:
1)	 During the first half of the supervised clinical experience (defined as having the 
first 1000 patient clinical contact hours and 60 individual supervision hours) all 
supervision shall be individual supervision with the same supervisor;
2)	 During the third quarter of the supervised clinical experience (defined as 
500 further patient clinical contact hours) the supervision shall be either 
individual or a mix of individual with the same supervisor during this period 
and group supervision with the same supervisor during this period; 
3)	 During the last quarter of the supervised clinical experience (defined as 
Letter from NYSSCSW on Licensing Regulation 
Sent to State Education Department
CONTINUED ON NEXT PAGE
14   The Clinician
the last 500 further patient clinical contact hours) all supervision may be 
individual, a mix of individual and group or group supervision.
We have serious concerns about the ability of supervisors to provide individual 
supervision if they carry more than four supervisees. With regard to group super­
vision, we have a greater concern since no guidelines have been established for 
the size of the group and the number of cases the supervisor is responsible for. 
For individual supervision, we recommend that the supervisor should not 
be permitted to carry more than four supervisees during the same time period. 
Given the fact that under the new regulations a supervisee will see an average of 
14 patients/week, that will mean that the supervisor has to be aware of what is 
happening with 56 patients, if he or she is supervising four supervisees. See, foot­
note 4, infra. Also, if a supervisor is providing group supervision, the group should 
be limited to four supervisees, which would require the supervisor to be aware of 
what is happening with their supervisees 56 patients. See, footnote 4, infra.
Further, we are concerned that supervisors be advised of their important role 
in assuring appropriate care for the patient being treated by their supervisees and 
their responsibility to those patients whose care and treatment they are supervis­
ing. To this end, we believe that the language used in the proposed amendment 
in § 74.4 (a)(3)(i) and § 74.4 (b)(3)(i), should apply equally to § 74.6(c)(1) and § 
74.6(d)(1); to wit: “the supervisor shall be responsible for appropriate oversight 
of all services provided by a permit holder under his or her general supervision.”4 
Finally, we wish to acknowledge the Department for taking some of our prior sug­
gestions regarding some of these issues raised by these proposed amendments; to wit:
(1)	 placing the burden on supervisors, not on the supervisees, by requiring them 
to maintain records of their supervisee’s client contact hours and supervision 
hours for the LCSW and provide them to the Office of the Professions;
(2)	 requiring each LCSW who is seeking the “R” Psychotherapy Privilege to 
provide a supervision program for review by the State Board for Social Work;
(3)	 changing the wording in the current “R” regulation from “supervision or con­
sultation” to consultation (consistent with the fact that the LCSWs seeking 
to obtain the “R” are already licensed and do not require further supervision 
but if they wish to obtain the “R” are required by law to have consultation with 
more senior clinicians to further develop their professional knowledge and 
skills);
(4)	  allowing LMSWs to submit a plan for supervised experience toward licensure 
as a LCSW, for review and approval by the State Board for Social Work. [By 
obtaining such approval prior to starting a position, an applicant would be 
able to avoid working for three years in a position which cannot be accepted 
toward meeting the experience requirements for licensure as a LCSW because 
the setting or supervisor was not authorized by law and/or regulation. The 
State Board’s review and approval of the voluntary plan would both protect the 
public and provide assurances to the LMSW that the setting and supervisor are 
authorized to engage in the practice of clinical social work in New York]; and
(5)	 the peer supervision to obtain the “R” Psychotherapy Privilege has been 
eliminated. 
We also support the provisions in the proposed amendment of § 74.7 relating to 
BSWs. We also support the new § 74.9 which allows the Department to endorse 
LCSWs from other jurisdictions to become LCSWs in New York.
Thank you for your consideration of these important clinical issues.
Marsha Wineburgh, DSW, LCSW, Legislative Chair, NYSSCSW
Jonathan Morgenstern, MSW, LCSW, President, NYSSCSW
Hillel Bodek, MSW, LCSW, Past-President, NYSSCSW
FOOTNOTES
1. In 1977 the Legislature enacted Chapter 893 of the Laws of 1977 adding sections 
162 and 253(8) to the Insurance Law [creating the so-called “P” endorsement 
on the licenses of certified social workers who must have, inter alia, three years 
of full-time supervised postgraduate clinical experience in the provision of 
psychotherapy services]. This law established the basic postgraduate minimum 
supervised clinical experience requirements that had to be met to assure that 
certified social workers in New York State had at least the minimum level of 
necessary clinical competence to provide clinical social work services (diagnosis, 
psychotherapy and assessment-based treatment planning) independently 
of supervision.
When the Clinical Social Work license was being drafted, at the sugges­
tion of legislative staff, the supervised clinical experience required for the “P” 
endorsement was adopted as the supervised clinical experience requirement for 
the new clinical social work license. By that time, the “P” had been in place for 
approximately twenty-four years and had become the benchmark for postgradu­
ate minimum supervised clinical experience requirements that had to be met to 
assure that certified social workers in New York State had at least the minimum 
level of clinical competence necessary to provide clinical social work services 
(diagnosis, psychotherapy and assessment-based treatment planning) indepen­
dent of supervision.
2. “A qualified individual shall mean a licensed master social worker, an individual 
with a limited permit to practice licensed clinical social work as authorized by sec­
tion 7705 of the Education Law, or an individual otherwise authorized to provide 
clinical social work services in a setting acceptable to the department and under 
appropriate supervision.” § 74.6(2)(a).
3. We note that the prior version of § 74.6 (2)(c)(v) read as follows, “provided 
that at least two hours per month shall be individual clinical supervision.”
4. In this regard, in People v. RR, 12 Misc.3d 161, 807 N.Y.S.2d 516 (Sup Ct, NY 
County 2005) the court held, that, “this Court further finds, as a matter of law, that 
licensed master social workers may not make or render diagnoses or prognoses 
(which of necessity flow from and are intimately related to diagnoses), formu­
late or develop treatment plans, interpret tests and measures of psychosocial 
functioning, or provide psychotherapy unless they are doing so under the supervi­
sion of a psychiatrist, psychologist or licensed clinical social worker. [FN27] .... 
Supervision in this context is a legal term. In relation to supervision of a licensed 
master social worker or a student, extern or intern in a mental health discipline 
who is providing clinical services under supervision, it means that the patients 
or clients being served by the supervisee are considered patients or clients of 
the supervisor, not of the supervisee, that the supervisor is personally profes­
sionally responsible and accountable for the evaluation, care and treatment of 
these patients or clients, that the supervisee is acting under the umbrella of 
the supervisor’s license, and that the supervisor is personally professionally 
responsible, accountable and liable under the doctrine of respondeat superior for 
the professional conduct, misconduct, malpractice and actions of or the failures 
to act by the supervisee in relation to the patients or clients with regard to whose 
evaluation, care and treatment he or she is the supervisor.” Id. at 12 Misc. 3d, at 
179-180, 807 NYS2d at 529. (emphasis supplied)  
Letter to State Education Dept.	
CONTINUED FROM PREVIOUS PAGE 
Fall 2010    15
Ms. H
Rowe chose one patient from his practice, “a depressed and potentially sui­
cidal woman,” to demonstrate this approach. Ms. H was a 44-year-old single, 
never married, childless, Caucasian artist whose mother had died one year 
prior to her presentation in treatment. She sought help initially for “feelings 
of disinterest in her work as a commercial artist and disinterest in life in 
general,” and cited a history of psychotherapy from elementary through high 
school which had generally served as a “crutch,” helping her to complete 
school, but never adequately addressing her pervasive feelings of “dissat­
isfaction and boredom.” In describing his impressions and the evolution of 
their early work together, Rowe highlighted Ms. H’s general aggression and 
annoyance, her preoccupation with death short of actively formulating a plan 
to kill herself, her tendency to “daydream,” withdraw, or stare into space in 
response to stressful material, her disbelief as to how colleagues could be 
excited enough to be committed to their work, her apathy towards meeting 
new people or serious relationships beyond brief affairs, and her overall 
sense “that she always knew that she was “waiting for life to begin.” He re­
lated that she spoke of a mother who was a “cleanliness freak” who allowed 
little room for playing, a family unappreciative of her artistic talent, and a 
brother two years older who, as a child, would mockingly “take her drawings 
from her room and hide them.” Of note, she described spending much of her 
childhood alone doing art, only to destroy her creations because they were 
“not good enough,” and of school personnel convinced that her extensive 
daydreaming was a sign of epilepsy or ADD.
Unlike other treatments, which might have sought primarily to address 
despairing symptoms, Rowe described focusing instead on the traumatic 
disruption of Ms. H’s undifferentiated selfobject experience. Evidenced in 
both her life perspective and her personal history, Rowe explained that Ms. 
H’s aforementioned presentation typifies individuals who have sustained 
such an experience and thus he proceeded in the following manner. While 
exploring her suicidal ideation, Rowe offered validation, stating, “I think 
that you have good reason for not wishing to continue the struggle you 
have had with life.” When Ms. H talked of spending hours staring out her 
apartment window, instead of pathologizing her actions, he esteemed them, 
commenting, “It’s relaxing for you, maybe like the comfort you sp[eak] 
about?” And when she spoke of daydreams organized around death, Rowe 
spoke directly to the fixation when he said, “I think that these daydreams 
were thoughts of how things could be better and they helped you feel 
sustained through all the rejections you experienced.” Finally, Rowe used 
Ms. H’s growing awareness that there had been more to experience in her 
past, and introduced the possibility of returning to the undifferentiated sel­
fobject phase in therapy, for a reparative experience in her present. Here 
he stated, “[w]hile this experience of knowing that greater things are yet to 
be achieved sustained you through the rejections you suffered as a child, it 
discards the present, as the greater achievements are yet to be. It is a form 
of waiting for the greater inspiration that prevents you from feeling that 
your [art]work is good.” 
Through interventions like these, Rowe helped Ms. H to become more 
aware of her past deprivations, respond emotionally to their corresponding 
trauma, and in turn, make sense of why she consistently discounted her 
work, found peers boring and simple, felt she had little of meaning to offer 
relationships, and lacked motivation to follow through with various tasks. 
Over the course of treatment, Rowe reported that Ms. H was promoted 
within her company, went on to start her own competing company with a 
colleague, maintained a fulfilling, long-term relationship with a partner, 
gained like-minded friends, and took pride in her contributions to her 
community. Freed from her core negative experience, Ms. H was able to 
recapture the motivating force of the undifferentiated selfobject, develop 
selfobject needs for idealization, twinship and mirroring and have them 
recognized, and experience a more positive and hopeful view of herself and 
of that which she creates. 
In acknowledging the pervasive trauma sustained by individuals whose 
undifferentiated selfobject needs have been disrupted, and in imparting 
this phenomena with a case illustrative in the therapist’s ability to honor 
and heal this experience in his patient, Rowe conveyed the importance of 
assessing for, and when present, working with thwarted undifferentiated 
selfobject needs. Through the lens of self psychology and his own extension 
of this theory, Rowe raised awareness among conference participants and 
no doubt influenced how many will heretofore conceptualize their patients’ 
struggles, and treat trauma resulting from unfulfilled, undifferentiated 
selfobject needs.  
Review of Crayton Rowe’s Presentation 
CONTINUED FROM PAGE 9 
United we stand, divided we fall; we’re all social workers and our special­
ties should lead to diversification of services, not to competition, division 
and alienation.
Our Society could become the supportive professional community for 
all clinical social workers regardless of practice setting. It should offer 
something of value to every clinical social worker.
And since we are committed to promoting professional expertise, we 
should also be invested in the next generation of LCSWs. We should recon­
nect with the social work schools and connect with social service agen­
cies, and with organizations such as the NYS Coalition of Social Workers. 
We should position ourselves to support those working towards becoming 
LCSWs, actively exploring ways to maximize our impact by providing quali­
fied supervision and mentorship.
Many of us are upset by our professional status and pay, feeling help­
less in relation to managed care. Our Society plays a key role in shaping 
President’s Message 
CONTINUED FROM PAGE 2
the way we would like to be perceived. We provide a service that helps 
all people lead more effective, productive and happier lives. How did this 
come to be perceived as unessential!? We must support each other in 
developing our professional self esteem. Our Managed Care Committee, 
chaired by Helen Hoffman, provides valuable information and programs to 
support members in managing their practice from a position of knowledge 
and strength.
Our power is in our membership that provides support through dues, 
and through their knowledge, creativity, time and energy. This is an elec­
tion year for the State Board, so please vote! Your ideas are appreciated; 
your voluntarism is appreciated more. Please consider becoming involved 
in our work. Contact your chapter president or me.
And thank you for being a member of the New York State Society for 
Clinical Social Work.  
16   The Clinician
Legislative
Committee Report 
CONTINUED FROM PAGE 3
Vendorship Committee 
Federal Parity Law 
CONTINUED FROM PAGE 4
the experience requirements for licensure as an LCSW because the setting 
or supervisor was not authorized by law and/or regulation. The State Board’s 
review and approval of the voluntary plan would both protect the public and 
provide assurances to the LMSW that the setting and supervisor are autho­
rized to engage in the practice of clinical social work in New York. Since an 
LMSW may provide diagnosis, psychotherapy and assessment-based treat­
ment planning under supervision without seeking licensure as an LCSW, the 
amendment requires such an LMSW to receive at least two hours per month 
of in-person individual or group clinical supervision.
The Department received comments from professional associations, 
state and private agencies and interested individuals.   
parity with a maximum number of sessions allotted for behavioral health 
sessions. 
• Whatever form or level of clinical reviewing takes place in 
the future, and whether or not diagnoses covered are expanded 
beyond the biologically based, the key words to providing continued 
behavioral health care are “medical necessity”. This will have to be 
documented in session notes. So far, the rule of thumb that I have 
gleaned from what I have read and been told is that (1) the patient 
must have enough symptoms and (2) the patient must have an im­
paired enough level of functioning to warrant continued treatment. 
Documentation based on DSM criteria should be made to support 
your argument. 
• It is also important to document progress and improvement 
in both symptoms and functioning to demonstrate that treatment 
is effective.
I welcome your thoughts, comments, observations and any experienc­
es that you have and would like to share so that we may all benefit from as 
much information and experience as possible. Contact me, Ruth Washton, 
at rwashton@verizon.net  
Fall 2010    17
Chapter Reports 
CONTINUED FROM PAGE 5
Staten Island Chapter
Mary FitzPatrick, President
The Staten island Chapter held monthly Board 
Meetings and educational presentations from 
September – June 2010. This year we made a 
special effort to vary the schedule of our meet­
ings to meet the needs of younger members who 
found it hard to get to Sunday morning meetings.
We covered a wide range of topics from 
Domestic Violence with input from the District 
Attorney’s Office and local advocacy groups 
as well as very interesting topics from our 
own members on issues ranging from sexual 
dysfunction to play therapy.
Helen Hoffman was kind enough to take 
the time on a Sunday morning to try to help us 
understand the Federal Parity Law,Managed 
care,and Vendorship Concerns.
We had our usual yearly half day 
conference,The speaker was Ron Taffel Ph.D 
on dealing with difficult adolescents and their 
families and it was extremely well received.
Our education Chair Person Catherine 
O’Brien is working very hard to ensure that we 
have an even better year this year. Again she is 
arranging great speakers as well as different 
times and locations to keep our small Chapter 
alive and relevant to all it’s members.
For information you may contact 
President Mary FitzPatrick, at 917-882-9118 or 
fitzrodal@aol.com.
Suffolk Chapter
Sandra Jo Lane, President
We take great pleasure in announcing that 
there is significant interest in reinvigorating 
the chapter. As a consequence of the terrific 
work done by Dr. Robert Berger in coordinating 
the listserv, and many phone calls from mem­
bers expressing appreciation for the chapter, 
we are making plans for new activities. The 
geographic realities of Suffolk County, and 
the general “business” of so many members, 
has made it a challenge to create a viable and 
vital chapter in the past. We will look for more 
centrally-located meeting places, and we are 
planning a meeting to explore new opportuni­
ties for the chapter. Your ideas are welcome. 
Please contact Sandra Jo Lane, President, 
at sjlsunshine@aol.com or 631 586 7429.
Westchester Chapter
Martin J. Lowery, President
We began our first General Membership 
Meeting of the year on November 11th with 
a minute of silence to commemorate the 
tragedy of 9/11. The speaker for the meeting 
was Nancy Kehoe, RSCJ, Ph.D, who spoke on 
“Exploring Religion and Spirituality in Clinical 
Work: The Last Taboo?” The Chapter meets 
on the first Saturday of each month from 
September to June. The monthly General 
Membership Meeting consists of a business 
meeting followed by an invited speaker who 
addresses topics of interest to members. Prior 
to the meeting the following interest groups 
gather and share: Group Therapy Practice, 
Career/Private Practice Building Mentorship, 
Peer Consultation, Creative Process-Therapy-
Exercise-Spirituality, Child and Adolescent 
Peer Consultation. In addition the following 
Committees serve the needs of the Chapter: 
Education, Legislation, Membership, Disaster 
Preparedness and Vendorship-Managed Care. 
We keep connected by a well-edited newslet­
ter and a list serv. Contact Martin Lowery, 
President, mlowery@maryknoll.org  
In Memoriam
O
n August 3rd the Staten Island Chapter lost a dear colleague and friend, Nancy 
Holzka, our past president, who died after a brief illness. Nancy spent her 
entire professional career serving the Staten Island community through her work 
in a children’s community mental health center and through her private practice.
When Nancy joined our chapter, she brought a strong sense of commitment 
and selflessness in sharing knowledge. You always felt accepted when you were 
with Nancy. She became a role model for so many of our members over the years. 
Those who knew Nancy will remember her for her generosity in the work she did 
for our chapter, for her love of clinical work and for her friendship.
18   The Clinician
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Fall 2010    19
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E-mail: info@clinicalsw.org
Phone: 1-800-288-4279
NEW YORK
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New York Society for
Clinical Social Work, Inc.
350 Fifth Avenue, Suite 3308
New York, NY 10118
Address Correction Requested
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ROCKVILLE CENTRE, NY