Addressing the Issue of Psychiatric Disability in Social Work Interns: The Need for a Problem-Solving Framework

By Gillis, Heather; Lewis, Judith S. | Journal of Social Work Education, Fall 2004 | Go to article overview

Addressing the Issue of Psychiatric Disability in Social Work Interns: The Need for a Problem-Solving Framework


Gillis, Heather, Lewis, Judith S., Journal of Social Work Education


GATE KEEPING HAS ALWAYS BEEN A TOPIC of particular interest and concern to social work field educators and students. Its importance, however, has been heightened as social work interns increasingly work with seriously troubled clients who face issues that require great skill and sensitivity from helping professionals. The literature suggests that social work interns are entering field placements with more serious unresolved life issues, thus presenting additional concerns for field educators (Koerin & Miller, 1995; Regehr, Stalker, Jacobs, & Pelech, 2001).

Working with students who have psychiatric problems can be most problematic for field educators. Until recently, there has been limited attention given to this issue in the social work literature. When the concerns of working with students who have psychiatric problems are addressed, the approach appears to come from the risk management perspective of avoiding lawsuits from dismissed students and improving admission and review procedures. These measures are critical to social work education but do not completely address the needs of the student, agency, academic program, or profession.

Field educators must balance the legal rights of students, clients, and agencies while preserving the integrity of educational programs that have struggled to deal with these problems, often in isolation and with little guidance and support. This article will address the needs of the student, agency, and academic program. A review of landmark legal decisions and seminal works as they pertain to psychiatric disability, gatekeeping and student suitability for the profession, and the use of the ADA as a guide are discussed. Detailed findings from a survey of 61 clinical field instructors and a framework for addressing these challenging situations are also presented.

Conceptualization of Key Terms

This article does not speak to the more general issue of having qualified psychiatrically disabled students in social work education programs but seeks to address problematic behavior in students who may or may not have a psychiatric disability. For the purposes of this study, the term psychiatric disability is used to describe any emotional, behavioral, or psychiatric problem that may negatively affect a student's performance in a social work education program. The student may or may not have a documented psychiatric disability. We have chosen to proceed as if the student having difficulty has a disability in order to use the ADA and Section 504 of the Rehabilitation Act of 1973 as an organizing framework for addressing these challenges, educating field instructors, and developing appropriate policies and practices. We believe adhering to the regulations found in the ADA when dealing with these issues provides some assurance that the rights of all are considered and protected and actions are ethically motivated.

Literature Review

Gatekeeping literature has historically addressed such issues as admission procedures, review procedures for continuing students in academic programs, and legal issues related to admission and termination of students (Cobb, 1994; Cole, 1991; Cole & Lewis, 1993). More recently, discussions about the suitability of an individual for the profession and the implications of the ADA and Section 504 of the Rehabilitation Act of 1973, as they pertain to social work education, have begun to appear in the literature (Cole, Christ, & Light, 1995; Reeser, 1992). Knowledge of the legal issues and guidelines for developing policies is critical for social work educators struggling with gatekeeping and the challenges presented by students with psychiatric disabilities.

Mary Richmond (1899) was one of the first social work educators to voice the need for standards of behavior and training for professional social workers. The recurrent theme in social work education has been centered on training and graduating competent social workers. …

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