Clinical vs. direct social work — what is the difference?

by John
Clinical vs Direct social work

People who choose social work as a career have something to look forward to. According to the Bureau of Labor Statistics, the sector will grow by 9% in the next 10 years. Every year, there are nearly 75,000 job openings for trained social workers. If you have the right qualifications, one of these jobs could be yours. 

Depending on the degree you pursue, you can either become a direct social worker or a clinical social worker. It is important to know the difference between these two types of social work because it determines what you study at university and where you will eventually work. It also determines your caseload once you are employed.

To become a social worker, you should enrol in a bachelor’s degree in social work or a related field. After you qualify, you can get a job working with disadvantaged families and individuals. This is considered entry-level social work. 

After your bachelor’s degree, you need to complete a clinically focused master’s degree to become a clinical social worker. It sets you apart from a direct social worker. You work with a different type of client and even your work environment is different. A degree will help you excel in the field and put your skills to the best use for your clients. 

Learning more about the two careers will help you decide which one suits you best.

What is a direct social worker?

Direct social work involves working with individuals and families that are experiencing difficulties. A direct social worker helps by assessing needs and guiding people toward resources that they can use to alleviate their difficulties. 

In simple terms, a direct social worker is much like the one you see on TV. They visit homes, talk with the occupants to determine their family and social problems, and provide advice on how they can move forward. 

Direct social workers handle caseloads. They are allocated clients, and it is their job to provide assistance, advice and mentorship until the clients no longer require social services. Although many direct social workers are general practitioners, some choose to specialize. 

Direct social workers fall under three broad categories:

  • Healthcare social workers — they are based in healthcare institutions, and their work is to help their clients access resources during recovery and understand their insurance options. They also advocate for patient rights.

  • Child and family social workers — they are charged with ensuring child and family safety. They work with adoption centers to evaluate potential foster homes, and with families to guide them through the adoption process.

  • School social workers — not all problems are caught in the home, and these social workers are tasked with connecting students with resources and giving advice and guidance to students who need it. 

Direct social workers are versatile. The fact that they specialize in one category does not mean that they adhere strictly to it. There are grey areas, and the social worker must learn how to handle them. 

A school social worker, for example, may find themselves visiting a student at home because meeting the parents could potentially solve a problem that the student is facing in school. 

Likewise, a child and family social worker may find themselves advising parents on matters such as recovery and insurance. 

Although social workers are split into the categories above, their caseloads can be quite varied. Quite often they work with individuals such as minorities who may be experiencing difficulties, members of the LGBTQ community, immigrants and the handicapped. 

They also work with people who are battling addiction, and victims of domestic violence and sexual assault. 

How do I become a direct social worker?

To become a direct social worker, you need a bachelor’s degree in social work. Although the curriculum varies depending on where you get your degree, you can expect to study modules like human behavior and the social environment, research methods and social work practice. You also learn communication, social welfare policy and services, as well as field education. 

Most states require direct social workers to be licensed. You need to have some hours of social work practice and you also need to pass one or two exams.

Doing a bachelor’s in social work early is a good idea because it leaves you plenty of time to do a master’s degree and climb the career ladder.

If you are not sure you want to do a bachelor’s degree to begin your social work career you can do a different degree and then do a master’s in social work. It helps if that degree is tangential to social services. Your options include sociology and psychology, early childhood development, political science, and peace and social justice. 

What is a clinical social worker?

The National Association of Social Workers defines clinical social work as focusing on the “assessment, diagnosis, treatment, and prevention of mental illness, emotional, and other behavioral disturbances”. 

Clinical social workers help people who are struggling with mental disorders. Clients can be individuals, families or groups. 

If you choose to do clinical social work you may end up working in a hospital, a private practice, a community mental health center, an addiction clinic or an agency that deals with mental disorders. Some clinical social workers set up on their own while others visit clients at home. 

Apart from giving advice and mentoring their patients, they also diagnose and treat mental and behavioral disorders. They are, however, not licensed to write prescriptions. Patients who need medication are referred to doctors, psychologists or psychiatrists. 

Clinical social work requires higher education than direct social work. You need a master’s in social work to become a practitioner. A clinically focused master’s gives you a combination of the necessary skills to mentor and counsel patients as well as a clinical understanding of mental illness. For many, clinical social work is the next step in their career after direct social work. 

As a clinical social worker, you will work with a broad variety of clients. Apart from those suffering from mental illness, you may find yourself counseling people suffering from drug and alcohol addiction. 

You also deal with victims of sexual and domestic violence and abuse as well as children who may be facing difficulties. Other clients include families that are going through a divorce and people from minority groups (LGBTQ and migrants, for example). 

All clinical social workers are licensed, but requirements vary from state to state. Check with your licensing board to find out what exams you are required to take and how you can prepare for them. 

How do I become a clinical social worker?

As mentioned earlier, the first step is to take a master’s course in social work. You also need to pass some additional exams and do some fieldwork to get a license. 

It is important to choose universities carefully. To get certified, you must attend a university that is accredited by the Council on Social Work Education

Most campuses give students the option to do their degree online. If you choose this path, be sure to understand the demands of the course before you enroll. Online learning requires students to be highly disciplined. They are expected to cover the same material as students who do in-person learning, only without supervision. 

If you are already working, you may find this challenging. However, the advantages of doing a master’s degree online are that you can move at your own pace, it takes a shorter time to complete, and it is often cheaper. 

To make things a little easier, talk to your employer about giving you a smaller caseload. Let your family know that you are taking classes so they can help you whenever possible. It gives you time to focus on your studies. 

What type of social work pays more?

You will see a lot of articles online that talk about clinical social work being the better-paying profession. The truth is, how much you make depends on where you work. A social worker in a private clinic, for example, is likely to earn more than a clinical social worker who works for the state. 

If you want to make more money, set your sights on a managerial position in a private institution. So long as you have a master’s in social work you qualify to do this kind of high-level job and will be paid quite well. 

Most social work programs are supported by the government, so career social workers tend to earn modest salaries. They are enough to live on, but you will not become rich. 


A career in social work is rewarding. It involves working with people who need counseling, mentorship and resources to better their lives. If you are not keen to spend years doing a master’s degree, a bachelor’s in social work can help you get a job as a direct social worker. 

However, if you want to handle more responsibility and earn a little bit more money, you need to do a clinically focused master’s degree. This will give you the skills to handle patients with mental disorders of different kinds and support them in their day-to-day lives. 

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