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Restricted Psychosocial Interventions

Restricted psychosocial interventions

Restricted psychosocial interventions are social work services performed to treat a substantial disorder to thought, mood, perception, or memory that grossly impairs judgement, behaviour, the capacity to recognize reality or the ability to meet the ordinary demands of life.

This is a specialized and regulated area of social work practice. Only qualified and authorized social workers can perform these services.

Psychosocial interventions and restricted psychosocial interventions 

A PSYCHOSOCIAL INTERVENTION is a social work service focused on psychological, behavioural, and social factors. It aims to improve functioning and quality of life. The service is typically made up of screening, assessment and intervention like supportive counselling, psychotherapy, referral services and giving information and assistance. These services could be delivered to individuals, couples, families, and groups.

A RESTRICTED PSYCHOSOCIAL INTERVENTION is a social work service performed to treat a grossly impairing mental health disorder. These interventions are performed with an expectation of treating a substantial disorder of thought, mood, perception, orientation, or memory that grossly impairs judgement, behaviour, capacity to recognize reality, or the ability to meet the ordinary demands of life.

Can I perform restricted psychosocial interventions?

Not all social workers have the competence to perform this restricted activity. You must limit your practice to areas in which you have gained competence through education, training, and supervised experience.

If you don’t have individual authorization, you may perform restricted psychosocial interventions under supervision of another authorized regulated health professional (such as a psychologist).

You can apply for individual authorization on your practice permit if you’ve demonstrated your competence through education, training and supervised practice of treating substantial mental health disorders that grossly impair. A Bachelor of Social Work is the minimum required education, though this treatment is usually performed by social workers with a Master of Social Work. Training, education, and supervised experience beyond academic coursework and practicum are required.

You need individual authorization when you are

  • treating substantial mental health disorders that grossly impair without appropriate supervision and collaboration
  • training or supervising others in the practice of restricted psychosocial interventions

This authorization does not replace the responsibility of an employer, practice supervisor, and individual social worker to assess the safe and competent practice of restricted psychosocial interventions appropriate to their specific practice setting.

Is this a restricted activity?

Deciding if a treatment is a restricted activity requires clinical judgement, both to identify a client’s condition and to form the intent to apply a psychosocial intervention to treat it. These examples are intended as a guideline only.

It’s NOT RESTRICTED to:

  • provide social work services other than treatment to people who have or could have disordered mental or behavioral health
  • provide supportive counselling to help a client cope with or navigate some challenges
  • conduct assessments and/or refer clients for things like substance use treatment, medication assessment, specialized treatment programs, etc.
  • provide treatment to complex clients using treatment planning and evidence-informed therapies and approaches to address issues like insecurity, grief, relationships, parenting, fear, trauma, adjusting to change, etc.
  • provide treatment targeting behavioural health issues in clients without a substantial mental health disorder
  • provide a wide range of psychosocial interventions to clients with a substantial mental health disorder, such as supportive counselling, assessment, issue navigation, referrals, etc.
  • provide a wide range of psychosocial interventions to hospitalized, incarcerated, or mandated clients with a substantial mental health disorder, such as supportive counselling, assessment, issue navigation, referrals, etc.

It’s NOT NECESSARILY RESTRICTED to:

  • provide psychotherapy (or other non-medication, non-surgical treatment) to clients who have a substantial mental illness, using treatment planning and evidence-informed therapies and approaches to address issues like mental health maintenance, insecurity, grief, relationships, parenting, fear, adjusting to change, etc.

It is RESTRICTED to:

  • provide psychosocial interventions (such as psychotherapy or non-medication, non-surgical treatments) targeted to treat a grossly impairing substantial mental health disorder to clients who have a substantial mental health disorder who are currently experiencing gross impairments

Expectations for social workers

Performing restricted psychosocial interventions is a narrow area of practice that treats substantial mental health disorders which grossly impair a client’s judgement, behaviour, capacity to recognize reality, or ability to meet the ordinary demands of life.

Social workers must limit their practice to areas in which they have gained competence through education, training, and supervised experience.

YOU ARE RESPONSIBLE FOR INFORMING ACSW IF AND WHEN YOU ARE UNABLE TO MEET ANY ONE OF THESE REQUIREMENTS.

Competence

  • You understand that treating grossly impairing substantial mental health disorders is restricted because it requires competencies that are not acquired from a social work credential alone
  • You are responsible for your safe and competent treatment of grossly impairing substantial mental health disorders
  • You will maintain competence in restricted psychosocial interventions annually
  • You are experienced at treating grossly impairing substantial mental health disorders and have received supervision and ongoing feedback regarding your safe and competent practice

Practice knowledge and skills

  • You understand that most social work services do not treat grossly impairing mental health disorders
  • You are knowledgeable about the smaller sub-set of diagnosable mental health disorders that are typically described as substantial, serious, severe or major mental health disorders
  • You are experienced at assessing, re-assessing and treating grossly impairing substantial mental health disorders
  • You understand the difference between supportive counselling, and psychotherapeutic treatment informed by the planned application of evidence-informed therapies to effect change
  • You understand that not all psychotherapy is a restricted activity
  • You understand that clients with a substantial mental health diagnosis might not be grossly impaired
  • You understand that impairments fall on a spectrum from minor to gross, that an individual’s level of impairment can change, and that treatment is targeted to elicit and support this change

Regulatory framework

  • You understand only those regulated health professions authorized by the Health Professions Act may perform restricted psychosocial interventions and that social work is one of those professions
  • You understand that social workers utilize clinical supervision and consultation to gain and maintain competence in the higher risk activity of treating grossly impairing substantial mental health disorders
  • You are responsible for staying informed about the regulatory framework regarding restricted psychosocial interventions in the Health Professions Act, Restricted Activity Regulation, Social Workers Profession Regulation, ACSW Standards of Practice and policies, Alberta Health guidance, ACSW guidance, and employers’ policies and guidance.

Requirements to apply for individual authorization 

You must be a registered social worker in Alberta.

Qualifications

  • Minimum of a Bachelor of Social Work. Usually a Master of Social Work.
  • Registered on the general registry
  • Education and training specific to the assessment and treatment of substantial mental health disorders that grossly impair
  • Confirmation of supervised safe and competent treatment of substantial mental health disorders that grossly impair
  • Training, education, and supervised experience beyond academic coursework and practicum

Documentation required

  • Application form
  • Current resume that highlights your experience treating substantial mental health disorders that grossly impair

Application processing

  • Complete submissions are reviewed in the order received and are typically processed within four weeks
  • Communication regarding application processing is sent to the primary email address in your registrant profile
  • When individual authorization is processed, it is noted in your practice permit and the public registry

Please note: Restricted psychosocial interventions can be performed by registered social workers under appropriate supervision and do not require individual authorization.

Temporarily, the restricted activity practice enhancement application is unavailable in the Registrant Portal. To request more information, please contact restrictedactivities@acsw.ab.ca.

Definitions

  • What is a disorder?

A disorder is a set of social determinant problems, illnesses, or conditions that cause significant difficulty or interference

  • What is a mental health disorder?

A disorder of mood, thought, perception or behaviour. The impact of the disorder can vary from no impairment to mild, moderate, and gross impairment.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), defines a mental disorder as a syndrome characterized by clinically significant disturbances in an individual’s cognition, emotion regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. This includes substance-related and addictive disorders.

The Alberta Mental Health Act defines a mental disorder as a substantial disorder of thought, mood, perception, orientation or memory that grossly impairs, i) judgement, ii) behaviour, iii) capacity to recognize reality, or iv) ability to meet the ordinary demands of life but does not include a disorder in which the resulting impairment is persistent and is caused solely by an acquired or congenital irreversible brain injury.

What is a substantial mental health disorder?

Substantial mental health disorders are a smaller sub-set of diagnosable disorders of mood, thought, perception or memory. They are generally described as substantial, severe, major, and/or serious. They can result in gross impairment(s) that limit the ability to function within one or more areas of a person’s life.

What is treatment?

Generally, treatment is a psychosocial intervention that applies intentionally planned, evidence-informed therapies in order to change and/or improve the psychosocial functioning of a client (for example, psychotherapy).

What are gross impairments?

Gross impairments of judgement are considerable reductions in judgement, behaviour, capacity to recognize reality, or ability to meet the ordinary demands of life that interfere with the ability to gain or maintain functional relationships, or the ability to functionally participate in areas of life such as parenting, education or work, for example.

Resources

Social Work Scope of Practice

Social workers are required to work within their scope of practice, which is defined by the Health Professions Act.

In their practice, social workers do one or more of the following:

  • enhance or restore the social functioning of individuals, families, groups, organizations and communities by improving developmental, problem-solving and coping capacities of people and systems,
  • promote effective and humane systems that provide resources, opportunities and services to people and link people to those systems,
  • contribute to the development and improvement of social policy, and teach, manage and conduct research in the science, techniques and practice of social work, and
  • provide restricted activities authorized by the regulations.

If your practice involves any of the above, you are active in social work.

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