MSW & LMSW: What They Can and Can’t Do Legally in Practice

If you’re thinking about becoming a therapist or already studying social work, it’s important to know what you can legally do with your degree or license. Many people ask questions like “Can you practice therapy with a MSW?” or “Can an LMSW diagnose?” This guide explains everything clearly, using easy words and real examples.

Can You Practice Therapy with a MSW?

Yes, you can practice therapy with a MSW, but you can’t work on your own right away. A Master of Social Work (MSW) is the degree you need to start a career in therapy or clinical social work. It teaches you how to help people through counseling, support, and social services.

However, just having an MSW doesn’t give you a license. You’ll need to apply for a license like LMSW (Licensed Master Social Worker) or LCSW (Licensed Clinical Social Worker), depending on your state. Until then, you must work under supervision from someone who is already licensed.

Can an LMSW Diagnose?

An LMSW can diagnose in some states, but not always independently. LMSWs are trained to recognize mental health conditions like depression or anxiety, but most states require them to be supervised by an LCSW or licensed psychologist when making a diagnosis.

So, if you’re an LMSW, you can often help identify what’s going on with a client, but your official diagnosis may need to be signed off by someone with a higher-level license.

Can LMSW Prescribe Medication?

No, LMSWs cannot prescribe medication. Only certain medical professionals like psychiatrists, nurse practitioners, or doctors can do that.

What can LMSWs do? They can talk to clients about medication needs and help them get a referral to a provider who can prescribe. LMSWs often work closely with doctors to create a full treatment plan that includes therapy and medications.

Can LMSW Diagnose ADHD?

LMSWs may help screen for ADHD, but they usually can’t make an official diagnosis without a supervisor. They can use tools like questionnaires or behavior checklists to see if someone might have ADHD.

However, the formal diagnosis is usually made by a licensed psychologist, psychiatrist, or LCSW with advanced training. LMSWs are still a big help because they can refer clients and support them during treatment.

Can LCSW Diagnose ASD?

Yes, LCSWs can diagnose ASD (Autism Spectrum Disorder) in many states. They are trained to use the DSM-5, which is the official manual for diagnosing mental health and developmental disorders.

That said, diagnosing ASD can be complex. Some clients may also need to see a team of professionals, such as psychologists, speech therapists, and pediatricians. But a LCSW is often the first person who helps start the process.

Can a LCSW Write You Out of Work?

Yes, a LCSW can write you out of work if you’re dealing with mental health issues like anxiety, depression, or stress. Employers often accept letters from licensed clinical social workers when you need time off or work adjustments.

A LCSW can write letters for:

• Short-term disability
• FMLA (Family and Medical Leave Act)
• Accommodations at work
• Return-to-work approvals

Make sure the LCSW is treating you regularly before requesting documentation. They need to understand your situation well to write an accurate letter.

Can an LMSW Have a Private Practice?

An LMSW can have a private practice in some states, but there are limits. Most states require that an LMSW work under supervision in private practice until they become a LCSW.

That means you can open a practice, but you must have a licensed supervisor review your work and support your clients’ care. If you want to work independently without a supervisor you’ll need to upgrade your license to an LCSW.

Scope of Practice

Role	Can Practice Therapy?	Diagnose?	Prescribe Meds?	Private Practice?	Supervision Required?
MSW	Yes, with supervision	No	No	No	Yes
LMSW	Yes, limited	Sometimes	No	Sometimes, supervised	Yes
LCSW	Yes, independently	Yes	No	Yes	No

Tips to Boost Your Career in Social Work

Here are a few easy ways to grow faster as a social worker:

• Join your state’s NASW chapter they offer updates, CEU courses, and support
• Find a good supervisor this is key to becoming an LCSW
• Track your clinical hours don’t wait until the last minute
• Take extra training get certified in trauma, CBT, or other specialties
• Stay current on state laws rules change, so check your licensing board often

FAQs

Whether you’re just starting your MSW or working toward your LCSW, knowing your legal scope of practice is essential. Always check your state’s board website for updates, get supervised, and never stop learning.

Want to become a licensed clinical social worker? Start tracking your hours today and find a great supervisor!