![]() ![]() BLS 2016 data indicate there were more than 680,000 social workers employed in the United States. The Bureau of Labor Statistics (BLS) has categorized social workers into the following four groups: child, family, and school health care mental health and substance abuse and all other social workers. The need for social workers in areas such as economics, justice and policy areas, occupational social work, community development, and other related macro areas is as important to the profession as the micro-clinical services. Less than 5% of social workers reported primarily working with developmental disabilities, higher education, addiction services, persons experiencing homelessness/displacement, criminal justice, occupational social work, community development, and income assistance (National Association of Social Workers Center for Workforce Studies, 2006). Only 6% of licensed social workers reported working with adolescents as their primary practice. Nine percent of social workers reported aging as primary practice, and only 8% reported working as school social workers. “Although generalist practice has been established as the core of social work education for several decades, many programs pay scant attention to macro content either in their coursework or field placements” (Reisch, 2016).Īreas most commonly reported by licensed social work practitioners are mental health (37%), child welfare/family services (13%), and health care services (13%). The survey findings note that “a devaluing of macro content by some program administrators, and a general lack of interest in or understanding of macro practice among many students” exists. Reisch cites a survey conducted by Rothman in 2013, which found that many social work faculty, in schools primarily emphasizing clinical education, were resistant to the idea of integrating macro practice into BSW and MSW curricula. Michael Reisch’s 2016 essay “Why Macro Practice Matters,” commissioned by the Special Commission to Advance Macro Practice in Social Work, sets the tone for further discussion. According to NASW, “Over the decades, professional social work practice have become relegated, in large part, to the delivery of clinical services in government health units, private and public social service units, school settings, case management, and other micro level direct service along with management administration of community-based mental and behavioral health and similar service organizations.” This ability to enter the marketplace by billing for clinical services accelerated the dominant interest in clinical practice, while deterring social work interest in pursuit of practice with larger macro social matters. ![]() ![]() The emergence of the Diagnostic and Statistical Manual of Mental Disorders ( DSM) in 1952, which used the International Classification of Diseases (ICD), sixth revision, as a model to develop the first DSM, provided the means for diagnostic billing as with the ICD, giving the profession occupational recognition in the marketplace. There is a significant initiative occurring that seeks “to infuse the foundational macro component of our profession into the classroom and field to achieve a more equal footing with its clinical counterpart.” The idea of promoting macro practice gained momentum when President Obama declared himself the “community organizer-in-chief,” (Rothman & Mizrahi, 2014). Mary Richmond and others like her promoted clinical work, looking primarily at individuals as the source of their conditions. Jane Addams and others promoted the generalist perspective looking at the environment, policies, housing, health care, and justice issues, in addition to individual conditions. The early years of the social work profession were marked by the search for identity, which continues to the present day as an ongoing challenge. Macro Matters - The Need for Specialization Beyond the Micro-Clinical Level
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