Generalist Social Work: A Unified Approach to Practice

The foundation of generalist social work practice is built on a wide range of knowledge, professional values, and a set of diversified practice skills designed to enable practitioners to target any system (individual, group, organization, and community) for change (Kirst-Ashman & Hull, 2009). Despite the unified foundation of social work practice, micro and macro skills are often perceived as separate rather than a set of skills that are inherently intertwined (Austin, Coombs, & Barr, 2005). The significance of micro and macro practice dates back to the Progressive Era, when Jane Addams and Mary Richmond took two very different approaches to addressing poverty.

As Richmond focused on ‘curing’ the individual through traditional casework, Addams sought to rectify systemic inequality and oppressive policies that shaped the collective fate of individuals. Both paths seek to benefit the individual and society by emphasizing personal and political empowerment of the most vulnerable. Nonetheless, Austin, Coombs, and Barr (2005) refer to the debate over the question of which approach is best as, “the misunderstanding and unproductive disconnection” between “two major domains of social work practice” (p. 10-11). Further, they argue that the tension itself departs from a core underpinning in generalist practice, primarily the ecological perspective (Austin et al., 2005).

Often when a social worker chooses a career path or concentration of study, she may feel compelled to select a specific role, to be either a micro or macro practitioner. Though not uncommon, such feelings are misleading. While advocacy and social change efforts are more often synonymous with practitioners employed specifically in macro practice settings, all social workers have an ethical responsibility to be advocates for social justice (NASW Code of Ethics). Advocacy and social change are vital to both individual and community practice, not just because of our professional mission and ethical mandates, but because of our knowledge of person-in-environment. Social workers understand the ways in which social, political, and economic factors contribute to client problems. We do not simply address what is within the individual, because we recognize the individual’s environment shapes her life choices, access to resources, and opportunities. That understanding helps us know the environment and all its systems either supports or detours positive change for and within our clients.

As beginning practitioner, I often had a narrow view of my role as an advocate and social change agent. I was prepared be the voice for my individual client’s needs, but I was not as inclined to challenge dysfunctional agency policies, poor resource management, or issues within my community. After all, I had spent the majority of my graduate education learning theory and psychotherapy, not macro practice. So like many others starting out in the field, I settled very comfortably into my micro role, hoping to change the world one life at a time. It did not take long before I discovered that I could not take such a simplistic approach to my clients or the problems they face. I was forced to see the reality that working with my individual clients was not enough.

Nearly 15 years ago, I was a new clinical social worker in the field of mental health and substance abuse. I quickly had to come to grips with several stark realities. A dearth of services existed in the community for my clients. The treatment system functioned more like a revolving door than a steppingstone to recovery.   More often than not, my clients were set up for failure before they even began. Acknowledging these realities compelled me to redefine my approach to practice and reconnect with my knowledge of generalist social work. I knew if I wanted to be an effective practitioner, I would have to abandon my own dichotomous thinking, work across practice levels, and become a strong advocate for just policies within my community and my own agency. I learned that my hope of seeing real progress within individuals I was serving included changing the environment to better fit my clients.

Kirst-Ashman and Hull (2009) suggest that most social workers practice within the organizational context, and in order to be effective advocates for clients and improve upon resources and programing, practitioners must develop skills within the agency and community contexts (p. 2). Further, they suggest that agency policies, gaps in services, community resources, and the macro context have a “monumental impact” on clients and on a social worker’s ability to practice (p. 2-3). Social workers in the trenches experience first-hand the impact on clients’ lives and social problems caused by ineffective policy, agency disorganization, and unequal resource distribution. Naturally, practitioners may feel more confident with certain roles or expertise within their specializations. However, there are skills that can (and must) transcend levels of practice. For example, empathy, cultural competence, empowerment perspectives, and communication skills are critical within both the micro and macro context. While these skills enable practitioners to understand an individual client’s perspective and build rapport, they also assist practitioners in their ability to be appropriately assertive advocates, resolve agency and community-based conflicts, and work effectively under supervision (Kirst-Ashman and Hull, 2009).

Social workers have the unique ability to practice with both depth and breadth. It is possible to strengthen and refine our chosen fields of practice and preserve our generalist knowledge base by better integrating our practice skills. The lessons we have gleaned from history have profoundly shaped the fabric of our profession, with the synthesis of micro and macro skills being at the very core of generalist social work. Fredrick Reamer, (2009) suggests that one of the most historically significant attributes to the social work profession is “the integration of case (helping individual clients address and cope with life’s challenges) and cause (engaging in social action, advocacy, and reform efforts)” (p. 1).  Both micro and macro practice provide clinicians with insight into the contextual factors contributing to the problems clients face, but it is where our practice skills converge that enables us to provide individual interventions and create an environment that is susceptible for change. Categories of practice are not mutually exclusive, and micro and macro skills work best when used in tandem. If my client is struggling with depression and poverty, I address both the interpersonal and the environmental factors contributing to the problem. Providing my client with psychotherapy each week is not likely to be gainful if her SNAP benefits are at risk of being cut, she has little food to feed her family, or she needs assistance with her electric bill.

Written by: Cayce Watson, LAPSW

Sources:

Austin, M., Coombs, M., and Barr, B. (2005). Community-Centered Clinical Practice: Is the Integration of Micro and Macro Social Work Practice Possible? Journal of Community Practice, 13(4) 9-30.

Kirst-Ashman, K. K., & Hull. G. H. (2009). Generalist Practice with Organizations and Communities (4^th ed.). Belmont, CA: Brooks/Cole.

National Association of Social Workers Code of Ethics (1996, Revised in 2008) PDF Retrieved from https://www.socialworkers.org/pubs/code/code.asp

Reamer, F. (2009). From “Case” to “Cause” in Social Work. Social Work Today- Eye on Ethics. PDF Retrieved from http://www.socialworktoday.com/news/eoe_081409.shtml