Macro Practice-A call to action By Mary Nienow, PhD student at the University of Minnesota-Twin Cities As an incoming freshman

at the University of Wisconsin-Eau Claire, I had never considered social work as a career path. I had a limited understanding of what a social worker was; my only experience being a “counselor” I saw briefly as a teenager when my mother thought my behavior was out of control. I declared English as my original major because I loved to read and thought I could turn my love of reading into a job. I quickly decided that this was not practical and switched my major to psychology. I don’t even remember the reason why I chose psychology, but it seemed more promising that English. I distinctly remember my first psychology course. The entire time I was in the class I felt like I was wearing pants that didn’t fit. I felt irritated without even knowing why. I knew I did not want to become a psychologist, but could not tell why. While psychology was not the right path for me, the idea of not having a path was equally disconcerting. One fall evening, I shared my lack of direction with a friend who was a sophomore and had chosen social work as a major. She encouraged me to consider social work. Again, not knowing very much about the profession, I chose to enroll in an introductory course because I trusted her judgment. I still remember the first day of class. It was like I had returned home after being away for many years. Everything the instructor talked about made sense. The NASW Code of Ethics outlined my value system in a way I always felt, but had never articulated. I immediately resonated with systems theory and the environment as critical factors in the way people experience and behave in the world. It dawned on me why I had so detested my psychology course—it focused on individual pathos. It narrowly defined the problems that human beings face as a set of diagnoses that rested on the symptoms an individual presented. It completely lacked the consideration of context, environment and systems in people’s lives. I value and recognize these factors as key components in the understanding of human behavior and the development of interventions to assist people and society in its quest to move toward the alleviation of human suffering.

Despite this recognition and resonation with the idea of interconnectedness and a systemic approach to problem solving, I still entered the field believing that the “work” of social workers consisted of one-on-one counseling or therapy. The major professional association of social workers, the National Association of Social Workers (NASW), asserts that macro practice is a critical component of effective social work practice (NASW Delegate Assembly, 2008). However, survey data continues to show that macro practice is a primary job function for only 25-35% of professional social workers (Association of Social Work Boards, 2010; Doelling, Matz, & Legal, 2003). Macro social work practice, for purposes of this article, is conceptualized as those activities in which social workers engage that are aimed at changing the environment within which individuals live rather than the individual themselves (Netting, Kettner & McMurtry 2004). My first position out of school was as a “counselor” in a domestic violence agency. I worked directly with women (never any male clients) in violent relationships. I ran support groups and on occasion advocated for or assisted them with the legal process, such as obtaining Orders of Protection or attending criminal hearings. I quickly discovered two things about myself-first that my empathy skill outweighed my shut off skill. I could not separate myself from the stories, the pain and the suffering my clients were experiencing. Secondly, the barriers to solving their problems were far greater than the kind of service I could provide. I became frustrated, depressed, and increasingly annoyed with my clients for “bothering” me with their problems. There was no way I could allow myself to go down a path of such jaded cynicism, it violated everything I thought I stood for-being a champion of the oppressed, the victimized, the fact that women were victims of male dominance, not the cause of it. I knew that I had to modify where I engaged in social change in order to maintain my values and sanity. The majority of the women I saw were stuck in abusive situations because they lacked access to housing, jobs, transportation, education, even intensive psychotherapy or medication. Our agency could not provide these things in a way that would truly help them move toward a life independent of violence.

And it wasn’t just our agency alone that couldn’t provide these things-I didn’t see the legal system, law enforcement, housing agencies or the community doing a good job either. I made a decision after only a year in the domestic violence agency to move toward macro practice. I wanted to remain a social worker, but didn’t want to burn out at the age of 23. Moving from micro to macro practice wasn’t too far of a leap. Macro practice still requires empathy, problem solving, relationship building, brokering and assessment. I slowly started to take positions that incorporated macro practice. The penultimate position was my four years as a health and human services researcher for the Minnesota Senate DLF Caucus. While many believe that policy making is based on the rational weighing of facts and evidence, nothing could be farther from the truth. Macro practice involves the same weighing of human experience, the same kinds of biases by decision makers, and the same use (and misuse) of research. It is my belief that to do macro practice effectively, the social worker needs to understand the lived experiences of the people for whom the rules will apply. They need to rely on the stories of people who have suffered and they need to often test solutions, sometimes not knowing until after the fact whether a particular intervention is effective. It is an iterative process with no “final resolution”. I value advocacy and social change; it is the place where I work best. I was successful in the macro practice setting only because I had friends and colleagues working on the front lines informing me and the policies I am hoping to change or implement. And of course the reverse is true as well. The common factors model teaches us that the key ingredients of change are external to the therapeutic intervention (Lambert, 1992). For me this means that micro practitioners have to be aware of the external environment and use it as a meaningful intervention tool in their work. The division between micro and macro social work is an historical one (Haynes, 1998). Described by Kay Haynes as the 100 year debate (1998), the field of social work continues to grapple with its primary function. While the mission of social work as defined by the National Association of Social

Work is to “to enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty” (NASW Delegate Assembly, 2008) how this is accomplished remains open to debate. Social workers who provide primary treatment to individuals, such as psychotherapy, counseling, or case management, are said to be engaged in micro practice (Austin et al., 2005). The theoretical underpinning of micro practice comes from one of social work’s early founders, Mary Richmond. Richmond worked for the Charity Organization Societies, an organization which sought to streamline charitable giving and employ a scientific method for administering public assistance. Richmond studied and wrote extensively on the “friendly visitor” model-providing individual support to the poor and vulnerable (Murdach, 2011). Juxtaposed to the work of Mary Richmond was her contemporary, Jane Addams. Addams’ work in the settlement houses of the late nineteenth and early twentieth centuries is the model for community organizing and social reform in current social work practice. Addams’ work focused on changing the societal conditions within which the poor and oppressed lived. Social workers today who focus their efforts on changing the system within which clients operate are said to be engaged in macro practice (Addams, 2000). Trying to straddle these two models of solving problems continues to be at the forefront of debate in the field. In some ways an integration of the perspectives can be seen through social work’s dominant theoretical perspectives and frameworks. For example, systems theory posits that aid to individuals requires an analysis of the person and their interaction with the systems that surround them. The ecological framework requires an understanding of the influence of the environment on the person. The empowerment perspective requires understanding of the person and their interaction with the political systems and loci of power and control in their lives (Salas, Sen, & Segal, 2010). However, analyses of the field continue to show that practitioners tend to stratify themselves within the field and full integration of both micro and macro methods of practice does not seem to be occurring (Hill et al., 2010; Holtz et al., 2007; Specht & Courtney, 1994).

Current research on the division between micro and macro practice is mostly descriptive in nature (Austin et al., 2005; Hill et al., 2010; Salas et al., 2010; Specht & Courtney, 1994). Empirical research on increasing the number of social workers engaged in macro practice has usually focused on social work education as the place to start this process (Bogo, 2005; Ezell et al., 2004; Holtz et al., 2007), with an emphasis on improving policy curriculum (Dooley, Sellers, & Gordon-Hempe, 2009) adding service learning (Sather, Weitz, & Carlson, 2007) and increasing macro practice placements (Weiss & Kaufman, 2006). Most of the studies and analysis have focused on graduate students (Bogo et al., 1993; Ezell et al., 2004; Holtz et al., 2007; Weiss, Cnaan, & Gal, 2005; Zippay & Demone, 2011) and involved their perceptions, knowledge acquisition and attitudes toward macro practice. Based upon my own experiences and listening to those experiences of my colleagues, I would recommend that future social work research should more closely examine social work’s primary pedagogical tool-field education-to test whether macro practice field experiences can help to increase the number of social workers choosing macro practice for their professional careers. A robust field education program that offers students the opportunity to integrate their classroom learning with on-the-ground practice is a part of every accredited school of social work’s curriculum. The student is placed in a setting where they are able to gain social work skills while supervised and mentored by a professional social worker. Knowing whether the number of macro experiences in field placement contributes to a more integrated generalist social work practitioner will help our profession live and practice the values we hold up as central to social work practice.

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